APEA 3P Advanced Practice Exam Prep |
Complete Actual Exam Questions with 100%
Verified Correct Answers and Detailed
Rationales | Latest Updated Edition 2026/2027
(Brand New Update!!) - Already Graded A+
Question 1
You are auscultating Jon's chest. When he sits up and leans forward, you can hear a high
pitched, blowing murmur at S2. What does this type of murmur most likely indicate?
A. Mitral stenosis
B. Aortic Stenosis
C. Mitral regurgitation
D. Aortic regurgitation
Answer: D
Rationale: Aortic regurgitation is a soft, high pitched, blowing diastolic decrescendo murmur
best heard at the 3rd left interspace at the base. The murmur is initiated with S2 and heard
when the patient sits up and leans forward. Mitral stenosis (A) is a low pitched diastolic
rumble best heard at the apex in the left lateral position. Aortic stenosis (B) is a loud, harsh
systolic murmur that radiates to the neck and apex. Mitral regurgitation (C) is a loud blowing
murmur heard at the apex and is pansystolic.
Question 2
Which of the following is the most common clinical manifestation of osteoporosis?
A. Bone deformity
B. Bone pain
C. Pathologic fracture
D. Fat embolism
Answer: A
Rationale: Osteoporosis is the most common metabolic bone disease, characterized by low
bone mass and deterioration of bone tissue, leading to increased skeletal fragility and
deformity. Osteoporosis is usually not apparent until AFTER a fracture occurs; 2/3 of
vertebral fractures are painless. Fat embolism (D) results from fat obstruction due to injury or
trauma and is not common in osteoporosis.
1
,Question 3
A male patient requests a phosphodiesterase inhibitor to treat erectile dysfunction. Which of
the following is appropriate?
A. Tadalafil (Cialis) may be used at a dose of 2.5 mg daily if sexual activity will take place
two or more times per week.
B. Vardenafil (Levitra), 5 mg, may be taken with a high-fat meal four hours before sexual
activity
C. Sildenafil (Viagra), 50 mg, may be taken one hour before sexual activity as long as the
patient has a resting blood pressure below 170/110 mm Hg
D. Avanafil (Stendra) is recommended at 50 mg for all patients, and may be taken 30 minutes
before sexual activity.
Answer: A
Rationale: Tadalafil (Cialis) may be used at a dose of 2.5 mg daily if sexual activity will take
place two or more times per week. Vardenafil (B) should not be taken with a high-fat meal.
Sildenafil (C) is contraindicated with blood pressure below 90/50 mmHg, not 170/110.
Avanafil (D) dosing is not recommended at 50 mg for all patients.
Question 4
Which of the following is NOT part of Virchow's Triad?
A. Hypercoagulability
B. Damage to endothelial cells
C. Sympathetic tone
D. Turbulent blood flow
Answer: C
Rationale: Virchow's triad describes the three main factors that lead to thrombosis:
hypercoagulability (A), endothelial cell damage (B), and turbulent blood flow/circulatory
stasis (D). Sympathetic tone (C) is not part of Virchow's triad and does not affect blood
clotting.
Question 5
A patient with kidney stones also presents with hypercalcemia and mental confusion. The
practitioner should evaluate the patient for which of the following?
A. Cushing Syndrome
B. Conn's Syndrome
C. Hyperparathyroidism
D. Addison's disease
Answer: C
Rationale: Hyperparathyroidism is associated with hypercalcemia, kidney stones ("stones"),
2
,and mental confusion ("moans"). Cushing syndrome (A) is associated with hypercortisolism.
Conn's syndrome (B) is associated with hyperaldosteronism. Addison's disease (D) is
associated with adrenal insufficiency.
Question 6
Which of the following statements is true regarding contraceptives?
A. Because oral contraceptives may cause harm to the fetus, they are pregnancy category X
drugs in pregnancy.
B. Oral contraceptives are linked to the promotion of ovarian, endometrial, and breast cancer.
C. By increasing angiotensin and aldosterone, oral contraceptives may increase blood pressure.
D. Oral contraceptives may reduce the effects of theophylline, benzodiazepines, and tricyclic
antidepressants
Answer: C
Rationale: Estrogen promotes aldosterone production, causing sodium retention and
hypertension. It also stimulates hepatic production of angiotensinogen, affecting the renal
system via elevated angiotensin and BP. OCPs are category X but decrease the incidence of
ovarian and endometrial cancer (B). OCPs containing progestin may enhance (not reduce) the
effects of theophylline, benzodiazepines, and tricyclic antidepressants.
Question 7
Upon percussion of the chest, you notice hyperresonance. Of the following choices which
would most likely be the cause?
A. Atelectasis
B. Normal Lung
C. Pneumothorax
D. Pulmonary embolism
Answer: C
Rationale: Hyperresonance is an abnormally loud, low-pitched sound heard over air-filled
spaces and is most commonly associated with pneumothorax. Atelectasis (A) would cause
dullness. Normal lung (B) would produce resonance. Pulmonary embolism (D) would not
typically produce hyperresonance.
Question 8
What is the proper order of steps to accurately perform the Ortolani maneuver?
A. Extend the legs, adduct the legs, and abduct the knees
B. Flex the knees, abduct the knees, and adduct the legs
3
, C. Flex the knees, adduct the legs, and abduct the legs
D. Extend the knees, abduct the legs, and adduct the knees
Answer: B
Rationale: The Ortolani maneuver is performed on a supine infant by flexing the knees while
holding the thighs, abducting the knees, and then adducting the legs until the lateral part of the
knee touches the table.
Question 9
You have four patients who all have a family history of developing coronary heart disease at
an early age. According to their blood test results, which patient would most likely develop
coronary heart disease first?
A. Cholesterol: 170; LDL: 120; Triglycerides: 120; HDL: 45
B. Cholesterol: 195; LDL: 110; Triglycerides: 135; HDL: 30
C. Cholesterol: 170; LDL: 100; Triglycerides: 140; HDL: 20
D. Cholesterol: 190; LDL: 140; Triglycerides: 151; HDL: 50
Answer: D
Rationale: Three of the four measurements in option D are above recommended levels. HDL
should be > 40 in men and > 50 in women. LDL aim is < 130 mg/dL. Cholesterol > 200
mg/dL and triglycerides > 150 mg/dL are attributed to increased risk of heart disease.
Question 10
This low-molecular-weight heparin is indicated for use with warfarin for the treatment of
acute symptomatic deep vein thrombosis, either with or without pulmonary embolism:
A. Nadroparin
B. Dalteparin
C. Tinzaparin
D. Fondaparinux
Answer: C
Rationale: Tinzaparin can be combined with warfarin for DVT treatment. Nadroparin (A) and
Dalteparin (B) are used independently and not with warfarin. Fondaparinux (D) is a Factor Xa
inhibitor, not a low-molecular-weight heparin.
Question 11
The main reason for discontinuance of implanted etonogestrel (Nexplanon) is:
A. Weight gain
4
Complete Actual Exam Questions with 100%
Verified Correct Answers and Detailed
Rationales | Latest Updated Edition 2026/2027
(Brand New Update!!) - Already Graded A+
Question 1
You are auscultating Jon's chest. When he sits up and leans forward, you can hear a high
pitched, blowing murmur at S2. What does this type of murmur most likely indicate?
A. Mitral stenosis
B. Aortic Stenosis
C. Mitral regurgitation
D. Aortic regurgitation
Answer: D
Rationale: Aortic regurgitation is a soft, high pitched, blowing diastolic decrescendo murmur
best heard at the 3rd left interspace at the base. The murmur is initiated with S2 and heard
when the patient sits up and leans forward. Mitral stenosis (A) is a low pitched diastolic
rumble best heard at the apex in the left lateral position. Aortic stenosis (B) is a loud, harsh
systolic murmur that radiates to the neck and apex. Mitral regurgitation (C) is a loud blowing
murmur heard at the apex and is pansystolic.
Question 2
Which of the following is the most common clinical manifestation of osteoporosis?
A. Bone deformity
B. Bone pain
C. Pathologic fracture
D. Fat embolism
Answer: A
Rationale: Osteoporosis is the most common metabolic bone disease, characterized by low
bone mass and deterioration of bone tissue, leading to increased skeletal fragility and
deformity. Osteoporosis is usually not apparent until AFTER a fracture occurs; 2/3 of
vertebral fractures are painless. Fat embolism (D) results from fat obstruction due to injury or
trauma and is not common in osteoporosis.
1
,Question 3
A male patient requests a phosphodiesterase inhibitor to treat erectile dysfunction. Which of
the following is appropriate?
A. Tadalafil (Cialis) may be used at a dose of 2.5 mg daily if sexual activity will take place
two or more times per week.
B. Vardenafil (Levitra), 5 mg, may be taken with a high-fat meal four hours before sexual
activity
C. Sildenafil (Viagra), 50 mg, may be taken one hour before sexual activity as long as the
patient has a resting blood pressure below 170/110 mm Hg
D. Avanafil (Stendra) is recommended at 50 mg for all patients, and may be taken 30 minutes
before sexual activity.
Answer: A
Rationale: Tadalafil (Cialis) may be used at a dose of 2.5 mg daily if sexual activity will take
place two or more times per week. Vardenafil (B) should not be taken with a high-fat meal.
Sildenafil (C) is contraindicated with blood pressure below 90/50 mmHg, not 170/110.
Avanafil (D) dosing is not recommended at 50 mg for all patients.
Question 4
Which of the following is NOT part of Virchow's Triad?
A. Hypercoagulability
B. Damage to endothelial cells
C. Sympathetic tone
D. Turbulent blood flow
Answer: C
Rationale: Virchow's triad describes the three main factors that lead to thrombosis:
hypercoagulability (A), endothelial cell damage (B), and turbulent blood flow/circulatory
stasis (D). Sympathetic tone (C) is not part of Virchow's triad and does not affect blood
clotting.
Question 5
A patient with kidney stones also presents with hypercalcemia and mental confusion. The
practitioner should evaluate the patient for which of the following?
A. Cushing Syndrome
B. Conn's Syndrome
C. Hyperparathyroidism
D. Addison's disease
Answer: C
Rationale: Hyperparathyroidism is associated with hypercalcemia, kidney stones ("stones"),
2
,and mental confusion ("moans"). Cushing syndrome (A) is associated with hypercortisolism.
Conn's syndrome (B) is associated with hyperaldosteronism. Addison's disease (D) is
associated with adrenal insufficiency.
Question 6
Which of the following statements is true regarding contraceptives?
A. Because oral contraceptives may cause harm to the fetus, they are pregnancy category X
drugs in pregnancy.
B. Oral contraceptives are linked to the promotion of ovarian, endometrial, and breast cancer.
C. By increasing angiotensin and aldosterone, oral contraceptives may increase blood pressure.
D. Oral contraceptives may reduce the effects of theophylline, benzodiazepines, and tricyclic
antidepressants
Answer: C
Rationale: Estrogen promotes aldosterone production, causing sodium retention and
hypertension. It also stimulates hepatic production of angiotensinogen, affecting the renal
system via elevated angiotensin and BP. OCPs are category X but decrease the incidence of
ovarian and endometrial cancer (B). OCPs containing progestin may enhance (not reduce) the
effects of theophylline, benzodiazepines, and tricyclic antidepressants.
Question 7
Upon percussion of the chest, you notice hyperresonance. Of the following choices which
would most likely be the cause?
A. Atelectasis
B. Normal Lung
C. Pneumothorax
D. Pulmonary embolism
Answer: C
Rationale: Hyperresonance is an abnormally loud, low-pitched sound heard over air-filled
spaces and is most commonly associated with pneumothorax. Atelectasis (A) would cause
dullness. Normal lung (B) would produce resonance. Pulmonary embolism (D) would not
typically produce hyperresonance.
Question 8
What is the proper order of steps to accurately perform the Ortolani maneuver?
A. Extend the legs, adduct the legs, and abduct the knees
B. Flex the knees, abduct the knees, and adduct the legs
3
, C. Flex the knees, adduct the legs, and abduct the legs
D. Extend the knees, abduct the legs, and adduct the knees
Answer: B
Rationale: The Ortolani maneuver is performed on a supine infant by flexing the knees while
holding the thighs, abducting the knees, and then adducting the legs until the lateral part of the
knee touches the table.
Question 9
You have four patients who all have a family history of developing coronary heart disease at
an early age. According to their blood test results, which patient would most likely develop
coronary heart disease first?
A. Cholesterol: 170; LDL: 120; Triglycerides: 120; HDL: 45
B. Cholesterol: 195; LDL: 110; Triglycerides: 135; HDL: 30
C. Cholesterol: 170; LDL: 100; Triglycerides: 140; HDL: 20
D. Cholesterol: 190; LDL: 140; Triglycerides: 151; HDL: 50
Answer: D
Rationale: Three of the four measurements in option D are above recommended levels. HDL
should be > 40 in men and > 50 in women. LDL aim is < 130 mg/dL. Cholesterol > 200
mg/dL and triglycerides > 150 mg/dL are attributed to increased risk of heart disease.
Question 10
This low-molecular-weight heparin is indicated for use with warfarin for the treatment of
acute symptomatic deep vein thrombosis, either with or without pulmonary embolism:
A. Nadroparin
B. Dalteparin
C. Tinzaparin
D. Fondaparinux
Answer: C
Rationale: Tinzaparin can be combined with warfarin for DVT treatment. Nadroparin (A) and
Dalteparin (B) are used independently and not with warfarin. Fondaparinux (D) is a Factor Xa
inhibitor, not a low-molecular-weight heparin.
Question 11
The main reason for discontinuance of implanted etonogestrel (Nexplanon) is:
A. Weight gain
4
