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APEA PRE-PREDICTOR EXAM COMPREHENSIVE QUESTIONS AND
CORRECT ANSWERS LATEST EDITION 2026
Question 1
A 65-year-old male with a history of hypertension presents with substernal chest pain that
radiates to his left arm. The pain started 30 minutes ago and is not relieved by rest. What is
the priority action?
A) Obtain a 12-lead ECG
B) Administer aspirin 325 mg
C) Administer nitroglycerin
D) Obtain a chest X-ray
Answer: A
Rationale: The priority is to obtain a 12-lead ECG within 10 minutes to evaluate for ST-elevation
myocardial infarction (STEMI). Aspirin and nitroglycerin are important but secondary to ECG
acquisition.
Question 2
On auscultation, you hear an S3 gallop. This finding is most commonly associated with:
A) Aortic stenosis
B) Heart failure
C) Mitral valve prolapse
D) Pericardial effusion
Answer: B
Rationale: An S3 gallop occurs during rapid ventricular filling and is a hallmark of decreased
ventricular compliance or volume overload, most commonly seen in heart failure. Aortic
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stenosis produces a systolic ejection murmur. Mitral valve prolapse produces a mid-systolic click.
Pericardial effusion causes muffled heart sounds .
Question 3
A 58-year-old female presents with fatigue, exertional dyspnea, and bilateral ankle edema.
Her BNP is elevated. Which medication class is first-line for her condition?
A) Beta-blockers
B) ACE inhibitors
C) Calcium channel blockers
D) Alpha-blockers
Answer: B
Rationale: ACE inhibitors are first-line therapy for heart failure with reduced ejection fraction
(HFrEF). They reduce mortality and improve symptoms by decreasing afterload and preventing
adverse remodeling.
Question 4
A patient with atrial fibrillation has a CHA₂DS₂-VASc score of 3. What is the recommended
anticoagulation strategy?
A) Aspirin 81 mg daily
B) Warfarin or a direct oral anticoagulant
C) Clopidogrel 75 mg daily
D) No anticoagulation required
Answer: B
Rationale: A CHA₂DS₂-VASc score of 2 or greater in men or 3 or greater in women warrants
anticoagulation with warfarin or a direct oral anticoagulant (DOAC) to prevent stroke.
Question 5
A 45-year-old male presents with episodic headaches, palpitations, and diaphoresis. His blood
pressure is 180/110 mm Hg. What is the most likely diagnosis?
A) Essential hypertension
B) Pheochromocytoma
C) Hyperthyroidism
D) Anxiety disorder
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Answer: B
Rationale: Episodic hypertension with headaches, palpitations, and diaphoresis is the classic
triad of pheochromocytoma, a tumor of the adrenal medulla that produces excess
catecholamines.
Question 6
A 72-year-old female with a history of heart failure presents with weight gain of 5 pounds in 3
days and increased dyspnea. Which finding is most concerning?
A) Blood pressure 110/70 mm Hg
B) Heart rate 88 bpm
C) Oxygen saturation 88% on room air
D) Mild ankle edema
Answer: C
Rationale: An oxygen saturation of 88% indicates hypoxemia and possible pulmonary edema,
requiring immediate intervention. Rapid weight gain and dyspnea suggest acute
decompensated heart failure.
Question 7
A patient is prescribed lisinopril. Which adverse effect should the nurse monitor for?
A) Dry cough
B) Bradycardia
C) Hypertension
D) Hyperglycemia
Answer: A
Rationale: ACE inhibitors such as lisinopril commonly cause a dry, persistent cough due to the
accumulation of bradykinin. This is a common reason for medication nonadherence.
Question 8
A 60-year-old male with diabetes and hypertension has an LDL of 160 mg/dL. What is the
recommended LDL target for this patient?
A) Less than 130 mg/dL
B) Less than 100 mg/dL
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C) Less than 70 mg/dL
D) Less than 50 mg/dL
Answer: C
Rationale: For patients with diabetes and hypertension who are at high risk for cardiovascular
events, the recommended LDL target is less than 70 mg/dL, often requiring high-intensity statin
therapy.
Question 9
A patient presents with sudden-onset severe tearing chest pain radiating to the back. What is
the most likely diagnosis?
A) Myocardial infarction
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Answer: B
Rationale: Aortic dissection typically presents with sudden, severe tearing chest pain radiating
to the back. It is a life-threatening emergency requiring immediate imaging and intervention.
Question 10
A patient with heart failure is prescribed furosemide. Which electrolyte imbalance should the
nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia.
Monitor serum potassium levels and assess for signs of hypokalemia.
SECTION 2: RESPIRATORY & INFECTIOUS DISEASE
Questions 26–50
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APEA PRE-PREDICTOR EXAM COMPREHENSIVE QUESTIONS AND
CORRECT ANSWERS LATEST EDITION 2026
Question 1
A 65-year-old male with a history of hypertension presents with substernal chest pain that
radiates to his left arm. The pain started 30 minutes ago and is not relieved by rest. What is
the priority action?
A) Obtain a 12-lead ECG
B) Administer aspirin 325 mg
C) Administer nitroglycerin
D) Obtain a chest X-ray
Answer: A
Rationale: The priority is to obtain a 12-lead ECG within 10 minutes to evaluate for ST-elevation
myocardial infarction (STEMI). Aspirin and nitroglycerin are important but secondary to ECG
acquisition.
Question 2
On auscultation, you hear an S3 gallop. This finding is most commonly associated with:
A) Aortic stenosis
B) Heart failure
C) Mitral valve prolapse
D) Pericardial effusion
Answer: B
Rationale: An S3 gallop occurs during rapid ventricular filling and is a hallmark of decreased
ventricular compliance or volume overload, most commonly seen in heart failure. Aortic
1|Page
,Page 2 of 35
stenosis produces a systolic ejection murmur. Mitral valve prolapse produces a mid-systolic click.
Pericardial effusion causes muffled heart sounds .
Question 3
A 58-year-old female presents with fatigue, exertional dyspnea, and bilateral ankle edema.
Her BNP is elevated. Which medication class is first-line for her condition?
A) Beta-blockers
B) ACE inhibitors
C) Calcium channel blockers
D) Alpha-blockers
Answer: B
Rationale: ACE inhibitors are first-line therapy for heart failure with reduced ejection fraction
(HFrEF). They reduce mortality and improve symptoms by decreasing afterload and preventing
adverse remodeling.
Question 4
A patient with atrial fibrillation has a CHA₂DS₂-VASc score of 3. What is the recommended
anticoagulation strategy?
A) Aspirin 81 mg daily
B) Warfarin or a direct oral anticoagulant
C) Clopidogrel 75 mg daily
D) No anticoagulation required
Answer: B
Rationale: A CHA₂DS₂-VASc score of 2 or greater in men or 3 or greater in women warrants
anticoagulation with warfarin or a direct oral anticoagulant (DOAC) to prevent stroke.
Question 5
A 45-year-old male presents with episodic headaches, palpitations, and diaphoresis. His blood
pressure is 180/110 mm Hg. What is the most likely diagnosis?
A) Essential hypertension
B) Pheochromocytoma
C) Hyperthyroidism
D) Anxiety disorder
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,Page 3 of 35
Answer: B
Rationale: Episodic hypertension with headaches, palpitations, and diaphoresis is the classic
triad of pheochromocytoma, a tumor of the adrenal medulla that produces excess
catecholamines.
Question 6
A 72-year-old female with a history of heart failure presents with weight gain of 5 pounds in 3
days and increased dyspnea. Which finding is most concerning?
A) Blood pressure 110/70 mm Hg
B) Heart rate 88 bpm
C) Oxygen saturation 88% on room air
D) Mild ankle edema
Answer: C
Rationale: An oxygen saturation of 88% indicates hypoxemia and possible pulmonary edema,
requiring immediate intervention. Rapid weight gain and dyspnea suggest acute
decompensated heart failure.
Question 7
A patient is prescribed lisinopril. Which adverse effect should the nurse monitor for?
A) Dry cough
B) Bradycardia
C) Hypertension
D) Hyperglycemia
Answer: A
Rationale: ACE inhibitors such as lisinopril commonly cause a dry, persistent cough due to the
accumulation of bradykinin. This is a common reason for medication nonadherence.
Question 8
A 60-year-old male with diabetes and hypertension has an LDL of 160 mg/dL. What is the
recommended LDL target for this patient?
A) Less than 130 mg/dL
B) Less than 100 mg/dL
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C) Less than 70 mg/dL
D) Less than 50 mg/dL
Answer: C
Rationale: For patients with diabetes and hypertension who are at high risk for cardiovascular
events, the recommended LDL target is less than 70 mg/dL, often requiring high-intensity statin
therapy.
Question 9
A patient presents with sudden-onset severe tearing chest pain radiating to the back. What is
the most likely diagnosis?
A) Myocardial infarction
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Answer: B
Rationale: Aortic dissection typically presents with sudden, severe tearing chest pain radiating
to the back. It is a life-threatening emergency requiring immediate imaging and intervention.
Question 10
A patient with heart failure is prescribed furosemide. Which electrolyte imbalance should the
nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia.
Monitor serum potassium levels and assess for signs of hypokalemia.
SECTION 2: RESPIRATORY & INFECTIOUS DISEASE
Questions 26–50
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