1
APEA 3P Predictor Test Bank 2025 |
Questions, NCLEX-Style Answers & Detailed
Explanations
APEA 3P – Advanced Practice Education
Associates: 3P Predictor Exam
, 2
APEA 3P Predictor Test Bank 2025 | Questions, NCLEX-Style Answers &
Detailed
1. A nurse practitioner is performing a skin exam and identifies a pearly, translucent
papule with telangiectasia on a patient’s nose. What is the most likely diagnosis?
a. Squamous cell carcinoma
b. Basal cell carcinoma
c. Actinic keratosis
d. Melanoma
Correct answer is: Basal cell carcinoma
Explanation:
Basal cell carcinoma (BCC) is the most common skin cancer in the U.S. and typically presents
as a pearly or translucent papule with visible surface blood vessels (telangiectasia), often on
sun-exposed areas like the nose. It grows slowly and rarely metastasizes but can be locally
invasive if untreated. Squamous cell carcinoma appears as a scaly or crusted lesion and may
bleed. Actinic keratosis is a precancerous lesion that’s dry and scaly. Melanoma is pigmented
with irregular borders and rapid growth. Management for BCC often involves surgical excision
or Mohs micrographic surgery.
2. A 45-year-old patient presents with fatigue, weight loss, and increased thirst. His fasting
glucose is 180 mg/dL. What’s the most likely diagnosis?
a. Hyperthyroidism
b. Type 2 Diabetes Mellitus
c. Hypertension
d. Acute myocardial infarction
Correct answer is: Type 2 Diabetes Mellitus
Explanation:
Classic symptoms—polyuria, polydipsia, weight loss—and a fasting glucose level ≥126 mg/dL
point toward type 2 diabetes. Although hypertension and hyperthyroidism may coexist, they fail
to explain the combination of thirst, weight loss, and elevated glucose. Acute MI presents with
chest pain and not chronic metabolic symptoms. Treatment involves lifestyle modifications and
glycemic control to prevent complications.
3. A 60-year-old man has chest pain that worsens with inspiration and a pericardial friction
rub. Which diagnosis fits?
a. Pleural effusion
b. Acute pericarditis
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c. Stable angina
d. Pulmonary embolism
Correct answer is: Acute pericarditis
Explanation:
Sharp, pleuritic chest pain that improves with leaning forward, plus a pericardial friction rub, are
hallmark findings of acute pericarditis. Pleural effusion causes dull pain and reduced breath
sounds. MI (angina) rarely improves with positional changes, and PE has different exam
findings. Management includes NSAIDs, colchicine, and addressing underlying causes to
prevent complications like tamponade.
4. A 32-year-old has a red, warm, tender lower leg and fever. What is the most likely
diagnosis?
a. DVT
b. Cellulitis
c. Sprain
d. Lymphangitis
Correct answer is: Cellulitis
Explanation:
Cellulitis presents as localized erythema, warmth, tenderness, and systemic symptoms (fever).
DVT can cause swelling and tenderness but less erythema and warmth. Lymphangitis shows red
streaking, and sprains lack infection signs. Treatment involves antibiotics, limb elevation, and
pain control to prevent spread to deeper tissues or sepsis.
5. A 60-year-old female presents with sudden severe headache, papilledema, and BP
220/120 mmHg. What’s the most likely diagnosis?
a. Hypertensive emergency
b. Stroke
c. Subarachnoid hemorrhage
d. Migraine headache
Correct answer is: Hypertensive emergency
Explanation:
A hypertensive emergency includes severely elevated BP with end-organ damage—here
indicated by papilledema. Stroke and SAH feature neurological deficits or meningeal signs,
whereas migraine lacks papilledema and extreme hypertension. Immediate BP reduction with IV
antihypertensives is required to prevent further damage.
, 4
6. Which medication might cause delirium and urinary incontinence in an 80-year-old
patient?
a. Short-acting beta-agonist
b. Inhaled corticosteroid
c. Oral corticosteroid
d. Long-acting beta-agonist
Correct answer is: Oral corticosteroid
Explanation:
Oral corticosteroids can cross the blood-brain barrier in elderly patients, increasing risk of
neuropsychiatric effects such as delirium, agitation, and confusion. Additionally, corticosteroids
may lead to fluid retention and muscle involvement, exacerbating urinary incontinence. Inhaled
or long-acting agents have less systemic absorption and therefore fewer central nervous system
impacts. Assessing medication history is essential when cognitive decline or new-onset
incontinence emerges. Tapering dosages or switching to inhaled formulations under provider
guidance can mitigate these adverse effects. Close monitoring and gradual adjustments help
maintain respiratory control while reducing side effects.
7. What best describes calf pain in peripheral artery disease (PAD)?
a. Electric shock
b. Dull aching or cramping
c. Pulsating pain
d. Sharp stabbing pain
Correct answer is: Dull aching or cramping
Explanation:
PAD manifests as intermittent claudication, presenting as dull, cramping pain in calves during
exertion that eases with rest due to inadequate blood flow distal to atherosclerotic blockages.
Electric or sharp pain can suggest neuropathy, while pulsating or stabbing pain is less the norm.
Assessing ankle-brachial index (ABI) and Doppler readings confirms diagnosis. Exercise
therapy, smoking cessation, and statin/antiplatelet therapy improve outcomes and relieve
symptoms. Early PAD identification can prevent critical limb ischemia, ulceration, and
amputation.
8. During cardiac auscultation of a left-sided heart failure patient, what breath sounds are
expected?
a. Resonant percussion only
b. Vesicular with late inspiratory crackles
c. Bronchial with early inspiratory wheezes
d. Absent breath sounds
APEA 3P Predictor Test Bank 2025 |
Questions, NCLEX-Style Answers & Detailed
Explanations
APEA 3P – Advanced Practice Education
Associates: 3P Predictor Exam
, 2
APEA 3P Predictor Test Bank 2025 | Questions, NCLEX-Style Answers &
Detailed
1. A nurse practitioner is performing a skin exam and identifies a pearly, translucent
papule with telangiectasia on a patient’s nose. What is the most likely diagnosis?
a. Squamous cell carcinoma
b. Basal cell carcinoma
c. Actinic keratosis
d. Melanoma
Correct answer is: Basal cell carcinoma
Explanation:
Basal cell carcinoma (BCC) is the most common skin cancer in the U.S. and typically presents
as a pearly or translucent papule with visible surface blood vessels (telangiectasia), often on
sun-exposed areas like the nose. It grows slowly and rarely metastasizes but can be locally
invasive if untreated. Squamous cell carcinoma appears as a scaly or crusted lesion and may
bleed. Actinic keratosis is a precancerous lesion that’s dry and scaly. Melanoma is pigmented
with irregular borders and rapid growth. Management for BCC often involves surgical excision
or Mohs micrographic surgery.
2. A 45-year-old patient presents with fatigue, weight loss, and increased thirst. His fasting
glucose is 180 mg/dL. What’s the most likely diagnosis?
a. Hyperthyroidism
b. Type 2 Diabetes Mellitus
c. Hypertension
d. Acute myocardial infarction
Correct answer is: Type 2 Diabetes Mellitus
Explanation:
Classic symptoms—polyuria, polydipsia, weight loss—and a fasting glucose level ≥126 mg/dL
point toward type 2 diabetes. Although hypertension and hyperthyroidism may coexist, they fail
to explain the combination of thirst, weight loss, and elevated glucose. Acute MI presents with
chest pain and not chronic metabolic symptoms. Treatment involves lifestyle modifications and
glycemic control to prevent complications.
3. A 60-year-old man has chest pain that worsens with inspiration and a pericardial friction
rub. Which diagnosis fits?
a. Pleural effusion
b. Acute pericarditis
, 3
c. Stable angina
d. Pulmonary embolism
Correct answer is: Acute pericarditis
Explanation:
Sharp, pleuritic chest pain that improves with leaning forward, plus a pericardial friction rub, are
hallmark findings of acute pericarditis. Pleural effusion causes dull pain and reduced breath
sounds. MI (angina) rarely improves with positional changes, and PE has different exam
findings. Management includes NSAIDs, colchicine, and addressing underlying causes to
prevent complications like tamponade.
4. A 32-year-old has a red, warm, tender lower leg and fever. What is the most likely
diagnosis?
a. DVT
b. Cellulitis
c. Sprain
d. Lymphangitis
Correct answer is: Cellulitis
Explanation:
Cellulitis presents as localized erythema, warmth, tenderness, and systemic symptoms (fever).
DVT can cause swelling and tenderness but less erythema and warmth. Lymphangitis shows red
streaking, and sprains lack infection signs. Treatment involves antibiotics, limb elevation, and
pain control to prevent spread to deeper tissues or sepsis.
5. A 60-year-old female presents with sudden severe headache, papilledema, and BP
220/120 mmHg. What’s the most likely diagnosis?
a. Hypertensive emergency
b. Stroke
c. Subarachnoid hemorrhage
d. Migraine headache
Correct answer is: Hypertensive emergency
Explanation:
A hypertensive emergency includes severely elevated BP with end-organ damage—here
indicated by papilledema. Stroke and SAH feature neurological deficits or meningeal signs,
whereas migraine lacks papilledema and extreme hypertension. Immediate BP reduction with IV
antihypertensives is required to prevent further damage.
, 4
6. Which medication might cause delirium and urinary incontinence in an 80-year-old
patient?
a. Short-acting beta-agonist
b. Inhaled corticosteroid
c. Oral corticosteroid
d. Long-acting beta-agonist
Correct answer is: Oral corticosteroid
Explanation:
Oral corticosteroids can cross the blood-brain barrier in elderly patients, increasing risk of
neuropsychiatric effects such as delirium, agitation, and confusion. Additionally, corticosteroids
may lead to fluid retention and muscle involvement, exacerbating urinary incontinence. Inhaled
or long-acting agents have less systemic absorption and therefore fewer central nervous system
impacts. Assessing medication history is essential when cognitive decline or new-onset
incontinence emerges. Tapering dosages or switching to inhaled formulations under provider
guidance can mitigate these adverse effects. Close monitoring and gradual adjustments help
maintain respiratory control while reducing side effects.
7. What best describes calf pain in peripheral artery disease (PAD)?
a. Electric shock
b. Dull aching or cramping
c. Pulsating pain
d. Sharp stabbing pain
Correct answer is: Dull aching or cramping
Explanation:
PAD manifests as intermittent claudication, presenting as dull, cramping pain in calves during
exertion that eases with rest due to inadequate blood flow distal to atherosclerotic blockages.
Electric or sharp pain can suggest neuropathy, while pulsating or stabbing pain is less the norm.
Assessing ankle-brachial index (ABI) and Doppler readings confirms diagnosis. Exercise
therapy, smoking cessation, and statin/antiplatelet therapy improve outcomes and relieve
symptoms. Early PAD identification can prevent critical limb ischemia, ulceration, and
amputation.
8. During cardiac auscultation of a left-sided heart failure patient, what breath sounds are
expected?
a. Resonant percussion only
b. Vesicular with late inspiratory crackles
c. Bronchial with early inspiratory wheezes
d. Absent breath sounds
