APEA 3P Actual Nursing Exam: 200 NP
Certification Questions with Correct
Answers & Explanations.
1. A nurse practitioner prescribes lisinopril for a patient recently diagnosed
with hypertension. Which adverse effect should the clinician discuss as a
possible reason to discontinue the medication?
A. Bradycardia
B. Cough
C. Constipation
D. Hypoglycemia
Correct Answer: B. Cough
ACE inhibitors like lisinopril can cause a persistent dry cough due to the
accumulation of bradykinin. This side effect often leads to a switch to an
angiotensin receptor blocker (ARB). Bradycardia and hypoglycemia are not
characteristic effects, and constipation is unrelated.
2. A patient with asthma is started on a non-selective beta blocker. What
adverse event might occur?
A. Hypotension crisis
B. Bronchoconstriction
C. Cardiac arrhythmias
D. Diuresis
,Correct Answer: B. Bronchoconstriction
Non-selective beta-blockers such as propranolol block both beta-one and
beta-two receptors. Beta-two blockade in the bronchial smooth muscle can
provoke bronchospasm, making these agents contraindicated in patients with
asthma.
3. Which of the following findings is most specific for left-sided heart
failure?
A. Peripheral edema
B. Ascites
C. Bibasilar crackles
D. Hepatomegaly
Correct Answer: C. Bibasilar crackles
Bibasilar crackles, also known as rales, are a classic sign of pulmonary
congestion resulting from left-sided heart failure. Peripheral edema, ascites,
and hepatomegaly are more characteristic of right-sided heart failure.
4. A patient presents with unilateral swelling, warmth, and erythema in the
left calf following a long flight. Which physical examination maneuver is
most specific for diagnosing deep vein thrombosis?
A. Homans sign
B. Palpable cord
C. Pitting edema
D. Distal cyanosis
,Correct Answer: B. Palpable cord
While Homans sign is historically associated with DVT, it is neither sensitive
nor specific. A palpable venous cord along the affected vessel is a more
specific physical finding for deep vein thrombosis, though imaging remains
the diagnostic standard.
5. Which laboratory value should be monitored closely in a patient
prescribed amiodarone for atrial fibrillation?
A. Serum potassium
B. Thyroid function tests
C. Serum creatinine
D. Liver enzymes
Correct Answer: B. Thyroid function tests
Amiodarone has a high iodine content and can cause both hypothyroidism
and hyperthyroidism due to its effects on thyroid hormone metabolism.
Baseline and periodic thyroid function monitoring is essential.
6. A patient reports a rash after starting trimethoprim-sulfamethoxazole.
What is the most concerning potential adverse reaction associated with this
antibiotic?
A. Photosensitivity
B. Stevens-Johnson syndrome
C. Gastrointestinal upset
D. Candidiasis
, Correct Answer: B. Stevens-Johnson syndrome
Trimethoprim-sulfamethoxazole is a sulfonamide antibiotic known to cause
severe cutaneous adverse reactions, including Stevens-Johnson syndrome and
toxic epidermal necrolysis. Although the other options are possible, they are
not as immediately life-threatening.
7. What is the primary mechanism of action of metformin?
A. Stimulating insulin secretion
B. Increasing peripheral glucose uptake
C. Decreasing hepatic glucose production
D. Delaying carbohydrate absorption
Correct Answer: C. Decreasing hepatic glucose production
Metformin primarily reduces hepatic gluconeogenesis and also increases
peripheral insulin sensitivity. It does not stimulate insulin release like
sulfonylureas, nor does it delay carbohydrate absorption like alpha-
glucosidase inhibitors.
8. A patient with chronic kidney disease is started on lisinopril. Which
electrolyte imbalance requires the closest monitoring?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Certification Questions with Correct
Answers & Explanations.
1. A nurse practitioner prescribes lisinopril for a patient recently diagnosed
with hypertension. Which adverse effect should the clinician discuss as a
possible reason to discontinue the medication?
A. Bradycardia
B. Cough
C. Constipation
D. Hypoglycemia
Correct Answer: B. Cough
ACE inhibitors like lisinopril can cause a persistent dry cough due to the
accumulation of bradykinin. This side effect often leads to a switch to an
angiotensin receptor blocker (ARB). Bradycardia and hypoglycemia are not
characteristic effects, and constipation is unrelated.
2. A patient with asthma is started on a non-selective beta blocker. What
adverse event might occur?
A. Hypotension crisis
B. Bronchoconstriction
C. Cardiac arrhythmias
D. Diuresis
,Correct Answer: B. Bronchoconstriction
Non-selective beta-blockers such as propranolol block both beta-one and
beta-two receptors. Beta-two blockade in the bronchial smooth muscle can
provoke bronchospasm, making these agents contraindicated in patients with
asthma.
3. Which of the following findings is most specific for left-sided heart
failure?
A. Peripheral edema
B. Ascites
C. Bibasilar crackles
D. Hepatomegaly
Correct Answer: C. Bibasilar crackles
Bibasilar crackles, also known as rales, are a classic sign of pulmonary
congestion resulting from left-sided heart failure. Peripheral edema, ascites,
and hepatomegaly are more characteristic of right-sided heart failure.
4. A patient presents with unilateral swelling, warmth, and erythema in the
left calf following a long flight. Which physical examination maneuver is
most specific for diagnosing deep vein thrombosis?
A. Homans sign
B. Palpable cord
C. Pitting edema
D. Distal cyanosis
,Correct Answer: B. Palpable cord
While Homans sign is historically associated with DVT, it is neither sensitive
nor specific. A palpable venous cord along the affected vessel is a more
specific physical finding for deep vein thrombosis, though imaging remains
the diagnostic standard.
5. Which laboratory value should be monitored closely in a patient
prescribed amiodarone for atrial fibrillation?
A. Serum potassium
B. Thyroid function tests
C. Serum creatinine
D. Liver enzymes
Correct Answer: B. Thyroid function tests
Amiodarone has a high iodine content and can cause both hypothyroidism
and hyperthyroidism due to its effects on thyroid hormone metabolism.
Baseline and periodic thyroid function monitoring is essential.
6. A patient reports a rash after starting trimethoprim-sulfamethoxazole.
What is the most concerning potential adverse reaction associated with this
antibiotic?
A. Photosensitivity
B. Stevens-Johnson syndrome
C. Gastrointestinal upset
D. Candidiasis
, Correct Answer: B. Stevens-Johnson syndrome
Trimethoprim-sulfamethoxazole is a sulfonamide antibiotic known to cause
severe cutaneous adverse reactions, including Stevens-Johnson syndrome and
toxic epidermal necrolysis. Although the other options are possible, they are
not as immediately life-threatening.
7. What is the primary mechanism of action of metformin?
A. Stimulating insulin secretion
B. Increasing peripheral glucose uptake
C. Decreasing hepatic glucose production
D. Delaying carbohydrate absorption
Correct Answer: C. Decreasing hepatic glucose production
Metformin primarily reduces hepatic gluconeogenesis and also increases
peripheral insulin sensitivity. It does not stimulate insulin release like
sulfonylureas, nor does it delay carbohydrate absorption like alpha-
glucosidase inhibitors.
8. A patient with chronic kidney disease is started on lisinopril. Which
electrolyte imbalance requires the closest monitoring?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
