APEA 3PS (PATHOPHYSIOLOGY, PHARMARMACOLOGY & PHYSICAL
ASSESSMENT) EXAM 2025 WITH COMPLETE SOLUTION.
1. Sarcomere .stretch .beyond .2.2 .microns .is .the .physiologic .mechanism .be-
hind .which .condition?: .CHF
2. A .female .patient .is .taking .amlodipine .10 .mg .daily, .which .controlled .her
. blood .pressure, .but .she .could .not .tolerate .the .side .effects. .She .was .switched
. to .losartan .100 .mg .daily, .but .her .blood .pressure .never .achieved .goal..Which
. statement .best .characterizes .the .clinical .comparison .of .these .two .medica-
. tions?: .Amlodipine .is .more .efficacious .than .losartan
3. During .a .routine .health .assessment, .the .NP .appreciates .a .decrease .in
. peripheral .vision .bilaterally .while .performing .visual .field .assessment .by .con-
. frontation. .Consequently, .the .NP .anticipates .which .of .the .following .findings
during .fundoscopic .assessment?: .A .cup-to-disk .ratio .of .70%.
.
4. A .66-year-old .woman .presents .with .a .complaint .of .a .4-day .history .of .a
. unilateral .headache .that .will .not .go .away .despite .taking .ibuprofen .and
aceta- . minophen. .She .has .a .history .of .hypertension .that .is .usually .well
.
controlled . with .an .ACE .inhibitor, .but .today .her .blood .pressure .is .162/92 .mm
.
Hg. .During . the .HPI .she .admits .that .she .has .had .some .transient .visual .loss
.
over .the .few . days, .but .it .has .been .very .short .lived .and .resolves .completely.
.
The .next .step .in .the .evaluation .of .this .patient .should .include:: .An .erythrocyte
.
sedimentation . rate
.
5. Which .information .best .describes .the .pathophysiology .of .most .mental
. health .disorders?: .Dysregulation .of .neurotransmitters .in .relevant .pathways
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,6. The .commonality.among .all .seizure .etiologies .is:: .Increased .neuron .excitabil-
. ity
7. The .NP .is .managing .a .patient .newly .diagnosed .with .essential .tremor .dis-
. order .and .prescribed .propranolol..The .patient .did .an .internet .search .for .the
. medication .and .wants .to .know .how .a ."heart .medication" .can .make .her .stop
. having .hand .tremors..What .is .the .best .explanation .for .this .patient?: .Propranolol
. blocks .the .action .of .the .sympathetic .nervous .system .in .all .body .systems .and .so .it
. will .calm .many .things, .including .the .tremors
8. A .48-year-old .man .presents .with .a .complaint .of .a .3-week .history .of .inter-
. mittent .shooting .pain .that .runs .down .the .buttocks .and .left .leg. .Suspecting
. sciatica, .the .NP .would .expect .which .of .the .following .during .physical .examina-
. tion?: .Pain .with .straight .leg .raise
9. During .the .routine .wellness .examination .of .a .12-year-old .male .patient, .the
. NP .appreciates .a .grade .II/VI .systolic .murmur .at .the .apex .while .the .patient .is
. lying .on .the .exam .table. .The .murmur .is .louder .when .the .patient .moves .to
the . sitting .position, .appreciated .at .grade .IV/VI. .The .cardiac .history .and
.
review .of
.
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, symptoms .is .negative..The .appropriate .approach .to .this .patient .is .to:: .Order
an .echocardiogram
10. A .57-year-old .woman .presents .with .a .3-day .history .of .fever, .dyspnea, .and
. a .purulent .cough. .Auscultation .of .the .lungs .identifies .an .area .of .egophony
. in . the .lower .left .lobe. .Palpation .reveals .increased .tactile .fremitus.The .NP
. expects . which .of .the .following .percussion .findings?: .Dullness
11. The .NP .is .learning .about .anginal .chest .pain .unresponsive .to .nitroglycerin,
. when .does .necrotic .injury .occur?: .The .mitochondrial .membrane .ruptures
12. A .35-year-old .female .is .skiing .fast .down .a .steep .trail. .She .falls .forward .and
. lands .on .an .abducted .and .extended .arm. .She .immediately .feels .a .pop, .has
. exquisite .pain .over .her .right .upper .shoulder, .and .has .no .sensation .in .her .right
. hand. .Her .diagnosis .is .most .likely:: .Anterior .dislocation .of .the .glenohumeral .joint.
13. The .NP .is .evaluating .a .patient .with .markedly .elevated .blood .pressure .that
. is .unresponsive .to .traditional .medications..There .is .some .mild .pedal .edema,
. but .other .than .the .elevated .BP, .the .physical .exam .is .essentially .normal. .A
. metabolic .panel .reveals .the .following:
Na+ .151 .mEq/LK+ .3.0 .mEq/LCl- .114 .mEq/LCO2 .28 .mEq/LBUN .10 .mg/dLCrea-
tinine .0.9 .mg/dL
The .NP .considers .which .of .the .following .as .a .secondary .cause .of .hyperten-
. sion .in .this .patient?: .Hyperaldosteronism
14. Which .of .the .following .statins .is .preferred .for .a .67-year-old .man .with
. hypercholesterolemia .who .drinks .a .glass .of .grapefruit .juice .every
. morning?-
: .Pravastatin
15. A .41-year-old .female .is .being .managed .by .her .mental .health .provider .with
3 ./
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ASSESSMENT) EXAM 2025 WITH COMPLETE SOLUTION.
1. Sarcomere .stretch .beyond .2.2 .microns .is .the .physiologic .mechanism .be-
hind .which .condition?: .CHF
2. A .female .patient .is .taking .amlodipine .10 .mg .daily, .which .controlled .her
. blood .pressure, .but .she .could .not .tolerate .the .side .effects. .She .was .switched
. to .losartan .100 .mg .daily, .but .her .blood .pressure .never .achieved .goal..Which
. statement .best .characterizes .the .clinical .comparison .of .these .two .medica-
. tions?: .Amlodipine .is .more .efficacious .than .losartan
3. During .a .routine .health .assessment, .the .NP .appreciates .a .decrease .in
. peripheral .vision .bilaterally .while .performing .visual .field .assessment .by .con-
. frontation. .Consequently, .the .NP .anticipates .which .of .the .following .findings
during .fundoscopic .assessment?: .A .cup-to-disk .ratio .of .70%.
.
4. A .66-year-old .woman .presents .with .a .complaint .of .a .4-day .history .of .a
. unilateral .headache .that .will .not .go .away .despite .taking .ibuprofen .and
aceta- . minophen. .She .has .a .history .of .hypertension .that .is .usually .well
.
controlled . with .an .ACE .inhibitor, .but .today .her .blood .pressure .is .162/92 .mm
.
Hg. .During . the .HPI .she .admits .that .she .has .had .some .transient .visual .loss
.
over .the .few . days, .but .it .has .been .very .short .lived .and .resolves .completely.
.
The .next .step .in .the .evaluation .of .this .patient .should .include:: .An .erythrocyte
.
sedimentation . rate
.
5. Which .information .best .describes .the .pathophysiology .of .most .mental
. health .disorders?: .Dysregulation .of .neurotransmitters .in .relevant .pathways
1 ./
.12
,6. The .commonality.among .all .seizure .etiologies .is:: .Increased .neuron .excitabil-
. ity
7. The .NP .is .managing .a .patient .newly .diagnosed .with .essential .tremor .dis-
. order .and .prescribed .propranolol..The .patient .did .an .internet .search .for .the
. medication .and .wants .to .know .how .a ."heart .medication" .can .make .her .stop
. having .hand .tremors..What .is .the .best .explanation .for .this .patient?: .Propranolol
. blocks .the .action .of .the .sympathetic .nervous .system .in .all .body .systems .and .so .it
. will .calm .many .things, .including .the .tremors
8. A .48-year-old .man .presents .with .a .complaint .of .a .3-week .history .of .inter-
. mittent .shooting .pain .that .runs .down .the .buttocks .and .left .leg. .Suspecting
. sciatica, .the .NP .would .expect .which .of .the .following .during .physical .examina-
. tion?: .Pain .with .straight .leg .raise
9. During .the .routine .wellness .examination .of .a .12-year-old .male .patient, .the
. NP .appreciates .a .grade .II/VI .systolic .murmur .at .the .apex .while .the .patient .is
. lying .on .the .exam .table. .The .murmur .is .louder .when .the .patient .moves .to
the . sitting .position, .appreciated .at .grade .IV/VI. .The .cardiac .history .and
.
review .of
.
2 ./
.12
, symptoms .is .negative..The .appropriate .approach .to .this .patient .is .to:: .Order
an .echocardiogram
10. A .57-year-old .woman .presents .with .a .3-day .history .of .fever, .dyspnea, .and
. a .purulent .cough. .Auscultation .of .the .lungs .identifies .an .area .of .egophony
. in . the .lower .left .lobe. .Palpation .reveals .increased .tactile .fremitus.The .NP
. expects . which .of .the .following .percussion .findings?: .Dullness
11. The .NP .is .learning .about .anginal .chest .pain .unresponsive .to .nitroglycerin,
. when .does .necrotic .injury .occur?: .The .mitochondrial .membrane .ruptures
12. A .35-year-old .female .is .skiing .fast .down .a .steep .trail. .She .falls .forward .and
. lands .on .an .abducted .and .extended .arm. .She .immediately .feels .a .pop, .has
. exquisite .pain .over .her .right .upper .shoulder, .and .has .no .sensation .in .her .right
. hand. .Her .diagnosis .is .most .likely:: .Anterior .dislocation .of .the .glenohumeral .joint.
13. The .NP .is .evaluating .a .patient .with .markedly .elevated .blood .pressure .that
. is .unresponsive .to .traditional .medications..There .is .some .mild .pedal .edema,
. but .other .than .the .elevated .BP, .the .physical .exam .is .essentially .normal. .A
. metabolic .panel .reveals .the .following:
Na+ .151 .mEq/LK+ .3.0 .mEq/LCl- .114 .mEq/LCO2 .28 .mEq/LBUN .10 .mg/dLCrea-
tinine .0.9 .mg/dL
The .NP .considers .which .of .the .following .as .a .secondary .cause .of .hyperten-
. sion .in .this .patient?: .Hyperaldosteronism
14. Which .of .the .following .statins .is .preferred .for .a .67-year-old .man .with
. hypercholesterolemia .who .drinks .a .glass .of .grapefruit .juice .every
. morning?-
: .Pravastatin
15. A .41-year-old .female .is .being .managed .by .her .mental .health .provider .with
3 ./
.12
