APEA NP PREDICTOR – QUESTIONS AND
ANSWERS | VERIFIED AND WELL DETAILED
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1. A 45-year-old patient presents with sudden onset chest pain radiating to the
left arm. Which initial diagnostic test is the priority?
A. Chest X-ray
B. Troponin level
C. 12-lead ECG
D. D-dimer
RATIONALE: A 12-lead ECG is the first-line diagnostic test in suspected acute
coronary syndrome to identify ischemia or infarction immediately.
2. A patient with type 2 diabetes has an HbA1c of 9.2%. What does this value
indicate?
A. Excellent glycemic control
B. Severe hypoglycemia
C. Poor long-term glucose control
D. Normal glucose regulation
RATIONALE: An HbA1c above 7% indicates inadequate glycemic control and
increased risk of complications.
3. A patient on metformin reports fatigue and muscle pain. Which
complication should be ruled out first?
A. Hypoglycemia
B. Lactic acidosis
C. Hyperthyroidism
D. Hyperkalemia
RATIONALE: Metformin can rarely cause lactic acidosis, especially in renal
impairment, presenting with fatigue and myalgias.
,4. A patient with hypertension is prescribed lisinopril. What is the most
important lab to monitor?
A. Calcium
B. Potassium
C. Platelets
D. Hemoglobin
RATIONALE: ACE inhibitors can cause hyperkalemia due to reduced aldosterone
secretion.
5. A patient presents with wheezing, chest tightness, and accessory muscle use.
What is the first-line medication?
A. Albuterol
B. Montelukast
C. Prednisone only
D. Theophylline
RATIONALE: Short-acting beta agonists provide rapid bronchodilation in acute
asthma exacerbations.
6. A patient taking warfarin has an INR of 6.2. What is the priority action?
A. Increase dose
B. Hold medication
C. Give aspirin
D. Continue therapy
RATIONALE: A supratherapeutic INR increases bleeding risk and requires
withholding warfarin.
7. A patient with suspected stroke arrives at the clinic. What is the first
nursing action?
A. Give aspirin
B. Check blood glucose
C. Start IV fluids
D. Administer tPA immediately
RATIONALE: Hypoglycemia can mimic stroke symptoms and must be ruled out
first.
,8. A patient with COPD should be maintained on oxygen therapy with what
target saturation?
A. 100%
B. 94–100%
C. 88–92%
D. 70–75%
RATIONALE: Controlled oxygen prevents CO₂ retention in COPD patients.
9. A patient develops sudden shortness of breath and chest pain after surgery.
What is the most likely diagnosis?
A. Pneumonia
B. Pulmonary embolism
C. Atelectasis
D. Asthma
RATIONALE: Postoperative sudden dyspnea and chest pain strongly suggest PE.
10. A patient with chronic kidney disease has elevated creatinine. What does
this indicate?
A. Normal kidney function
B. Improved filtration
C. Decreased renal function
D. Liver dysfunction
RATIONALE: Elevated creatinine reflects impaired kidney filtration.
11. A patient with heart failure reports weight gain of 2 kg in 24 hours. What
does this indicate?
A. Fluid overload
B. Improved cardiac output
C. Dehydration
D. Normal variation
, RATIONALE: Rapid weight gain indicates fluid retention and worsening heart
failure.
12. A patient with hyperkalemia is at highest risk for which complication?
A. Respiratory failure
B. Cardiac arrhythmias
C. Hypertension
D. Hypoglycemia
RATIONALE: Hyperkalemia disrupts cardiac conduction and can be fatal.
13. A patient with diabetic ketoacidosis presents with which lab finding?
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Normal pH
RATIONALE: Ketone production leads to acid accumulation in DKA.
14. A patient with pneumonia will most likely present with?
A. Bradycardia
B. Fever and productive cough
C. Hypothermia
D. Rash
RATIONALE: Respiratory infection causes fever and sputum production.
15. A patient with suspected appendicitis reports periumbilical pain migrating
to RLQ. What does this indicate?
A. Gastroenteritis
B. Classic appendicitis
C. Kidney stone
D. Liver disease
RATIONALE: Pain migration is a hallmark sign of appendicitis.
ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS PLUS RATIONALES | GUARANTEED
PASS | LATEST EXAM UPDATE | EXAM PREP |
STUDY GUIDE | PRACTICE TEST| DOWNLOAD
INSTANT PDF
1. A 45-year-old patient presents with sudden onset chest pain radiating to the
left arm. Which initial diagnostic test is the priority?
A. Chest X-ray
B. Troponin level
C. 12-lead ECG
D. D-dimer
RATIONALE: A 12-lead ECG is the first-line diagnostic test in suspected acute
coronary syndrome to identify ischemia or infarction immediately.
2. A patient with type 2 diabetes has an HbA1c of 9.2%. What does this value
indicate?
A. Excellent glycemic control
B. Severe hypoglycemia
C. Poor long-term glucose control
D. Normal glucose regulation
RATIONALE: An HbA1c above 7% indicates inadequate glycemic control and
increased risk of complications.
3. A patient on metformin reports fatigue and muscle pain. Which
complication should be ruled out first?
A. Hypoglycemia
B. Lactic acidosis
C. Hyperthyroidism
D. Hyperkalemia
RATIONALE: Metformin can rarely cause lactic acidosis, especially in renal
impairment, presenting with fatigue and myalgias.
,4. A patient with hypertension is prescribed lisinopril. What is the most
important lab to monitor?
A. Calcium
B. Potassium
C. Platelets
D. Hemoglobin
RATIONALE: ACE inhibitors can cause hyperkalemia due to reduced aldosterone
secretion.
5. A patient presents with wheezing, chest tightness, and accessory muscle use.
What is the first-line medication?
A. Albuterol
B. Montelukast
C. Prednisone only
D. Theophylline
RATIONALE: Short-acting beta agonists provide rapid bronchodilation in acute
asthma exacerbations.
6. A patient taking warfarin has an INR of 6.2. What is the priority action?
A. Increase dose
B. Hold medication
C. Give aspirin
D. Continue therapy
RATIONALE: A supratherapeutic INR increases bleeding risk and requires
withholding warfarin.
7. A patient with suspected stroke arrives at the clinic. What is the first
nursing action?
A. Give aspirin
B. Check blood glucose
C. Start IV fluids
D. Administer tPA immediately
RATIONALE: Hypoglycemia can mimic stroke symptoms and must be ruled out
first.
,8. A patient with COPD should be maintained on oxygen therapy with what
target saturation?
A. 100%
B. 94–100%
C. 88–92%
D. 70–75%
RATIONALE: Controlled oxygen prevents CO₂ retention in COPD patients.
9. A patient develops sudden shortness of breath and chest pain after surgery.
What is the most likely diagnosis?
A. Pneumonia
B. Pulmonary embolism
C. Atelectasis
D. Asthma
RATIONALE: Postoperative sudden dyspnea and chest pain strongly suggest PE.
10. A patient with chronic kidney disease has elevated creatinine. What does
this indicate?
A. Normal kidney function
B. Improved filtration
C. Decreased renal function
D. Liver dysfunction
RATIONALE: Elevated creatinine reflects impaired kidney filtration.
11. A patient with heart failure reports weight gain of 2 kg in 24 hours. What
does this indicate?
A. Fluid overload
B. Improved cardiac output
C. Dehydration
D. Normal variation
, RATIONALE: Rapid weight gain indicates fluid retention and worsening heart
failure.
12. A patient with hyperkalemia is at highest risk for which complication?
A. Respiratory failure
B. Cardiac arrhythmias
C. Hypertension
D. Hypoglycemia
RATIONALE: Hyperkalemia disrupts cardiac conduction and can be fatal.
13. A patient with diabetic ketoacidosis presents with which lab finding?
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Normal pH
RATIONALE: Ketone production leads to acid accumulation in DKA.
14. A patient with pneumonia will most likely present with?
A. Bradycardia
B. Fever and productive cough
C. Hypothermia
D. Rash
RATIONALE: Respiratory infection causes fever and sputum production.
15. A patient with suspected appendicitis reports periumbilical pain migrating
to RLQ. What does this indicate?
A. Gastroenteritis
B. Classic appendicitis
C. Kidney stone
D. Liver disease
RATIONALE: Pain migration is a hallmark sign of appendicitis.
