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APEA Predictor Exam 4 2025-2026
UPDATE ACTUAL EXAM ALL QUESTIONS
AND CORRECT DETAILED ANSWERS.
Q1. In the majority of children, the first permanent teeth start to erupt at the
age of 6 years. Which of the following are the first permanent teeth to erupt in
this time period?
A. First Molars
B. Second Molars
C. Lower or upper incisors
D. Canines
Answer: A. First Molars
Rationale: The first permanent molars (often called "six-year molars") are
typically the first permanent teeth to erupt, around age 6. They erupt behind the
primary second molars and do not replace any primary teeth.
Q2. All of the following are classified as activities of daily living (ADLs) except:
A. Ability to feed self
B. Ability to manage bladder and bowel elimination
C. Personal hygiene and grooming
D. Grocery shopping
Answer: D. Grocery shopping
Rationale: ADLs are basic self-care tasks (eating, toileting, grooming, bathing,
transferring, dressing). Grocery shopping is an Instrumental Activity of Daily Living
(IADL), which includes more complex skills needed for independent living.
,Q3. You note the following result on a routine urinalysis of a 37-year old
primigravida at 30 weeks gestation: leukocyte = trace, nitrite = negative, protein
= 2+, blood = negative. Her weight has increased by 5 lbs during the past week.
Which of the following is most likely?
A. HELLP syndrome
B. Pregnancy-induced hypertension (pre-eclampsia)
C. Eclampsia of pregnancy
D. Primary hypertension
Answer: B. Pregnancy-induced hypertension (pre-eclampsia)
Rationale: The classic triad of preeclampsia includes hypertension, edema (rapid
weight gain), and proteinuria (2+). HELLP syndrome involves hemolysis, elevated
liver enzymes, and low platelets. Eclampsia includes seizures. Primary
hypertension lacks proteinuria.
Q4. The mother of a 12-month-old infant reports that her child had a high fever
for several days, which spontaneously resolved. After the fever resolved, the
child developed a maculopapular rash. Which of the following is the most likely?
A. Fifth Disease (erythema infectiosum)
B. Roseola infantum (exanthema subitum)
C. Varicella
D. Infantile maculopapular rashes
Answer: B. Roseola infantum (exanthema subitum)
Rationale: Roseola is classically described as "fever first, rash later" – high fever
for 3-5 days that abruptly ends, followed by a maculopapular rash. Fifth disease
causes "slapped cheek" rash with fever. Varicella causes vesicular rash.
Q5. A 70-year-old male patient complains of a bright red-colored spot in his left
eye for 2 days. He denies eye pain, visual changes, or headaches. He has a new
,onset of cough from a recent viral URI. The only medicine he is on is Bayer
aspirin, 1 tablet a day. Which of the following is most likely?
A. Corneal abrasion
B. Acute bacterial conjunctivitis
C. Acute uveitis
D. Subconjunctival hemorrhage
Answer: D. Subconjunctival hemorrhage
Rationale: Bright red blood in a sharply defined area surrounded by normal
conjunctiva is classic for subconjunctival hemorrhage. It is painless, often
triggered by coughing, sneezing, or aspirin use.
Q6. A woman is being evaluated for dyspareunia. Microscopy reveals large
numbers of atrophic squamous epithelial cells. Vaginal pH is 4.0. Very few
leukocytes and no RBCs are seen. Which of the following is most likely?
A. Atrophic vaginitis
B. Bacterial vaginosis
C. Trichomoniasis
D. This is a normal finding
Answer: A. Atrophic vaginitis
Rationale: Atrophic vaginitis (due to estrogen deficiency) presents with
dyspareunia, atrophic epithelial cells, and a normal acidic pH (3.8-4.5). BV has pH
>4.5 and clue cells. Trichomoniasis has pH >4.5 and motile trichomonads.
Q7. The most common type of skin malignancy is:
A. Squamous cell cancer
B. Basal skin cancer
C. Melanoma
, D. Dysplastic nevi
Answer: B. Basal skin cancer
Rationale: Basal cell carcinoma is the most common skin malignancy, accounting
for about 80% of all skin cancers. It is several times more common than squamous
cell carcinoma.
Q8. Koplik's spots are associated with:
A. Poxvirus infections
B. Measles
C. Kawasaki's disease
D. Reye's syndrome
Answer: B. Measles
Rationale: Koplik's spots (small white spots on buccal mucosa) are
pathognomonic for measles (rubeola), appearing before the rash. They are not
seen in other viral exanthems.
Q9. At what level of prevention would you classify screening for lung cancer?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Primordial prevention
Answer: B. Secondary prevention
Rationale: Secondary prevention focuses on early detection and screening (e.g.,
low-dose CT for lung cancer in high-risk populations). Primary prevention
prevents disease onset. Tertiary prevention reduces complications. Primordial
prevention prevents risk factors.
APEA Predictor Exam 4 2025-2026
UPDATE ACTUAL EXAM ALL QUESTIONS
AND CORRECT DETAILED ANSWERS.
Q1. In the majority of children, the first permanent teeth start to erupt at the
age of 6 years. Which of the following are the first permanent teeth to erupt in
this time period?
A. First Molars
B. Second Molars
C. Lower or upper incisors
D. Canines
Answer: A. First Molars
Rationale: The first permanent molars (often called "six-year molars") are
typically the first permanent teeth to erupt, around age 6. They erupt behind the
primary second molars and do not replace any primary teeth.
Q2. All of the following are classified as activities of daily living (ADLs) except:
A. Ability to feed self
B. Ability to manage bladder and bowel elimination
C. Personal hygiene and grooming
D. Grocery shopping
Answer: D. Grocery shopping
Rationale: ADLs are basic self-care tasks (eating, toileting, grooming, bathing,
transferring, dressing). Grocery shopping is an Instrumental Activity of Daily Living
(IADL), which includes more complex skills needed for independent living.
,Q3. You note the following result on a routine urinalysis of a 37-year old
primigravida at 30 weeks gestation: leukocyte = trace, nitrite = negative, protein
= 2+, blood = negative. Her weight has increased by 5 lbs during the past week.
Which of the following is most likely?
A. HELLP syndrome
B. Pregnancy-induced hypertension (pre-eclampsia)
C. Eclampsia of pregnancy
D. Primary hypertension
Answer: B. Pregnancy-induced hypertension (pre-eclampsia)
Rationale: The classic triad of preeclampsia includes hypertension, edema (rapid
weight gain), and proteinuria (2+). HELLP syndrome involves hemolysis, elevated
liver enzymes, and low platelets. Eclampsia includes seizures. Primary
hypertension lacks proteinuria.
Q4. The mother of a 12-month-old infant reports that her child had a high fever
for several days, which spontaneously resolved. After the fever resolved, the
child developed a maculopapular rash. Which of the following is the most likely?
A. Fifth Disease (erythema infectiosum)
B. Roseola infantum (exanthema subitum)
C. Varicella
D. Infantile maculopapular rashes
Answer: B. Roseola infantum (exanthema subitum)
Rationale: Roseola is classically described as "fever first, rash later" – high fever
for 3-5 days that abruptly ends, followed by a maculopapular rash. Fifth disease
causes "slapped cheek" rash with fever. Varicella causes vesicular rash.
Q5. A 70-year-old male patient complains of a bright red-colored spot in his left
eye for 2 days. He denies eye pain, visual changes, or headaches. He has a new
,onset of cough from a recent viral URI. The only medicine he is on is Bayer
aspirin, 1 tablet a day. Which of the following is most likely?
A. Corneal abrasion
B. Acute bacterial conjunctivitis
C. Acute uveitis
D. Subconjunctival hemorrhage
Answer: D. Subconjunctival hemorrhage
Rationale: Bright red blood in a sharply defined area surrounded by normal
conjunctiva is classic for subconjunctival hemorrhage. It is painless, often
triggered by coughing, sneezing, or aspirin use.
Q6. A woman is being evaluated for dyspareunia. Microscopy reveals large
numbers of atrophic squamous epithelial cells. Vaginal pH is 4.0. Very few
leukocytes and no RBCs are seen. Which of the following is most likely?
A. Atrophic vaginitis
B. Bacterial vaginosis
C. Trichomoniasis
D. This is a normal finding
Answer: A. Atrophic vaginitis
Rationale: Atrophic vaginitis (due to estrogen deficiency) presents with
dyspareunia, atrophic epithelial cells, and a normal acidic pH (3.8-4.5). BV has pH
>4.5 and clue cells. Trichomoniasis has pH >4.5 and motile trichomonads.
Q7. The most common type of skin malignancy is:
A. Squamous cell cancer
B. Basal skin cancer
C. Melanoma
, D. Dysplastic nevi
Answer: B. Basal skin cancer
Rationale: Basal cell carcinoma is the most common skin malignancy, accounting
for about 80% of all skin cancers. It is several times more common than squamous
cell carcinoma.
Q8. Koplik's spots are associated with:
A. Poxvirus infections
B. Measles
C. Kawasaki's disease
D. Reye's syndrome
Answer: B. Measles
Rationale: Koplik's spots (small white spots on buccal mucosa) are
pathognomonic for measles (rubeola), appearing before the rash. They are not
seen in other viral exanthems.
Q9. At what level of prevention would you classify screening for lung cancer?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Primordial prevention
Answer: B. Secondary prevention
Rationale: Secondary prevention focuses on early detection and screening (e.g.,
low-dose CT for lung cancer in high-risk populations). Primary prevention
prevents disease onset. Tertiary prevention reduces complications. Primordial
prevention prevents risk factors.
