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APEA NP PREDICTOR NEWEST EXAM
2026 | 150 QUESTIONS AND CORRECT
DETAILED ANSWERS | RATED A + |
NEW AND REVISED
1. A 62-year-old with sudden right arm weakness and slurred speech
presents to triage. The most appropriate first action is:
A. Give aspirin immediately
B. Obtain a CT scan of the head
C. Start high-dose steroids
D. Perform lumbar puncture
Early neuroimaging is critical to differentiate ischemic versus
hemorrhagic stroke before interventions.
2. A trauma patient arrives with hypotension, tachycardia, distended
neck veins, and muffled heart sounds. The most likely diagnosis is:
A. Cardiac tamponade
B. Tension pneumothorax
C. Beck’s triad indicates cardiac tamponade requiring
pericardiocentesis
D. Pulmonary embolism
Classic Beck’s triad (JVD, hypotension, muffled heart sounds)
suggests tamponade.
3. An ED NP orders tPA for acute ischemic stroke. Before
administration, the most important lab to verify is:
A. Serum creatinine
B. INR
C. ALT
D. Serum sodium
INR is critical to assess bleeding risk prior to thrombolytic
therapy.
4. A patient presents with chest pain radiating to the jaw and
diaphoresis. ECG shows ST elevations in leads II, III, and aVF.
The affected coronary artery is most likely:
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A. LAD
B. Circumflex
C. Right coronary artery
D. Posterior descending
Inferior MI pattern corresponds to right coronary artery
occlusion.
5. Which of the following is most appropriate for a patient in v-fib in
the ED?
A. IV morphine
B. Synchronized cardioversion
C. Defibrillation unsynchronized
D. Atropine
Pulseless v-fib requires immediate unsynchronized defibrillation.
6. A patient with COPD exacerbation presents with hypercapnia and
altered mental status. Best initial intervention:
A. Oral corticosteroids
B. Non-invasive ventilation
C. Inhaled albuterol only
D. Broad-spectrum antibiotics
NIV improves ventilation and CO₂ clearance in hypercapnic
respiratory failure.
7. A child with suspected epiglottitis should be positioned:
A. Supine
B. Upright, with airway equipment ready
C. Left lateral decubitus
D. Trendelenburg
Epiglottitis patients maintain posture for comfort; avoid supine
to prevent airway compromise.
8. In trauma primary survey, “A” stands for:
A. Alertness
B. Airway with cervical spine protection
C. Assessment of limbs
D. Abdomen exam
The ABCs prioritize airway first while protecting the cervical
spine.
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9. A 45-year-old with sudden severe abdominal pain, hypotension,
and a pulsatile abdominal mass most likely has:
A. Acute pancreatitis
B. Ruptured abdominal aortic aneurysm
C. Mesenteric ischemia
D. Perforated ulcer
Classic presentation of ruptured AAA.
10. A patient with suspected spinal cord injury should be
immobilized to protect:
A. Thoracic spine
B. Cervical spine
C. Lumbar spine
D. Sacral spine
Cervical spine is most vulnerable and must be immobilized first.
11. A patient with suspected pulmonary embolism has a Wells
score indicating high probability. Next best step:
A. Empiric antibiotics
B. D-dimer only
C. CT pulmonary angiography
D. Echocardiogram
CTPA is definitive imaging for PE in high-probability cases.
12. Which medication is first-line for anaphylaxis?
A. Diphenhydramine
B. Epinephrine IM
C. Albuterol
D. Steroids
Epinephrine IM is first-line for anaphylactic shock.
13. A patient with DKA has serum glucose 840 mg/dL. The next
step is:
A. Oral glucose
B. IV insulin infusion and fluids
C. Subcutaneous insulin only
D. Immediate potassium supplementation
DKA requires fluids and insulin; potassium is monitored and
supplemented as needed.
APEA NP PREDICTOR NEWEST EXAM
2026 | 150 QUESTIONS AND CORRECT
DETAILED ANSWERS | RATED A + |
NEW AND REVISED
1. A 62-year-old with sudden right arm weakness and slurred speech
presents to triage. The most appropriate first action is:
A. Give aspirin immediately
B. Obtain a CT scan of the head
C. Start high-dose steroids
D. Perform lumbar puncture
Early neuroimaging is critical to differentiate ischemic versus
hemorrhagic stroke before interventions.
2. A trauma patient arrives with hypotension, tachycardia, distended
neck veins, and muffled heart sounds. The most likely diagnosis is:
A. Cardiac tamponade
B. Tension pneumothorax
C. Beck’s triad indicates cardiac tamponade requiring
pericardiocentesis
D. Pulmonary embolism
Classic Beck’s triad (JVD, hypotension, muffled heart sounds)
suggests tamponade.
3. An ED NP orders tPA for acute ischemic stroke. Before
administration, the most important lab to verify is:
A. Serum creatinine
B. INR
C. ALT
D. Serum sodium
INR is critical to assess bleeding risk prior to thrombolytic
therapy.
4. A patient presents with chest pain radiating to the jaw and
diaphoresis. ECG shows ST elevations in leads II, III, and aVF.
The affected coronary artery is most likely:
,2|Page
A. LAD
B. Circumflex
C. Right coronary artery
D. Posterior descending
Inferior MI pattern corresponds to right coronary artery
occlusion.
5. Which of the following is most appropriate for a patient in v-fib in
the ED?
A. IV morphine
B. Synchronized cardioversion
C. Defibrillation unsynchronized
D. Atropine
Pulseless v-fib requires immediate unsynchronized defibrillation.
6. A patient with COPD exacerbation presents with hypercapnia and
altered mental status. Best initial intervention:
A. Oral corticosteroids
B. Non-invasive ventilation
C. Inhaled albuterol only
D. Broad-spectrum antibiotics
NIV improves ventilation and CO₂ clearance in hypercapnic
respiratory failure.
7. A child with suspected epiglottitis should be positioned:
A. Supine
B. Upright, with airway equipment ready
C. Left lateral decubitus
D. Trendelenburg
Epiglottitis patients maintain posture for comfort; avoid supine
to prevent airway compromise.
8. In trauma primary survey, “A” stands for:
A. Alertness
B. Airway with cervical spine protection
C. Assessment of limbs
D. Abdomen exam
The ABCs prioritize airway first while protecting the cervical
spine.
, 3|Page
9. A 45-year-old with sudden severe abdominal pain, hypotension,
and a pulsatile abdominal mass most likely has:
A. Acute pancreatitis
B. Ruptured abdominal aortic aneurysm
C. Mesenteric ischemia
D. Perforated ulcer
Classic presentation of ruptured AAA.
10. A patient with suspected spinal cord injury should be
immobilized to protect:
A. Thoracic spine
B. Cervical spine
C. Lumbar spine
D. Sacral spine
Cervical spine is most vulnerable and must be immobilized first.
11. A patient with suspected pulmonary embolism has a Wells
score indicating high probability. Next best step:
A. Empiric antibiotics
B. D-dimer only
C. CT pulmonary angiography
D. Echocardiogram
CTPA is definitive imaging for PE in high-probability cases.
12. Which medication is first-line for anaphylaxis?
A. Diphenhydramine
B. Epinephrine IM
C. Albuterol
D. Steroids
Epinephrine IM is first-line for anaphylactic shock.
13. A patient with DKA has serum glucose 840 mg/dL. The next
step is:
A. Oral glucose
B. IV insulin infusion and fluids
C. Subcutaneous insulin only
D. Immediate potassium supplementation
DKA requires fluids and insulin; potassium is monitored and
supplemented as needed.
