APEA 3PS EXAM STUDY GUIDE 157 PRACTICE
QUESTIONS WITH ANSWERS & RATIONALES
Latest 2024/2025
1. A visual acuity test shows 20/30 in the left eye and 20/40 in the right
eye using the Snellen chart. What should the provider do?
a) Schedule a follow-up vision exam in 2 weeks
b) Dilate and recheck the eyes
c) Refer to an ophthalmologist
d) Record as normal findings
Rationale: A visual disparity like 20/40 suggests a refractive error or
pathology needing ophthalmology referral.
2. Munchausen Syndrome by Proxy is best described as:
a) Self-harming behavior for attention
b) A caregiver creating or causing illness in someone under their care
c) Abusive neglect without direct harm
d) Emotional inattentiveness from a caregiver
Rationale: It's a psychiatric condition where caregivers fabricate or
induce illness, often in children.
3. Which neurotransmitter-related medication class can cause depression
as a side effect?
a) Dopamine, serotonin, norepinephrine meds
b) Gabapentin
c) Mil
d) Cortisol
Rationale: Altered serotonin and norepinephrine levels are linked to
mood regulation and can induce depressive symptoms.
4. A raised, asymmetric lesion with irregular borders is most likely:
a) Nevus
b) Actinic keratosis
c) Keratoacanthoma
d) Melanoma
Rationale: Melanomas often present with asymmetry, irregular margins,
and color variation.
5. A 32-year-old woman with puffy, non-pitting swelling around her eyes
likely has:
a) Nephrotic syndrome
,b) Myxedema
c) Cushing’s syndrome
d) Sinusitis
Rationale: Myxedema from hypothyroidism leads to
mucopolysaccharide buildup causing periorbital edema.
6. A woman with a migraine history requests a preventive treatment.
Which drug is suitable?
a) Sumatriptan
b) Amitriptyline
c) Verapamil
d) Metoprolol
Rationale: Amitriptyline is used off-label for migraine prevention;
sumatriptan is for acute relief.
7. A child has scalp scaling and circular patches of hair loss. What’s the
likely diagnosis?
a) Tinea capitis
b) Seborrheic dermatitis
c) Trichotillomania
d) Alopecia areata
Rationale: Tinea capitis is a fungal infection with patchy alopecia and
scalp scaling.
8. What is a suitable migraine prevention drug for an 18-year-old woman?
a) Sumatriptan
b) Propranolol
c) Ibuprofen
d) Dihydroergotamine
Rationale: Beta-blockers like propranolol are first-line for migraine
prophylaxis.
9. Why is combined hormonal contraception risky for a 36-year-old
smoker with diabetes and obesity?
a) She is obese
b) She has type 2 diabetes
c) Her age and tobacco use
d) Her sedentary lifestyle
Rationale: Smoking after age 35 while using estrogen-containing
contraceptives significantly raises thrombotic risk.
10. A woman has bloody spontaneous discharge from one nipple. What
should be suspected?
a) Fibroadenoma
, b) Polycystic breast disease
c) Intraductal papilloma
d) Pituitary prolactinoma
Rationale: Intraductal papillomas cause bloody nipple discharge and
require further evaluation.
11. When should an Rh-negative woman receive Rho(D)
immunoglobulin?
a) 6 weeks
b) 12 weeks
c) 28 weeks
d) 35 weeks
Rationale: RhoGAM is given at 28 weeks to prevent isoimmunization.
12. In a CBC, which value represents the average size of red blood cells?
a) Hemoglobin
b) Mean corpuscular volume (MCV)
c) Red cell distribution width (RDW)
d) Hematocrit
Rationale: MCV indicates average RBC size; low MCV means
microcytosis, high means macrocytosis.
13. Which medication should not be used for migraine prophylaxis?
a) Verapamil
b) Propranolol
c) Venlafaxine
d) Nimodipine
Rationale: Nimodipine is not typically used in migraine prevention and
lacks supporting evidence.
14. What is the role of prostaglandin E1 in transposition of the great
arteries?
a) Equalize ventricular pressures
b) Keep the ductus arteriosus open
c) Cause vasodilation
d) Trap blood in lower circulation
Rationale: PG E1 maintains ductal patency, allowing blood mixing in
cyanotic heart defects.
15. Which symptom best describes peripheral artery disease calf pain?
a) Sharp stabbing pain
b) Dull pain or cramping with exertion
c) Electric shock sensation
d) Pulsating pain
QUESTIONS WITH ANSWERS & RATIONALES
Latest 2024/2025
1. A visual acuity test shows 20/30 in the left eye and 20/40 in the right
eye using the Snellen chart. What should the provider do?
a) Schedule a follow-up vision exam in 2 weeks
b) Dilate and recheck the eyes
c) Refer to an ophthalmologist
d) Record as normal findings
Rationale: A visual disparity like 20/40 suggests a refractive error or
pathology needing ophthalmology referral.
2. Munchausen Syndrome by Proxy is best described as:
a) Self-harming behavior for attention
b) A caregiver creating or causing illness in someone under their care
c) Abusive neglect without direct harm
d) Emotional inattentiveness from a caregiver
Rationale: It's a psychiatric condition where caregivers fabricate or
induce illness, often in children.
3. Which neurotransmitter-related medication class can cause depression
as a side effect?
a) Dopamine, serotonin, norepinephrine meds
b) Gabapentin
c) Mil
d) Cortisol
Rationale: Altered serotonin and norepinephrine levels are linked to
mood regulation and can induce depressive symptoms.
4. A raised, asymmetric lesion with irregular borders is most likely:
a) Nevus
b) Actinic keratosis
c) Keratoacanthoma
d) Melanoma
Rationale: Melanomas often present with asymmetry, irregular margins,
and color variation.
5. A 32-year-old woman with puffy, non-pitting swelling around her eyes
likely has:
a) Nephrotic syndrome
,b) Myxedema
c) Cushing’s syndrome
d) Sinusitis
Rationale: Myxedema from hypothyroidism leads to
mucopolysaccharide buildup causing periorbital edema.
6. A woman with a migraine history requests a preventive treatment.
Which drug is suitable?
a) Sumatriptan
b) Amitriptyline
c) Verapamil
d) Metoprolol
Rationale: Amitriptyline is used off-label for migraine prevention;
sumatriptan is for acute relief.
7. A child has scalp scaling and circular patches of hair loss. What’s the
likely diagnosis?
a) Tinea capitis
b) Seborrheic dermatitis
c) Trichotillomania
d) Alopecia areata
Rationale: Tinea capitis is a fungal infection with patchy alopecia and
scalp scaling.
8. What is a suitable migraine prevention drug for an 18-year-old woman?
a) Sumatriptan
b) Propranolol
c) Ibuprofen
d) Dihydroergotamine
Rationale: Beta-blockers like propranolol are first-line for migraine
prophylaxis.
9. Why is combined hormonal contraception risky for a 36-year-old
smoker with diabetes and obesity?
a) She is obese
b) She has type 2 diabetes
c) Her age and tobacco use
d) Her sedentary lifestyle
Rationale: Smoking after age 35 while using estrogen-containing
contraceptives significantly raises thrombotic risk.
10. A woman has bloody spontaneous discharge from one nipple. What
should be suspected?
a) Fibroadenoma
, b) Polycystic breast disease
c) Intraductal papilloma
d) Pituitary prolactinoma
Rationale: Intraductal papillomas cause bloody nipple discharge and
require further evaluation.
11. When should an Rh-negative woman receive Rho(D)
immunoglobulin?
a) 6 weeks
b) 12 weeks
c) 28 weeks
d) 35 weeks
Rationale: RhoGAM is given at 28 weeks to prevent isoimmunization.
12. In a CBC, which value represents the average size of red blood cells?
a) Hemoglobin
b) Mean corpuscular volume (MCV)
c) Red cell distribution width (RDW)
d) Hematocrit
Rationale: MCV indicates average RBC size; low MCV means
microcytosis, high means macrocytosis.
13. Which medication should not be used for migraine prophylaxis?
a) Verapamil
b) Propranolol
c) Venlafaxine
d) Nimodipine
Rationale: Nimodipine is not typically used in migraine prevention and
lacks supporting evidence.
14. What is the role of prostaglandin E1 in transposition of the great
arteries?
a) Equalize ventricular pressures
b) Keep the ductus arteriosus open
c) Cause vasodilation
d) Trap blood in lower circulation
Rationale: PG E1 maintains ductal patency, allowing blood mixing in
cyanotic heart defects.
15. Which symptom best describes peripheral artery disease calf pain?
a) Sharp stabbing pain
b) Dull pain or cramping with exertion
c) Electric shock sensation
d) Pulsating pain
