3P APEA EXAM Update
1. +what is the significance of AV nicking? -- Correct Answer --this is indicative of
longstanding hypertension
2. A 15-year-old male has worked this summer as a lifeguard at a local swimming pool. He
complains of itching in the groin area. He is dx with tinea cruris. The NP is likely to
identify -- Correct Answer --well marginated half moon shape macules on the inner thigh
3. A 30-year-old female pt. with complaints of fatigue undergoes a screening TSH. Her TSH
is 8 what should be done next? -- Correct Answer --repeat the TSH and add T4
4. a 38-year-old male pt. presents for his annual exam. He reports nervousness and weight
loss, but denies any change in his dietary intake or exercise level. Based on this findings
and the following lab values: TSH 0.01, free T4 6, free T3 205. what is the most likely
dx? -- Correct Answer --Hyperthyroidism
5. A 40-year-old African-American pt. has a b/p of 175/100 and 170/102. What is a
reasonable plan of care for this pt today? -- Correct Answer --initiate amlodipine 5mg
daily
6. a 40-year-old pt. with newly dx of T2DM asks what his target b/p should be. the most
correct answer is: -- Correct Answer --less than 140/90
7. A 43 year old Hispanic male has an audible diastolic murmur best heard in the mitral
listening point. There is no audible click. His status has been monitored for the past two
years. This murmur is probably -- Correct Answer --mitral stenosis
8. A 45-year-old female pt has fatigue for the past 3 months and a 10-lbs weight gain. She
previously had regular menses occurring about every 30 days, but in the last 3 months her
, menses have varied between 30-45 days . Her TSH value is 13. It was repeated 1week
later and found to be 15. What explains this finding? -- Correct Answer --hypothyroidism
9. A 50-year-old patient with hypertension has taken HCTZ 25mg daily for the past 4
weeks. Her b/p has decreased from 155/95 to 145/90. How should the NP proceed? --
Correct Answer --add another drug from another class to the daily 25mg HCTZ
10. A 52-year-old presents w/thirst and frequent urination today. His glucose is 352. How
should this be managed today? -- Correct Answer --start insulin
11. A 65-year-old diabetic has been on oral antihyperglycemic agents and is still having poor
glycemic control. His AM fasting glucose range from 140-160. You decide to add insulin.
He weighs 127 kg. What should the NP order as an initial starting dose? -- Correct
Answer --10u of long-acting insulin at bedtime
12. A 70-year-old pt. has begun to have hearing loss. She relates that her elderly parents had
difficulty hearing. Which complaints below is typical of presbycusis? -- Correct Answer -
-inability to hear consonants
13. A 74 year old patient has PAD. Which item listed below is an important nonmodifiable
risk factor for PAD? -- Correct Answer --diabetes
14. A 74-year-old is dx w/shingles. The NP is deciding how to best manage her care. What
should be prescribed? -- Correct Answer --an oral antiviral agent
15. a 74-year-old patient has had an increase in b/p since the last exam. his b/p has increased
from 144/90 to reading in the upper 160's/upper 80's. If medication is to be started on this
patient, what would be a good first choice? -- Correct Answer --Calcium channel blocker
1. +what is the significance of AV nicking? -- Correct Answer --this is indicative of
longstanding hypertension
2. A 15-year-old male has worked this summer as a lifeguard at a local swimming pool. He
complains of itching in the groin area. He is dx with tinea cruris. The NP is likely to
identify -- Correct Answer --well marginated half moon shape macules on the inner thigh
3. A 30-year-old female pt. with complaints of fatigue undergoes a screening TSH. Her TSH
is 8 what should be done next? -- Correct Answer --repeat the TSH and add T4
4. a 38-year-old male pt. presents for his annual exam. He reports nervousness and weight
loss, but denies any change in his dietary intake or exercise level. Based on this findings
and the following lab values: TSH 0.01, free T4 6, free T3 205. what is the most likely
dx? -- Correct Answer --Hyperthyroidism
5. A 40-year-old African-American pt. has a b/p of 175/100 and 170/102. What is a
reasonable plan of care for this pt today? -- Correct Answer --initiate amlodipine 5mg
daily
6. a 40-year-old pt. with newly dx of T2DM asks what his target b/p should be. the most
correct answer is: -- Correct Answer --less than 140/90
7. A 43 year old Hispanic male has an audible diastolic murmur best heard in the mitral
listening point. There is no audible click. His status has been monitored for the past two
years. This murmur is probably -- Correct Answer --mitral stenosis
8. A 45-year-old female pt has fatigue for the past 3 months and a 10-lbs weight gain. She
previously had regular menses occurring about every 30 days, but in the last 3 months her
, menses have varied between 30-45 days . Her TSH value is 13. It was repeated 1week
later and found to be 15. What explains this finding? -- Correct Answer --hypothyroidism
9. A 50-year-old patient with hypertension has taken HCTZ 25mg daily for the past 4
weeks. Her b/p has decreased from 155/95 to 145/90. How should the NP proceed? --
Correct Answer --add another drug from another class to the daily 25mg HCTZ
10. A 52-year-old presents w/thirst and frequent urination today. His glucose is 352. How
should this be managed today? -- Correct Answer --start insulin
11. A 65-year-old diabetic has been on oral antihyperglycemic agents and is still having poor
glycemic control. His AM fasting glucose range from 140-160. You decide to add insulin.
He weighs 127 kg. What should the NP order as an initial starting dose? -- Correct
Answer --10u of long-acting insulin at bedtime
12. A 70-year-old pt. has begun to have hearing loss. She relates that her elderly parents had
difficulty hearing. Which complaints below is typical of presbycusis? -- Correct Answer -
-inability to hear consonants
13. A 74 year old patient has PAD. Which item listed below is an important nonmodifiable
risk factor for PAD? -- Correct Answer --diabetes
14. A 74-year-old is dx w/shingles. The NP is deciding how to best manage her care. What
should be prescribed? -- Correct Answer --an oral antiviral agent
15. a 74-year-old patient has had an increase in b/p since the last exam. his b/p has increased
from 144/90 to reading in the upper 160's/upper 80's. If medication is to be started on this
patient, what would be a good first choice? -- Correct Answer --Calcium channel blocker
