APEA Predictor Exam 2026/2027 | Actual Questions and Correct Answers
Question 1
A 67-year-old male presents with crushing chest pain radiating to the left arm and jaw.
Which cardiac biomarker is most specific for myocardial infarction?
A. CK-MB
B. Myoglobin
C. Troponin I
D. LDH
Correct Answer: C. Troponin I
Rationale: Troponin I is the most specific and sensitive biomarker for myocardial infarction. It
rises within 3–6 hours after myocardial injury and remains elevated for several days.
Question 2
A patient with type 2 diabetes is prescribed metformin. Which instruction should the NP
provide?
A. Take on an empty stomach
B. Stop the medication before contrast dye studies
C. Avoid all dairy products
D. Take only at bedtime
Correct Answer: B. Stop the medication before contrast dye studies
Rationale: Metformin should be temporarily discontinued before iodinated contrast studies
to reduce the risk of lactic acidosis and renal impairment.
Question 3
Which finding is most consistent with bacterial meningitis?
A. Negative Kernig sign
B. Clear cerebrospinal fluid
C. Severe headache and nuchal rigidity
D. Bradycardia without fever
Correct Answer: C. Severe headache and nuchal rigidity
,Rationale: Bacterial meningitis commonly presents with fever, headache, neck stiffness, and
photophobia. Positive Kernig and Brudzinski signs may also occur.
Question 4
A patient presents with hyperthyroidism. Which symptom is expected?
A. Weight gain
B. Bradycardia
C. Heat intolerance
D. Constipation
Correct Answer: C. Heat intolerance
Rationale: Hyperthyroidism increases metabolic activity, leading to heat intolerance,
tachycardia, weight loss, and diarrhea.
Question 5
Which medication is considered first-line treatment for hypertension in a patient with
chronic kidney disease?
A. ACE inhibitor
B. Calcium channel blocker
C. Beta blocker
D. Loop diuretic
Correct Answer: A. ACE inhibitor
Rationale: ACE inhibitors help protect renal function and reduce proteinuria in patients with
chronic kidney disease.
Question 6
A patient with COPD has worsening dyspnea and productive cough. Which diagnosis is most
likely?
A. Stable angina
B. COPD exacerbation
C. Pulmonary embolism
D. Pneumothorax
Correct Answer: B. COPD exacerbation
,Rationale: Increased sputum production, worsening cough, and dyspnea are hallmark
findings of a COPD exacerbation.
Question 7
Which laboratory finding is associated with iron deficiency anemia?
A. Elevated ferritin
B. High MCV
C. Low serum iron
D. Elevated vitamin B12
Correct Answer: C. Low serum iron
Rationale: Iron deficiency anemia commonly presents with low serum iron, low ferritin, and
microcytic hypochromic red blood cells.
Question 8
A patient reports sudden unilateral facial drooping. Which cranial nerve is affected in Bell’s
palsy?
A. Cranial nerve III
B. Cranial nerve V
C. Cranial nerve VII
D. Cranial nerve XII
Correct Answer: C. Cranial nerve VII
Rationale: Bell’s palsy affects the facial nerve (CN VII), causing unilateral facial weakness.
Question 9
Which symptom is most commonly associated with gastroesophageal reflux disease (GERD)?
A. Hemoptysis
B. Heartburn
C. Hematuria
D. Bradycardia
Correct Answer: B. Heartburn
Rationale: GERD commonly presents with heartburn, regurgitation, and sour taste due to
acid reflux.
, Question 10
A patient has a fasting blood glucose of 140 mg/dL. Which interpretation is correct?
A. Normal finding
B. Prediabetes
C. Diabetes mellitus
D. Hypoglycemia
Correct Answer: C. Diabetes mellitus
Rationale: A fasting glucose ≥126 mg/dL on two separate occasions indicates diabetes
mellitus.
Question 11
Which organism most commonly causes urinary tract infections?
A. Streptococcus pneumoniae
B. Escherichia coli
C. Staphylococcus aureus
D. Klebsiella pneumoniae
Correct Answer: B. Escherichia coli
Rationale: E. coli accounts for the majority of uncomplicated urinary tract infections.
Question 12
A patient with asthma is prescribed albuterol. What is the primary action of this medication?
A. Reduce airway inflammation
B. Suppress cough reflex
C. Bronchodilation
D. Mucus thinning
Correct Answer: C. Bronchodilation
Rationale: Albuterol is a short-acting beta2 agonist that relaxes bronchial smooth muscle for
rapid symptom relief.
Question 13
Which electrolyte imbalance is commonly seen with prolonged vomiting?
A. Hyperkalemia
Question 1
A 67-year-old male presents with crushing chest pain radiating to the left arm and jaw.
Which cardiac biomarker is most specific for myocardial infarction?
A. CK-MB
B. Myoglobin
C. Troponin I
D. LDH
Correct Answer: C. Troponin I
Rationale: Troponin I is the most specific and sensitive biomarker for myocardial infarction. It
rises within 3–6 hours after myocardial injury and remains elevated for several days.
Question 2
A patient with type 2 diabetes is prescribed metformin. Which instruction should the NP
provide?
A. Take on an empty stomach
B. Stop the medication before contrast dye studies
C. Avoid all dairy products
D. Take only at bedtime
Correct Answer: B. Stop the medication before contrast dye studies
Rationale: Metformin should be temporarily discontinued before iodinated contrast studies
to reduce the risk of lactic acidosis and renal impairment.
Question 3
Which finding is most consistent with bacterial meningitis?
A. Negative Kernig sign
B. Clear cerebrospinal fluid
C. Severe headache and nuchal rigidity
D. Bradycardia without fever
Correct Answer: C. Severe headache and nuchal rigidity
,Rationale: Bacterial meningitis commonly presents with fever, headache, neck stiffness, and
photophobia. Positive Kernig and Brudzinski signs may also occur.
Question 4
A patient presents with hyperthyroidism. Which symptom is expected?
A. Weight gain
B. Bradycardia
C. Heat intolerance
D. Constipation
Correct Answer: C. Heat intolerance
Rationale: Hyperthyroidism increases metabolic activity, leading to heat intolerance,
tachycardia, weight loss, and diarrhea.
Question 5
Which medication is considered first-line treatment for hypertension in a patient with
chronic kidney disease?
A. ACE inhibitor
B. Calcium channel blocker
C. Beta blocker
D. Loop diuretic
Correct Answer: A. ACE inhibitor
Rationale: ACE inhibitors help protect renal function and reduce proteinuria in patients with
chronic kidney disease.
Question 6
A patient with COPD has worsening dyspnea and productive cough. Which diagnosis is most
likely?
A. Stable angina
B. COPD exacerbation
C. Pulmonary embolism
D. Pneumothorax
Correct Answer: B. COPD exacerbation
,Rationale: Increased sputum production, worsening cough, and dyspnea are hallmark
findings of a COPD exacerbation.
Question 7
Which laboratory finding is associated with iron deficiency anemia?
A. Elevated ferritin
B. High MCV
C. Low serum iron
D. Elevated vitamin B12
Correct Answer: C. Low serum iron
Rationale: Iron deficiency anemia commonly presents with low serum iron, low ferritin, and
microcytic hypochromic red blood cells.
Question 8
A patient reports sudden unilateral facial drooping. Which cranial nerve is affected in Bell’s
palsy?
A. Cranial nerve III
B. Cranial nerve V
C. Cranial nerve VII
D. Cranial nerve XII
Correct Answer: C. Cranial nerve VII
Rationale: Bell’s palsy affects the facial nerve (CN VII), causing unilateral facial weakness.
Question 9
Which symptom is most commonly associated with gastroesophageal reflux disease (GERD)?
A. Hemoptysis
B. Heartburn
C. Hematuria
D. Bradycardia
Correct Answer: B. Heartburn
Rationale: GERD commonly presents with heartburn, regurgitation, and sour taste due to
acid reflux.
, Question 10
A patient has a fasting blood glucose of 140 mg/dL. Which interpretation is correct?
A. Normal finding
B. Prediabetes
C. Diabetes mellitus
D. Hypoglycemia
Correct Answer: C. Diabetes mellitus
Rationale: A fasting glucose ≥126 mg/dL on two separate occasions indicates diabetes
mellitus.
Question 11
Which organism most commonly causes urinary tract infections?
A. Streptococcus pneumoniae
B. Escherichia coli
C. Staphylococcus aureus
D. Klebsiella pneumoniae
Correct Answer: B. Escherichia coli
Rationale: E. coli accounts for the majority of uncomplicated urinary tract infections.
Question 12
A patient with asthma is prescribed albuterol. What is the primary action of this medication?
A. Reduce airway inflammation
B. Suppress cough reflex
C. Bronchodilation
D. Mucus thinning
Correct Answer: C. Bronchodilation
Rationale: Albuterol is a short-acting beta2 agonist that relaxes bronchial smooth muscle for
rapid symptom relief.
Question 13
Which electrolyte imbalance is commonly seen with prolonged vomiting?
A. Hyperkalemia
