APEA 3P High Stakes Actual Exam Study
Guide Qs & Ans to Pass the Exam (2026 /
2027), 100% Verified
hypertension
Stage 1 (140-159/90-99)
Hypertension: If Goal BP is not reached at __ month, increase the dose on the initial
drug and/or add a second drug
• If Goal BP is not reached at 1 month, increase the dose on the initial drug and/or add a
second drug
Thiazide diuretics; do not give to a patient with a _____ allergy
Do not give thiazide diuretics to a patient who has a sulfa allergy
Ace inhibitors
-pril: HTN, HF. AD: angioedema, cough, hypotension, hyperkalemia, hepatotoxicity,
neutropenia, agranulocytosis, pancreatitis, SJS. Contra: pregnancy. Nursing: empty
stomach, monitor for infection, dry cough, use contraception (teratogenic), avoid sports
drinks/salt substitutes (extra K)
ARB drugs
-sartan
Losartan
Valsartan
HTN drug of choice for diabetics
Ace inhibitors or ARBS
these protect kidneys
Do not use Ace drugs and _____ together
Do not use Ace drugs (lisinopril) and Arb drugs (losartan) together
Beta bocker
,-olol
Avoid abrupt discontinuation: wean slowly to avoid rebound HTN
Calcium channel blocker
"CA" Calan, Procardia, Cardizem
Slow the HR and decrease BP (check HR and BP before). Inhibits mvmt of Calcium ions
across membrane or cardiac and arterial muscle cells. Results in slowed impulse
conduction, depression of myocardial constractility, dilation of coroanry arteries.
SE: Constipation
Procardia sometimes causes peripheral edema
First line treatment of HTN for african americans
CCB or Thiazide
CCB: cardizem, diltiazem
New York Heart Association (NYHA) Function Capacity: Heart failure classification
Class II: ordinary activity results in fatigue and dyspnea
*Symptoms 1st appear*
Left sided heart failure effects ?
Lungs
S3, crackles, decreased breath sounds, wheezing
Right sided heart failure effects?
Edema
JVD (jugular vein distention)
Dyspnea on exertion
BMI (body mass index)
Underweight - Less than 18.5
Normal - 18.5 - 24.9
Overweight - 25 - 29.9
Obese - 30 - 39.9
,Hypercholesterolemia
excessive cholesterol in the blood
statin first line
*When triglycerides are extremely high , goal ist o lower them to prevent pancreatitis*
Prior to starting statins you should
check Liver function tests (LFT's)
Rhabdomylosis, what drug do you hold?
Hold statin and hydrate
Pulmonary embolism
most common cause is a DVT
cough may be productive and pink tinged
tachycardia, pallor and the feeling of impending doom
Anaphylaxis is a ___ mediated reaction
IgE
Give 1:1000 IM or Subq then call 911; have one give epi and then one call 911
Percussion: Resonance
low pitched, hollow sounds heard over normal lung tissue
Percussion: Dull
Heard over fluid filled organs such as the heart or liver. Pleaural effusion or lobar
pneumonia
Percussion: hyper-resonant sound
emphysema
Spirometry helps diagnose
COPD
FEVI less than 80% predicted
FEV1/FVC ratio of <0.7 is diagnostic for COPD
#1 risk factor for COPD
, smoking
COPD gold guidelines
Anticholinergics are first line for COPD (ipratropium/Atrovent)
chronic bronchitis
Productive cough that occurs >3 months/year for 2 consecutive years --> dirty-chest
appearance on CXR
Typically are "blue bloaters" (overweight and cyanotic)
**Clinical Diagnosis**
common side effect of ACE inhibitors
Dry cough.
Increased potassium levels in the blood (hyperkalemia)
Fatigue.
Dizziness from blood pressure going too low.
Headaches.
Loss of taste.
Most common type of skin cancer in USA
Skin cancer
Most common type of skin cancer
basal cell carcinoma
basal cell carcinoma symptoms
Appearance varies; smooth, shiny bump, pink to pearly white
Basal cell carcinoma common locations
cheeks, nose, face, neck, arms, back
basal cell carcinoma diagnosis gold standard
biopsy. if not an option, refer to derm
Actinic keratosis
Guide Qs & Ans to Pass the Exam (2026 /
2027), 100% Verified
hypertension
Stage 1 (140-159/90-99)
Hypertension: If Goal BP is not reached at __ month, increase the dose on the initial
drug and/or add a second drug
• If Goal BP is not reached at 1 month, increase the dose on the initial drug and/or add a
second drug
Thiazide diuretics; do not give to a patient with a _____ allergy
Do not give thiazide diuretics to a patient who has a sulfa allergy
Ace inhibitors
-pril: HTN, HF. AD: angioedema, cough, hypotension, hyperkalemia, hepatotoxicity,
neutropenia, agranulocytosis, pancreatitis, SJS. Contra: pregnancy. Nursing: empty
stomach, monitor for infection, dry cough, use contraception (teratogenic), avoid sports
drinks/salt substitutes (extra K)
ARB drugs
-sartan
Losartan
Valsartan
HTN drug of choice for diabetics
Ace inhibitors or ARBS
these protect kidneys
Do not use Ace drugs and _____ together
Do not use Ace drugs (lisinopril) and Arb drugs (losartan) together
Beta bocker
,-olol
Avoid abrupt discontinuation: wean slowly to avoid rebound HTN
Calcium channel blocker
"CA" Calan, Procardia, Cardizem
Slow the HR and decrease BP (check HR and BP before). Inhibits mvmt of Calcium ions
across membrane or cardiac and arterial muscle cells. Results in slowed impulse
conduction, depression of myocardial constractility, dilation of coroanry arteries.
SE: Constipation
Procardia sometimes causes peripheral edema
First line treatment of HTN for african americans
CCB or Thiazide
CCB: cardizem, diltiazem
New York Heart Association (NYHA) Function Capacity: Heart failure classification
Class II: ordinary activity results in fatigue and dyspnea
*Symptoms 1st appear*
Left sided heart failure effects ?
Lungs
S3, crackles, decreased breath sounds, wheezing
Right sided heart failure effects?
Edema
JVD (jugular vein distention)
Dyspnea on exertion
BMI (body mass index)
Underweight - Less than 18.5
Normal - 18.5 - 24.9
Overweight - 25 - 29.9
Obese - 30 - 39.9
,Hypercholesterolemia
excessive cholesterol in the blood
statin first line
*When triglycerides are extremely high , goal ist o lower them to prevent pancreatitis*
Prior to starting statins you should
check Liver function tests (LFT's)
Rhabdomylosis, what drug do you hold?
Hold statin and hydrate
Pulmonary embolism
most common cause is a DVT
cough may be productive and pink tinged
tachycardia, pallor and the feeling of impending doom
Anaphylaxis is a ___ mediated reaction
IgE
Give 1:1000 IM or Subq then call 911; have one give epi and then one call 911
Percussion: Resonance
low pitched, hollow sounds heard over normal lung tissue
Percussion: Dull
Heard over fluid filled organs such as the heart or liver. Pleaural effusion or lobar
pneumonia
Percussion: hyper-resonant sound
emphysema
Spirometry helps diagnose
COPD
FEVI less than 80% predicted
FEV1/FVC ratio of <0.7 is diagnostic for COPD
#1 risk factor for COPD
, smoking
COPD gold guidelines
Anticholinergics are first line for COPD (ipratropium/Atrovent)
chronic bronchitis
Productive cough that occurs >3 months/year for 2 consecutive years --> dirty-chest
appearance on CXR
Typically are "blue bloaters" (overweight and cyanotic)
**Clinical Diagnosis**
common side effect of ACE inhibitors
Dry cough.
Increased potassium levels in the blood (hyperkalemia)
Fatigue.
Dizziness from blood pressure going too low.
Headaches.
Loss of taste.
Most common type of skin cancer in USA
Skin cancer
Most common type of skin cancer
basal cell carcinoma
basal cell carcinoma symptoms
Appearance varies; smooth, shiny bump, pink to pearly white
Basal cell carcinoma common locations
cheeks, nose, face, neck, arms, back
basal cell carcinoma diagnosis gold standard
biopsy. if not an option, refer to derm
Actinic keratosis
