Combined – Updated 2025/2026 NP
Certification Prep with Detailed Rationales
APEA Predictor Exam 2025/2026 – NP
Certification Prep
Questions 1–30 (Original Practice)
1. A 56-year-old patient presents with sudden onset chest pain radiating to
the left arm and jaw. Priority action:
A. Administer sublingual nitroglycerin and monitor vitals
B. Perform an ECG immediately
C. Encourage ambulation
D. Provide diet education
Correct Answer: B
Rationale:
ECG is the first step to assess for myocardial infarction and guide urgent interventions.
2. A patient with type 2 diabetes reports polyuria, polydipsia, and blurred
vision. Which lab should the NP review first?
,A. HbA1c
B. Fasting glucose
C. Serum electrolytes
D. BUN/Creatinine
Correct Answer: B
Rationale:
Acute hyperglycemia requires immediate assessment of blood glucose to guide therapy.
3. A patient with hypertension has a persistent cough on lisinopril. NP
teaching:
A. Discontinue medication immediately
B. Report to provider; cough is a common ACE inhibitor side effect
C. Increase dose for effectiveness
D. Take medication only during symptoms
Correct Answer: B
Rationale:
Persistent dry cough is a common ACE inhibitor side effect; alternatives may be considered.
4. A patient presents with sudden shortness of breath, tachycardia, and
unilateral leg swelling. Likely diagnosis:
A. Pneumonia
B. Pulmonary embolism
C. Myocardial infarction
D. Congestive heart failure
Correct Answer: B
Rationale:
Classic signs of PE include dyspnea, tachycardia, and leg swelling.
5. A patient with COPD reports increased dyspnea and sputum production.
NP priority:
A. Encourage ambulation
B. Administer prescribed bronchodilator
, C. Provide diet education
D. Document assessment
Correct Answer: B
Rationale:
Bronchodilators relieve airway obstruction and improve oxygenation.
6. Lab priority for patient on warfarin therapy:
A. PT/INR
B. Hemoglobin
C. Creatinine
D. Electrolytes
Correct Answer: A
Rationale:
Monitoring PT/INR ensures therapeutic anticoagulation and prevents bleeding complications.
7. A patient with suspected DKA presents with blood glucose 650 mg/dL
and fruity breath. NP intervention:
A. Administer oral glucose
B. Initiate IV insulin and fluids
C. Provide diet education
D. Monitor vitals
Correct Answer: B
Rationale:
DKA is life-threatening; IV insulin and fluids are essential for stabilization.
8. A patient reports sudden confusion and restlessness postoperatively. NP
priority:
A. Hypoxia assessment
B. Pain management
C. Oral hydration
D. Documentation