APEA 3P POST UNIVERSITY MSN-FNP CERTIFICATION PREPARATION
STUDY GUIDE 2026 EXAM GAURANTEED PASS WITH 100+ TEST BANK
QUESTIONS 2026 CARRICULUM BASSED VERRIFIED TEST INSTANT PDF
DOWNLOAD
Question 1
Which patient could be expected to have the highest systolic blood pressure?
A) A 21-year-old male
B) A 50-year-old perimenopausal female
C) A 35-year-old patient with Type 2 diabetes
D) A 75-year-old male
Answer: D
Rationale: Nearly 25% of the US population has hypertension. The greatest incidence is in
older adults because of changes in the intima of vessels as aging and calcium deposition
occur. Males of any age are more likely to be hypertensive than females of the same age.
African American adults have the highest incidence in the general population .
Question 2
Mrs. Brandy is having contrast dye next week for a heart catheterization. Which drug does
NOT need to be stopped prior to her catheterization?
A) Naproxen
B) Furosemide
C) Metformin
D) Losartan
,Answer: D
Rationale: Naproxen and furosemide should be stopped for 24 hours prior to catheterization.
Metformin should be stopped 48 hours prior to the catheterization. Furosemide is stopped
because it contributes to volume depletion. NSAIDs like naproxen are withheld because of
the impact on renal prostaglandin production. Metformin has been implicated in lactic
acidosis when combined with contrast dye in an impaired kidney .
Question 3
A 25-year-old patient has aortic stenosis (AS). The etiology of his AS is most likely:
A) Congenital
B) Rheumatic
C) Acquired calcific
D) Unknown
Answer: A
Rationale: In someone younger than 65 years, the most likely cause is congenital. The aortic
valve usually consists of three cusps, but some people are born with a bicuspid aortic valve.
Rheumatic heart disease is the second most common cause of aortic stenosis in this age
group, but the incidence has decreased drastically due to antibiotic use for Streptococcal
infections. In more than 90% of patients older than 65 years, acquired calcifications appear
on a normal aortic valve and produce aortic stenosis .
Question 4
A 75-year-old patient with longstanding hypertension takes an ACE inhibitor and a thiazide
diuretic daily. He has developed dyspnea on exertion and peripheral edema over the past
several days. This probably indicates:
,A) Worsening hypertension
B) Development of heart failure (HF)
C) Noncompliance with medication
D) Acute myocardial infarction
Answer: B
Rationale: The symptoms of dyspnea on exertion and peripheral edema are symptoms of HF.
Long-standing hypertension is a risk factor for HF. Acute myocardial infarction would result in
acute symptoms, not development of symptoms over several days. Noncompliance with
medication and fluid or sodium excess might result in peripheral edema and development of
heart failure .
Question 5
A patient is diagnosed with mild heart failure (HF). Which drug would be a good choice for
reducing morbidity and mortality long term?
A) Verapamil
B) Digoxin
C) Furosemide
D) Metoprolol
Answer: D
Rationale: Metoprolol is a beta-blocker. Beta-blockers are known to reduce morbidity and
mortality associated with HF. Verapamil is a calcium channel blocker; this class is
contraindicated because they decrease cardiac contractility. Furosemide and digoxin will
improve symptoms but not long-term outcomes. Their main benefit is in treating
symptomatic patients .
, Question 6
An older adult who has hypertension and angina takes multiple medications. Which one
decreases the likelihood of his having angina?
A) ACE inhibitor
B) Beta blocker
C) Diuretic
D) Angiotensin receptor blocker
Answer: B
Rationale: The beta blocker slows down heart rate, depresses myocardial contractility, and
decreases sympathetic stimulation. These decrease myocardial oxygen demand and improve
angina symptoms. Calcium channel blockers are another class that could be used to improve
symptoms of angina .
Question 7
Orthostatic hypotension can be diagnosed in an older adult if the systolic blood pressure
decreases:
A) More than 20 points anytime after rising
B) More than 20 points within 3 minutes after rising
C) More than 20 points within 1 minute after rising
D) Any degree drop if the patient becomes weak or dizzy
Answer: B
Rationale: Orthostatic hypotension is diagnosed in older adults when the systolic blood
pressure drops 20 mm Hg or more within 3 minutes of moving to a more upright position.
STUDY GUIDE 2026 EXAM GAURANTEED PASS WITH 100+ TEST BANK
QUESTIONS 2026 CARRICULUM BASSED VERRIFIED TEST INSTANT PDF
DOWNLOAD
Question 1
Which patient could be expected to have the highest systolic blood pressure?
A) A 21-year-old male
B) A 50-year-old perimenopausal female
C) A 35-year-old patient with Type 2 diabetes
D) A 75-year-old male
Answer: D
Rationale: Nearly 25% of the US population has hypertension. The greatest incidence is in
older adults because of changes in the intima of vessels as aging and calcium deposition
occur. Males of any age are more likely to be hypertensive than females of the same age.
African American adults have the highest incidence in the general population .
Question 2
Mrs. Brandy is having contrast dye next week for a heart catheterization. Which drug does
NOT need to be stopped prior to her catheterization?
A) Naproxen
B) Furosemide
C) Metformin
D) Losartan
,Answer: D
Rationale: Naproxen and furosemide should be stopped for 24 hours prior to catheterization.
Metformin should be stopped 48 hours prior to the catheterization. Furosemide is stopped
because it contributes to volume depletion. NSAIDs like naproxen are withheld because of
the impact on renal prostaglandin production. Metformin has been implicated in lactic
acidosis when combined with contrast dye in an impaired kidney .
Question 3
A 25-year-old patient has aortic stenosis (AS). The etiology of his AS is most likely:
A) Congenital
B) Rheumatic
C) Acquired calcific
D) Unknown
Answer: A
Rationale: In someone younger than 65 years, the most likely cause is congenital. The aortic
valve usually consists of three cusps, but some people are born with a bicuspid aortic valve.
Rheumatic heart disease is the second most common cause of aortic stenosis in this age
group, but the incidence has decreased drastically due to antibiotic use for Streptococcal
infections. In more than 90% of patients older than 65 years, acquired calcifications appear
on a normal aortic valve and produce aortic stenosis .
Question 4
A 75-year-old patient with longstanding hypertension takes an ACE inhibitor and a thiazide
diuretic daily. He has developed dyspnea on exertion and peripheral edema over the past
several days. This probably indicates:
,A) Worsening hypertension
B) Development of heart failure (HF)
C) Noncompliance with medication
D) Acute myocardial infarction
Answer: B
Rationale: The symptoms of dyspnea on exertion and peripheral edema are symptoms of HF.
Long-standing hypertension is a risk factor for HF. Acute myocardial infarction would result in
acute symptoms, not development of symptoms over several days. Noncompliance with
medication and fluid or sodium excess might result in peripheral edema and development of
heart failure .
Question 5
A patient is diagnosed with mild heart failure (HF). Which drug would be a good choice for
reducing morbidity and mortality long term?
A) Verapamil
B) Digoxin
C) Furosemide
D) Metoprolol
Answer: D
Rationale: Metoprolol is a beta-blocker. Beta-blockers are known to reduce morbidity and
mortality associated with HF. Verapamil is a calcium channel blocker; this class is
contraindicated because they decrease cardiac contractility. Furosemide and digoxin will
improve symptoms but not long-term outcomes. Their main benefit is in treating
symptomatic patients .
, Question 6
An older adult who has hypertension and angina takes multiple medications. Which one
decreases the likelihood of his having angina?
A) ACE inhibitor
B) Beta blocker
C) Diuretic
D) Angiotensin receptor blocker
Answer: B
Rationale: The beta blocker slows down heart rate, depresses myocardial contractility, and
decreases sympathetic stimulation. These decrease myocardial oxygen demand and improve
angina symptoms. Calcium channel blockers are another class that could be used to improve
symptoms of angina .
Question 7
Orthostatic hypotension can be diagnosed in an older adult if the systolic blood pressure
decreases:
A) More than 20 points anytime after rising
B) More than 20 points within 3 minutes after rising
C) More than 20 points within 1 minute after rising
D) Any degree drop if the patient becomes weak or dizzy
Answer: B
Rationale: Orthostatic hypotension is diagnosed in older adults when the systolic blood
pressure drops 20 mm Hg or more within 3 minutes of moving to a more upright position.
