APEA QBank Comprehensive Nurse
Practitioner EXAM 2026-2027 LATEST UPDATED
VERSION 280 QUESTIONS AND
1. A 65-year-old male has predictable exertional chest pain relieved by rest.
Most likely diagnosis?
A. Unstable angina
B. Stable angina
C. Myocardial infarction
D. Pericarditis
B. Stable angina
Rationale: Stable angina is predictable, occurs with exertion, and resolves
with rest or nitroglycerin.
2. A 28-year-old female has dysuria, frequency, urgency, and positive leukocyte
esterase/nitrites. First-line treatment?
A. Amoxicillin
B. Ciprofloxacin
C. Nitrofurantoin
D. Doxycycline
C. Nitrofurantoin
Rationale: Nitrofurantoin is first-line for uncomplicated UTI.
3. Most common cause of acute bronchitis in adults?
A. Bacterial infection
B. Viral infection
C. Fungal infection
D. Allergic reaction
B. Viral infection
Rationale: Acute bronchitis is usually viral and does not routinely require
antibiotics.
,4. Patient with heart failure has edema, JVD, and crackles. Best acute symptom
management?
A. Metoprolol
B. Lisinopril
C. Furosemide
D. Spironolactone
C. Furosemide
Rationale: Loop diuretics rapidly reduce fluid overload in acute
decompensated heart failure.
5. Child with barking cough, inspiratory stridor, low-grade fever. Most likely
diagnosis?
A. Epiglottitis
B. Croup
C. Bronchiolitis
D. Asthma
B. Croup
Rationale: Croup causes a barking cough and inspiratory stridor.
6. USPSTF screening recommendation for a 55-year-old postmenopausal
woman?
A. Ovarian cancer
B. Lipid disorders
C. Thyroid dysfunction
D. Diabetes
B. Lipid disorders
Rationale: Lipid screening is recommended for adults 40–75 to assess
cardiovascular risk.
7. Severe vertigo triggered by head position changes, with nystagmus. Most
likely diagnosis?
A. Meniere’s disease
B. Vestibular neuritis
C. BPPV
,D. Labyrinthitis
C. BPPV
Rationale: Benign paroxysmal positional vertigo is triggered by positional
changes.
8. Classic sign of hypothyroidism?
A. Weight loss
B. Tachycardia
C. Heat intolerance
D. Constipation
D. Constipation
Rationale: Hypothyroidism slows metabolism and commonly causes
constipation.
9. Painless, firm testicular nodule. Next step?
A. Antibiotics
B. Reassurance
C. Scrotal ultrasound
D. Immediate surgery
C. Scrotal ultrasound
Rationale: A painless firm testicular mass requires ultrasound to rule out
malignancy.
10. Vaccine contraindicated in severe immunocompromise?
A. Inactivated influenza
B. Tdap
C. MMR
D. PCV13
C. MMR
Rationale: MMR is a live vaccine and is contraindicated in severe
immunocompromise.
11. New headache, jaw claudication, blurred vision, elevated ESR. Diagnosis?
A. Migraine
, B. Tension headache
C. Giant cell arteritis
D. Cluster headache
C. Giant cell arteritis
Rationale: Giant cell arteritis can cause vision loss and requires urgent
steroids.
12. Reflex that should disappear by 2–4 months?
A. Moro
B. Rooting
C. Palmar grasp
D. Stepping
A. Moro
Rationale: The Moro reflex usually disappears by 3–4 months.
13. First-line medication for major depressive disorder?
A. CBT alone
B. SSRI
C. MAOI
D. ECT
B. SSRI
Rationale: SSRIs are first-line due to efficacy and safety.
14. Target/bull’s-eye rash is characteristic of?
A. Rocky Mountain spotted fever
B. Lyme disease
C. Cellulitis
D. Shingles
B. Lyme disease
Rationale: Erythema migrans is the hallmark of early Lyme disease.
15. Most common cause of peptic ulcer disease?
A. Stress
B. Spicy food
Practitioner EXAM 2026-2027 LATEST UPDATED
VERSION 280 QUESTIONS AND
1. A 65-year-old male has predictable exertional chest pain relieved by rest.
Most likely diagnosis?
A. Unstable angina
B. Stable angina
C. Myocardial infarction
D. Pericarditis
B. Stable angina
Rationale: Stable angina is predictable, occurs with exertion, and resolves
with rest or nitroglycerin.
2. A 28-year-old female has dysuria, frequency, urgency, and positive leukocyte
esterase/nitrites. First-line treatment?
A. Amoxicillin
B. Ciprofloxacin
C. Nitrofurantoin
D. Doxycycline
C. Nitrofurantoin
Rationale: Nitrofurantoin is first-line for uncomplicated UTI.
3. Most common cause of acute bronchitis in adults?
A. Bacterial infection
B. Viral infection
C. Fungal infection
D. Allergic reaction
B. Viral infection
Rationale: Acute bronchitis is usually viral and does not routinely require
antibiotics.
,4. Patient with heart failure has edema, JVD, and crackles. Best acute symptom
management?
A. Metoprolol
B. Lisinopril
C. Furosemide
D. Spironolactone
C. Furosemide
Rationale: Loop diuretics rapidly reduce fluid overload in acute
decompensated heart failure.
5. Child with barking cough, inspiratory stridor, low-grade fever. Most likely
diagnosis?
A. Epiglottitis
B. Croup
C. Bronchiolitis
D. Asthma
B. Croup
Rationale: Croup causes a barking cough and inspiratory stridor.
6. USPSTF screening recommendation for a 55-year-old postmenopausal
woman?
A. Ovarian cancer
B. Lipid disorders
C. Thyroid dysfunction
D. Diabetes
B. Lipid disorders
Rationale: Lipid screening is recommended for adults 40–75 to assess
cardiovascular risk.
7. Severe vertigo triggered by head position changes, with nystagmus. Most
likely diagnosis?
A. Meniere’s disease
B. Vestibular neuritis
C. BPPV
,D. Labyrinthitis
C. BPPV
Rationale: Benign paroxysmal positional vertigo is triggered by positional
changes.
8. Classic sign of hypothyroidism?
A. Weight loss
B. Tachycardia
C. Heat intolerance
D. Constipation
D. Constipation
Rationale: Hypothyroidism slows metabolism and commonly causes
constipation.
9. Painless, firm testicular nodule. Next step?
A. Antibiotics
B. Reassurance
C. Scrotal ultrasound
D. Immediate surgery
C. Scrotal ultrasound
Rationale: A painless firm testicular mass requires ultrasound to rule out
malignancy.
10. Vaccine contraindicated in severe immunocompromise?
A. Inactivated influenza
B. Tdap
C. MMR
D. PCV13
C. MMR
Rationale: MMR is a live vaccine and is contraindicated in severe
immunocompromise.
11. New headache, jaw claudication, blurred vision, elevated ESR. Diagnosis?
A. Migraine
, B. Tension headache
C. Giant cell arteritis
D. Cluster headache
C. Giant cell arteritis
Rationale: Giant cell arteritis can cause vision loss and requires urgent
steroids.
12. Reflex that should disappear by 2–4 months?
A. Moro
B. Rooting
C. Palmar grasp
D. Stepping
A. Moro
Rationale: The Moro reflex usually disappears by 3–4 months.
13. First-line medication for major depressive disorder?
A. CBT alone
B. SSRI
C. MAOI
D. ECT
B. SSRI
Rationale: SSRIs are first-line due to efficacy and safety.
14. Target/bull’s-eye rash is characteristic of?
A. Rocky Mountain spotted fever
B. Lyme disease
C. Cellulitis
D. Shingles
B. Lyme disease
Rationale: Erythema migrans is the hallmark of early Lyme disease.
15. Most common cause of peptic ulcer disease?
A. Stress
B. Spicy food
