3P APEA EXAM 2025/2026| All Questions
with Expert Verified Answers for
Guaranteed Pass
1. Difference between varicose vein and arteriosclerosis
Question: What is the primary difference between varicose veins and arteriosclerosis?
Options:
A) Varicose veins affect arteries, while arteriosclerosis affects veins
B) Arteriosclerosis affects arteries, while varicose veins affect veins
C) Both conditions affect the same type of blood vessel
D) Varicose veins are caused by plaque buildup, while arteriosclerosis is caused by valve
dysfunction
Correct Answer: B) Arteriosclerosis affects arteries, while varicose veins affect veins
Explanation: Arteriosclerosis involves thickening and hardening of arteries, whereas varicose
veins result from weakened valves in veins, leading to pooling and dilation.
2. Point of maximal impulse (PMI) in uncontrolled hypertension
Question: A patient has poorly controlled hypertension for more than 10 years. Where is his
PMI most likely located?
Options:
A) 2nd ICS, right of sternum
B) 3rd ICS, left of MCL
C) 5th ICS, left of MCL
D) 6th ICS, midaxillary line
Correct Answer: C) 5th ICS, left of MCL
Explanation: Chronic hypertension causes left ventricular hypertrophy, displacing the PMI
laterally but typically remaining in the 5th intercostal space (ICS), left midclavicular line
(MCL).
3. Diastolic murmur at mitral listening point
Question: A 43-year-old Hispanic male has an audible diastolic murmur at the mitral listening
point with no click. What is the most likely diagnosis?
Options:
A) Mitral regurgitation
,B) Mitral stenosis
C) Aortic regurgitation
D) Aortic stenosis
Correct Answer: B) Mitral stenosis
Explanation: A diastolic murmur at the mitral area (apex) without a click is classic
for mitral stenosis, often due to rheumatic heart disease.
4. Pain in lower legs with walking (claudication)
Question: A diabetic patient reports lower leg pain while walking that resolves with rest. Where
is the pain most likely located?
Options:
A) Thigh
B) Calf muscle
C) Foot arch
D) Knee
Correct Answer: B) Calf muscle
Explanation: Calf pain (claudication) is typical of peripheral arterial disease (PAD) due to
reduced blood flow during exertion.
5. Sulfa allergy and contraindicated medication
Question: A hypertensive patient with a sulfa allergy (skin sloughing) should avoid which
medication?
Options:
A) Lisinopril
B) Amlodipine
C) Hydrochlorothiazide
D) Metoprolol
Correct Answer: C) Hydrochlorothiazide
Explanation: Thiazides (e.g., HCTZ) are sulfonamide derivatives and contraindicated in sulfa-
allergic patients with severe reactions.
6. Symptoms of worsening aortic stenosis
Question: A 75-year-old with aortic stenosis should be warned about which symptoms?
Options:
A) Palpitations and headache
B) Shortness of breath and syncope
, C) Leg swelling and fatigue
D) Chest rash and cough
Correct Answer: B) Shortness of breath and syncope
Explanation: Syncope and dyspnea indicate severe stenosis and poor cardiac output, requiring
urgent evaluation.
7. Nonmodifiable risk factor for PAD
Question: Which is a nonmodifiable risk factor for PAD in a 74-year-old?
Options:
A) Smoking
B) Diabetes
C) Hypertension
D) Age
Correct Answer: D) Age
Explanation: Age is nonmodifiable, while diabetes, smoking, and hypertension are modifiable.
8. Discontinuing benazepril
Question: Benazepril should be discontinued immediately if:
Options:
A) Cough develops
B) Pregnancy occurs
C) Blood pressure drops
D) Potassium rises slightly
Correct Answer: B) Pregnancy occurs
Explanation: ACE inhibitors are teratogenic and must be stopped in pregnancy due to fetal risk.
9. Aortic regurgitation characteristics
Question: What describes aortic regurgitation progression?
Options:
A) Sudden chest pain and collapse
B) Long asymptomatic period, then exercise intolerance
C) Persistent cough and wheezing
D) No symptoms until end-stage
Correct Answer: B) Long asymptomatic period, then exercise intolerance
Explanation: Aortic regurgitation has a prolonged asymptomatic phase before
decompensation causes exercise intolerance and dyspnea.
with Expert Verified Answers for
Guaranteed Pass
1. Difference between varicose vein and arteriosclerosis
Question: What is the primary difference between varicose veins and arteriosclerosis?
Options:
A) Varicose veins affect arteries, while arteriosclerosis affects veins
B) Arteriosclerosis affects arteries, while varicose veins affect veins
C) Both conditions affect the same type of blood vessel
D) Varicose veins are caused by plaque buildup, while arteriosclerosis is caused by valve
dysfunction
Correct Answer: B) Arteriosclerosis affects arteries, while varicose veins affect veins
Explanation: Arteriosclerosis involves thickening and hardening of arteries, whereas varicose
veins result from weakened valves in veins, leading to pooling and dilation.
2. Point of maximal impulse (PMI) in uncontrolled hypertension
Question: A patient has poorly controlled hypertension for more than 10 years. Where is his
PMI most likely located?
Options:
A) 2nd ICS, right of sternum
B) 3rd ICS, left of MCL
C) 5th ICS, left of MCL
D) 6th ICS, midaxillary line
Correct Answer: C) 5th ICS, left of MCL
Explanation: Chronic hypertension causes left ventricular hypertrophy, displacing the PMI
laterally but typically remaining in the 5th intercostal space (ICS), left midclavicular line
(MCL).
3. Diastolic murmur at mitral listening point
Question: A 43-year-old Hispanic male has an audible diastolic murmur at the mitral listening
point with no click. What is the most likely diagnosis?
Options:
A) Mitral regurgitation
,B) Mitral stenosis
C) Aortic regurgitation
D) Aortic stenosis
Correct Answer: B) Mitral stenosis
Explanation: A diastolic murmur at the mitral area (apex) without a click is classic
for mitral stenosis, often due to rheumatic heart disease.
4. Pain in lower legs with walking (claudication)
Question: A diabetic patient reports lower leg pain while walking that resolves with rest. Where
is the pain most likely located?
Options:
A) Thigh
B) Calf muscle
C) Foot arch
D) Knee
Correct Answer: B) Calf muscle
Explanation: Calf pain (claudication) is typical of peripheral arterial disease (PAD) due to
reduced blood flow during exertion.
5. Sulfa allergy and contraindicated medication
Question: A hypertensive patient with a sulfa allergy (skin sloughing) should avoid which
medication?
Options:
A) Lisinopril
B) Amlodipine
C) Hydrochlorothiazide
D) Metoprolol
Correct Answer: C) Hydrochlorothiazide
Explanation: Thiazides (e.g., HCTZ) are sulfonamide derivatives and contraindicated in sulfa-
allergic patients with severe reactions.
6. Symptoms of worsening aortic stenosis
Question: A 75-year-old with aortic stenosis should be warned about which symptoms?
Options:
A) Palpitations and headache
B) Shortness of breath and syncope
, C) Leg swelling and fatigue
D) Chest rash and cough
Correct Answer: B) Shortness of breath and syncope
Explanation: Syncope and dyspnea indicate severe stenosis and poor cardiac output, requiring
urgent evaluation.
7. Nonmodifiable risk factor for PAD
Question: Which is a nonmodifiable risk factor for PAD in a 74-year-old?
Options:
A) Smoking
B) Diabetes
C) Hypertension
D) Age
Correct Answer: D) Age
Explanation: Age is nonmodifiable, while diabetes, smoking, and hypertension are modifiable.
8. Discontinuing benazepril
Question: Benazepril should be discontinued immediately if:
Options:
A) Cough develops
B) Pregnancy occurs
C) Blood pressure drops
D) Potassium rises slightly
Correct Answer: B) Pregnancy occurs
Explanation: ACE inhibitors are teratogenic and must be stopped in pregnancy due to fetal risk.
9. Aortic regurgitation characteristics
Question: What describes aortic regurgitation progression?
Options:
A) Sudden chest pain and collapse
B) Long asymptomatic period, then exercise intolerance
C) Persistent cough and wheezing
D) No symptoms until end-stage
Correct Answer: B) Long asymptomatic period, then exercise intolerance
Explanation: Aortic regurgitation has a prolonged asymptomatic phase before
decompensation causes exercise intolerance and dyspnea.
