APEA 3P Exam Predictor Practice Question Bank LATEST
QUESTIONS AND CORRECT ANSWERS 2026
Instructions: Each question is followed by four possible answers. The correct answer and an
explanation are provided immediately after.
1. When performing a neurologic exam on a patient with suspected Parkinson's disease, the
nurse practitioner would expect to find which of the following?
A) Intention tremor
B) Cogwheel rigidity
C) Flaccid tone
D) Hyperreflexia
ANSWER: B
EXPLANATION: Cogwheel rigidity, a ratchet-like resistance to passive movement, is a classic
sign of Parkinson's disease. Intention tremor is associated with cerebellar disorders.
2. A 45-year-old female presents with fatigue, weight gain, dry skin, and hair loss. Thyroid
function tests reveal a TSH of 8.2 mIU/L (elevated) and a low free T4. What is the most
appropriate initial pharmacotherapy?
A) Liothyronine (Cytomel)
B) Propylthiouracil (PTU)
C) Levothyroxine (Synthroid)
D) Propranolol
ANSWER: C
, EXPLANATION: The lab results and symptoms indicate primary hypothyroidism.
Levothyroxine, a synthetic T4, is the standard first-line replacement therapy.
3. During a well-child visit for a 6-month-old, the parent reports the infant rolls from front to
back but not back to front. The nurse practitioner's best response is:
A) "This is a significant developmental delay; we need a neurology referral."
B) "This is normal; infants typically roll front-to-back first around 5-6 months."
C) "The infant should be rolling both ways by now; this requires physical therapy."
D) "This indicates possible muscular dystrophy; we will order a CK test."
ANSWER: B
EXPLANATION: Rolling from prone to supine (front-to-back) usually develops around 5
months, while rolling supine to prone (back-to-front) comes later, around 6-7 months. This
infant's development is within normal limits.
4. A patient with Type 2 Diabetes Mellitus has an HbA1c of 9.5% on metformin 1000mg BID.
According to the ADA guidelines, what is the recommended next step in therapy?
A) Add a sulfonylurea (e.g., glipizide)
B) Add a GLP-1 receptor agonist
C) Switch to insulin therapy
D) Increase metformin to 1000mg TID
ANSWER: B
EXPLANATION: For patients not at goal on metformin alone, current ADA/EASD guidelines
recommend adding an agent with proven cardiovascular benefit, such as a GLP-1 receptor
agonist or SGLT2 inhibitor, particularly if the patient has atherosclerotic cardiovascular disease,
heart failure, or chronic kidney disease.
QUESTIONS AND CORRECT ANSWERS 2026
Instructions: Each question is followed by four possible answers. The correct answer and an
explanation are provided immediately after.
1. When performing a neurologic exam on a patient with suspected Parkinson's disease, the
nurse practitioner would expect to find which of the following?
A) Intention tremor
B) Cogwheel rigidity
C) Flaccid tone
D) Hyperreflexia
ANSWER: B
EXPLANATION: Cogwheel rigidity, a ratchet-like resistance to passive movement, is a classic
sign of Parkinson's disease. Intention tremor is associated with cerebellar disorders.
2. A 45-year-old female presents with fatigue, weight gain, dry skin, and hair loss. Thyroid
function tests reveal a TSH of 8.2 mIU/L (elevated) and a low free T4. What is the most
appropriate initial pharmacotherapy?
A) Liothyronine (Cytomel)
B) Propylthiouracil (PTU)
C) Levothyroxine (Synthroid)
D) Propranolol
ANSWER: C
, EXPLANATION: The lab results and symptoms indicate primary hypothyroidism.
Levothyroxine, a synthetic T4, is the standard first-line replacement therapy.
3. During a well-child visit for a 6-month-old, the parent reports the infant rolls from front to
back but not back to front. The nurse practitioner's best response is:
A) "This is a significant developmental delay; we need a neurology referral."
B) "This is normal; infants typically roll front-to-back first around 5-6 months."
C) "The infant should be rolling both ways by now; this requires physical therapy."
D) "This indicates possible muscular dystrophy; we will order a CK test."
ANSWER: B
EXPLANATION: Rolling from prone to supine (front-to-back) usually develops around 5
months, while rolling supine to prone (back-to-front) comes later, around 6-7 months. This
infant's development is within normal limits.
4. A patient with Type 2 Diabetes Mellitus has an HbA1c of 9.5% on metformin 1000mg BID.
According to the ADA guidelines, what is the recommended next step in therapy?
A) Add a sulfonylurea (e.g., glipizide)
B) Add a GLP-1 receptor agonist
C) Switch to insulin therapy
D) Increase metformin to 1000mg TID
ANSWER: B
EXPLANATION: For patients not at goal on metformin alone, current ADA/EASD guidelines
recommend adding an agent with proven cardiovascular benefit, such as a GLP-1 receptor
agonist or SGLT2 inhibitor, particularly if the patient has atherosclerotic cardiovascular disease,
heart failure, or chronic kidney disease.
