APEA 3P LATEST UPDATE EXAM GUIDE
WITH 100% BOARD-STYLE EXAM FOR 2026
GRADED A+
Which information best describes the pathophysiology of
most mental health disorders?
Dysregulation of neurotransmitters in relevant pathways
The commonality among all seizure etiologies is:
Increased neuron excitability
The NP is managing a patient newly diagnosed with essential
tremor disorder 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
A 48-year-old man presents with a complaint of a 3-week
history of intermittent shooting pain that runs down the
buttocks and left leg. Suspecting sciatica, the NP would
expect which of the following during physical examination?
Pain with straight leg raise
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 symptoms is negative. The appropriate
approach to this patient is to:
Order an echocardiogram
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
The NP is learning about anginal chest pain unresponsive to
nitroglycerin, when does necrotic injury occur?
The mitochondrial membrane ruptures
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.
Sarcomere stretch beyond 2.2 microns is the physiologic
mechanism behind which condition?
CHF
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
medications?
Amlodipine is more efficacious than losartan
During a routine health assessment, the NP appreciates a
decrease in peripheral vision bilaterally while performing
visual field assessment by confrontation. Consequently, the
NP anticipates which of the following findings during
fundoscopic assessment?
A cup-to-disk ratio of 70%.
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 acetaminophen. 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
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/dLCreatinine 0.9 mg/dL
, The NP considers which of the following as a secondary
cause of hypertension in this patient?
Hyperaldosteronism
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
A 41-year-old female is being managed by her mental health
provider with lithium. She presents for a primary care
wellness exam and has no complaints, but routine laboratory
assessment reveals a TSH of 4.5 iU/L. What is the most
appropriate approach for this patient?
Begin thyroid replacement therapy
A 42-year-old man was recently evaluated for progressive
fatigue. His diagnostic evaluation included a comprehensive
laboratory assessment which showed a HgbA1c of 8.4% and
a urinalysis with 4+ glucose. Which of the following
laboratory assessments is consistent with the presumed
diagnosis?
C-peptide of 9 ng/dL
Which pathophysiologic feature do multiple sclerosis and
Guillain-Barre syndrome share?
Immune-mediated demyelination
A 41-year-old woman presents with chronic diarrhea. She
says she has had problems with her bowels for as long as
she can remember, but it is getting worse; more often she
WITH 100% BOARD-STYLE EXAM FOR 2026
GRADED A+
Which information best describes the pathophysiology of
most mental health disorders?
Dysregulation of neurotransmitters in relevant pathways
The commonality among all seizure etiologies is:
Increased neuron excitability
The NP is managing a patient newly diagnosed with essential
tremor disorder 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
A 48-year-old man presents with a complaint of a 3-week
history of intermittent shooting pain that runs down the
buttocks and left leg. Suspecting sciatica, the NP would
expect which of the following during physical examination?
Pain with straight leg raise
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 symptoms is negative. The appropriate
approach to this patient is to:
Order an echocardiogram
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
The NP is learning about anginal chest pain unresponsive to
nitroglycerin, when does necrotic injury occur?
The mitochondrial membrane ruptures
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.
Sarcomere stretch beyond 2.2 microns is the physiologic
mechanism behind which condition?
CHF
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
medications?
Amlodipine is more efficacious than losartan
During a routine health assessment, the NP appreciates a
decrease in peripheral vision bilaterally while performing
visual field assessment by confrontation. Consequently, the
NP anticipates which of the following findings during
fundoscopic assessment?
A cup-to-disk ratio of 70%.
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 acetaminophen. 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
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/dLCreatinine 0.9 mg/dL
, The NP considers which of the following as a secondary
cause of hypertension in this patient?
Hyperaldosteronism
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
A 41-year-old female is being managed by her mental health
provider with lithium. She presents for a primary care
wellness exam and has no complaints, but routine laboratory
assessment reveals a TSH of 4.5 iU/L. What is the most
appropriate approach for this patient?
Begin thyroid replacement therapy
A 42-year-old man was recently evaluated for progressive
fatigue. His diagnostic evaluation included a comprehensive
laboratory assessment which showed a HgbA1c of 8.4% and
a urinalysis with 4+ glucose. Which of the following
laboratory assessments is consistent with the presumed
diagnosis?
C-peptide of 9 ng/dL
Which pathophysiologic feature do multiple sclerosis and
Guillain-Barre syndrome share?
Immune-mediated demyelination
A 41-year-old woman presents with chronic diarrhea. She
says she has had problems with her bowels for as long as
she can remember, but it is getting worse; more often she
