APEA Pre-Predictor Practice Test Bank 2026/2027 –
150 Verified Questions with Answers and Detailed
Rationales | Advanced Practice Exam Preparation |
INSTANT PDF DOWNLOAD
1. A 32-year-old patient presents with persistent sadness, loss of interest,
insomnia, and fatigue for 3 weeks. Which is the most likely diagnosis?
A. Bipolar I Disorder
B. Major Depressive Disorder
C. Generalized Anxiety Disorder
D. Adjustment Disorder
Answer: B
Rationale: Symptoms meet criteria for Major Depressive Disorder (≥2 weeks,
depressed mood or anhedonia, plus other symptoms).
2. A patient on lithium therapy presents with coarse tremors, nausea, and
polyuria. What is the priority action?
A. Increase the lithium dose
B. Check serum lithium level
C. Start SSRIs
D. Advise exercise
Answer: B
Rationale: Symptoms suggest lithium toxicity; serum levels must be checked
immediately.
3. Which therapy is first-line for panic disorder?
A. Psychoanalysis
,B. Cognitive Behavioral Therapy (CBT)
C. ECT
D. Family therapy
Answer: B
Rationale: CBT is evidence-based first-line therapy for panic disorder.
4. Scenario: A patient with schizophrenia reports auditory hallucinations telling
him to harm himself. What is the priority intervention?
A. Monitor vital signs
B. Assess suicide risk and ensure safety
C. Schedule outpatient therapy
D. Encourage journaling
Answer: B
Rationale: Immediate suicide risk requires safety measures and close
supervision.
5. Which lab test is essential before starting valproate therapy?
A. Complete blood count and liver function tests
B. Electrolytes
C. Urinalysis
D. Serum lithium level
Answer: A
Rationale: Valproate can cause hepatotoxicity and thrombocytopenia; baseline
labs are required.
6. A patient with generalized anxiety disorder asks about medication options.
Which class is commonly first-line pharmacotherapy?
A. SSRIs
B. Benzodiazepines (long-term)
C. Antipsychotics
D. Stimulants
Answer: A
Rationale: SSRIs are first-line; benzodiazepines are for short-term or adjunct use.
,7. Which side effect is most commonly associated with second-generation
antipsychotics?
A. Agranulocytosis
B. Metabolic syndrome
C. Cardiotoxicity
D. Hepatitis
Answer: B
Rationale: SGAs (e.g., olanzapine, risperidone) commonly cause weight gain,
dyslipidemia, and hyperglycemia.
8. Scenario: A 19-year-old college student presents with excessive worry about
grades, muscle tension, and difficulty concentrating. Diagnosis?
A. Social Anxiety Disorder
B. Generalized Anxiety Disorder
C. Obsessive-Compulsive Disorder
D. Panic Disorder
Answer: B
Rationale: Excessive anxiety about multiple domains for ≥6 months indicates
GAD.
9. Which medication is first-line for obsessive-compulsive disorder?
A. Fluoxetine
B. Lorazepam
C. Lithium
D. Haloperidol
Answer: A
Rationale: SSRIs are first-line for OCD; therapy may be combined with CBT.
10. A patient with alcohol use disorder is in withdrawal. Which symptom
indicates severe withdrawal?
A. Mild tremor
, B. Anxiety
C. Seizures or delirium tremens
D. Nausea
Answer: C
Rationale: Seizures and DTs indicate medical emergency.
11. Scenario: A patient presents with flattened affect, social withdrawal, and
poor self-care for 6 months. Diagnosis?
A. Schizophrenia
B. Schizoaffective disorder
C. Major depression
D. Bipolar II disorder
Answer: A
Rationale: Negative symptoms ≥6 months suggest schizophrenia.
12. What is the primary goal of cognitive behavioral therapy?
A. Identify and modify distorted thinking patterns
B. Improve sleep hygiene
C. Replace medication
D. Strengthen family bonds
Answer: A
Rationale: CBT targets maladaptive thoughts to influence behavior and mood.
13. Which symptom is considered a positive symptom in schizophrenia?
A. Flat affect
B. Anhedonia
C. Hallucinations
D. Social withdrawal
Answer: C
Rationale: Positive symptoms are excesses of normal function (hallucinations,
delusions).
150 Verified Questions with Answers and Detailed
Rationales | Advanced Practice Exam Preparation |
INSTANT PDF DOWNLOAD
1. A 32-year-old patient presents with persistent sadness, loss of interest,
insomnia, and fatigue for 3 weeks. Which is the most likely diagnosis?
A. Bipolar I Disorder
B. Major Depressive Disorder
C. Generalized Anxiety Disorder
D. Adjustment Disorder
Answer: B
Rationale: Symptoms meet criteria for Major Depressive Disorder (≥2 weeks,
depressed mood or anhedonia, plus other symptoms).
2. A patient on lithium therapy presents with coarse tremors, nausea, and
polyuria. What is the priority action?
A. Increase the lithium dose
B. Check serum lithium level
C. Start SSRIs
D. Advise exercise
Answer: B
Rationale: Symptoms suggest lithium toxicity; serum levels must be checked
immediately.
3. Which therapy is first-line for panic disorder?
A. Psychoanalysis
,B. Cognitive Behavioral Therapy (CBT)
C. ECT
D. Family therapy
Answer: B
Rationale: CBT is evidence-based first-line therapy for panic disorder.
4. Scenario: A patient with schizophrenia reports auditory hallucinations telling
him to harm himself. What is the priority intervention?
A. Monitor vital signs
B. Assess suicide risk and ensure safety
C. Schedule outpatient therapy
D. Encourage journaling
Answer: B
Rationale: Immediate suicide risk requires safety measures and close
supervision.
5. Which lab test is essential before starting valproate therapy?
A. Complete blood count and liver function tests
B. Electrolytes
C. Urinalysis
D. Serum lithium level
Answer: A
Rationale: Valproate can cause hepatotoxicity and thrombocytopenia; baseline
labs are required.
6. A patient with generalized anxiety disorder asks about medication options.
Which class is commonly first-line pharmacotherapy?
A. SSRIs
B. Benzodiazepines (long-term)
C. Antipsychotics
D. Stimulants
Answer: A
Rationale: SSRIs are first-line; benzodiazepines are for short-term or adjunct use.
,7. Which side effect is most commonly associated with second-generation
antipsychotics?
A. Agranulocytosis
B. Metabolic syndrome
C. Cardiotoxicity
D. Hepatitis
Answer: B
Rationale: SGAs (e.g., olanzapine, risperidone) commonly cause weight gain,
dyslipidemia, and hyperglycemia.
8. Scenario: A 19-year-old college student presents with excessive worry about
grades, muscle tension, and difficulty concentrating. Diagnosis?
A. Social Anxiety Disorder
B. Generalized Anxiety Disorder
C. Obsessive-Compulsive Disorder
D. Panic Disorder
Answer: B
Rationale: Excessive anxiety about multiple domains for ≥6 months indicates
GAD.
9. Which medication is first-line for obsessive-compulsive disorder?
A. Fluoxetine
B. Lorazepam
C. Lithium
D. Haloperidol
Answer: A
Rationale: SSRIs are first-line for OCD; therapy may be combined with CBT.
10. A patient with alcohol use disorder is in withdrawal. Which symptom
indicates severe withdrawal?
A. Mild tremor
, B. Anxiety
C. Seizures or delirium tremens
D. Nausea
Answer: C
Rationale: Seizures and DTs indicate medical emergency.
11. Scenario: A patient presents with flattened affect, social withdrawal, and
poor self-care for 6 months. Diagnosis?
A. Schizophrenia
B. Schizoaffective disorder
C. Major depression
D. Bipolar II disorder
Answer: A
Rationale: Negative symptoms ≥6 months suggest schizophrenia.
12. What is the primary goal of cognitive behavioral therapy?
A. Identify and modify distorted thinking patterns
B. Improve sleep hygiene
C. Replace medication
D. Strengthen family bonds
Answer: A
Rationale: CBT targets maladaptive thoughts to influence behavior and mood.
13. Which symptom is considered a positive symptom in schizophrenia?
A. Flat affect
B. Anhedonia
C. Hallucinations
D. Social withdrawal
Answer: C
Rationale: Positive symptoms are excesses of normal function (hallucinations,
delusions).
