APEA Predictor Exam – Complete Study Guide with Actual Exam
Questions, Verified Correct Answers with Detailed Rationales |
Latest Update 2026/2027 | Graded A+
Question 1
A 68-year-old man presents with increasing shortness of breath over the past
week. He has a history of hypertension, coronary artery disease, and heart
failure with reduced ejection fraction. Physical examination reveals bilateral
crackles at the lung bases, jugular venous distention, and 2+ pitting edema of
both lower extremities. His blood pressure is 158/92 mmHg, heart rate is 104
beats/min, respiratory rate is 24 breaths/min, and oxygen saturation is 91%
on room air.
Which medication should be initiated first to improve his acute symptoms?
A. Metoprolol
B. Furosemide
C. Atorvastatin
D. Aspirin
Correct Answer: B
Rationale
This patient is experiencing acute decompensated heart failure with evidence
of volume overload. Loop diuretics such as furosemide rapidly reduce
pulmonary and peripheral congestion by promoting diures
Question 2
A 24-year-old woman presents with dysuria, urinary frequency, and urgency
for two days. She denies fever, flank pain, or vaginal discharge. Urinalysis
reveals positive leukocyte esterase and nitrites.
1|Page
,What is the most likely diagnosis?
A. Acute pyelonephritis
B. Acute uncomplicated cystitis
C. Vaginitis
D. Interstitial cystitis
Correct Answer: B
Rationale
The patient has classic symptoms of an uncomplicated lower urinary tract
infection without systemic signs of upper tract involvement.
Question 3
A 57-year-old man with type 2 diabetes has an HbA1c of 9.2% despite
adherence to metformin. His estimated glomerular filtration rate (eGFR) is
normal, and he has established atherosclerotic cardiovascular disease.
Which medication provides both glycemic control and cardiovascular benefit?
A. Glyburide
B. Empagliflozin
C. Regular insulin only
D. Acarbose
Correct Answer: B
Rationale
SGLT2 inhibitors such as empagliflozin improve glycemic control and reduce
cardiovascular and heart failure events in appropriate patients.
2|Page
,Question 4
A patient presents with sudden onset unilateral facial drooping involving the
forehead, inability to close one eye, and loss of taste on the anterior tongue.
No extremity weakness is present.
What is the most likely diagnosis?
A. Bell's palsy
B. Ischemic stroke
C. Trigeminal neuralgia
D. Myasthenia gravis
Correct Answer: A
Rationale
Bell's palsy affects the entire ipsilateral face, including the forehead, unlike a
typical cortical stroke, which usually spares the forehead.
Question 5
A 65-year-old smoker reports coughing up blood, unexplained weight loss,
and persistent cough for three months.
Which diagnostic study should be obtained first?
A. Chest radiograph
B. Pulmonary function testing
C. Allergy testing
D. Echocardiogram
3|Page
, Correct Answer: A
Rationale
A chest radiograph is the appropriate initial imaging study for hemoptysis and
suspected lung pathology. Abnormal findings often lead to chest CT and
further evaluation.
Question 6
A patient with atrial fibrillation has a CHA₂DS₂-VASc score of 4.
What is the most appropriate management?
A. Aspirin alone
B. Oral anticoagulation unless contraindicated
C. No therapy
D. Daily NSAID therapy
Correct Answer: B
Rationale
A CHA₂DS₂-VASc score of 4 indicates a significant risk of stroke, and oral
anticoagulation is generally recommended unless contraindicated.
Question 7
A 45-year-old woman reports fatigue, cold intolerance, constipation, and
weight gain. Laboratory testing shows elevated thyroid-stimulating hormone
(TSH) and low free thyroxine (T4).
Which diagnosis is most likely?
A. Hyperthyroidism
4|Page
Questions, Verified Correct Answers with Detailed Rationales |
Latest Update 2026/2027 | Graded A+
Question 1
A 68-year-old man presents with increasing shortness of breath over the past
week. He has a history of hypertension, coronary artery disease, and heart
failure with reduced ejection fraction. Physical examination reveals bilateral
crackles at the lung bases, jugular venous distention, and 2+ pitting edema of
both lower extremities. His blood pressure is 158/92 mmHg, heart rate is 104
beats/min, respiratory rate is 24 breaths/min, and oxygen saturation is 91%
on room air.
Which medication should be initiated first to improve his acute symptoms?
A. Metoprolol
B. Furosemide
C. Atorvastatin
D. Aspirin
Correct Answer: B
Rationale
This patient is experiencing acute decompensated heart failure with evidence
of volume overload. Loop diuretics such as furosemide rapidly reduce
pulmonary and peripheral congestion by promoting diures
Question 2
A 24-year-old woman presents with dysuria, urinary frequency, and urgency
for two days. She denies fever, flank pain, or vaginal discharge. Urinalysis
reveals positive leukocyte esterase and nitrites.
1|Page
,What is the most likely diagnosis?
A. Acute pyelonephritis
B. Acute uncomplicated cystitis
C. Vaginitis
D. Interstitial cystitis
Correct Answer: B
Rationale
The patient has classic symptoms of an uncomplicated lower urinary tract
infection without systemic signs of upper tract involvement.
Question 3
A 57-year-old man with type 2 diabetes has an HbA1c of 9.2% despite
adherence to metformin. His estimated glomerular filtration rate (eGFR) is
normal, and he has established atherosclerotic cardiovascular disease.
Which medication provides both glycemic control and cardiovascular benefit?
A. Glyburide
B. Empagliflozin
C. Regular insulin only
D. Acarbose
Correct Answer: B
Rationale
SGLT2 inhibitors such as empagliflozin improve glycemic control and reduce
cardiovascular and heart failure events in appropriate patients.
2|Page
,Question 4
A patient presents with sudden onset unilateral facial drooping involving the
forehead, inability to close one eye, and loss of taste on the anterior tongue.
No extremity weakness is present.
What is the most likely diagnosis?
A. Bell's palsy
B. Ischemic stroke
C. Trigeminal neuralgia
D. Myasthenia gravis
Correct Answer: A
Rationale
Bell's palsy affects the entire ipsilateral face, including the forehead, unlike a
typical cortical stroke, which usually spares the forehead.
Question 5
A 65-year-old smoker reports coughing up blood, unexplained weight loss,
and persistent cough for three months.
Which diagnostic study should be obtained first?
A. Chest radiograph
B. Pulmonary function testing
C. Allergy testing
D. Echocardiogram
3|Page
, Correct Answer: A
Rationale
A chest radiograph is the appropriate initial imaging study for hemoptysis and
suspected lung pathology. Abnormal findings often lead to chest CT and
further evaluation.
Question 6
A patient with atrial fibrillation has a CHA₂DS₂-VASc score of 4.
What is the most appropriate management?
A. Aspirin alone
B. Oral anticoagulation unless contraindicated
C. No therapy
D. Daily NSAID therapy
Correct Answer: B
Rationale
A CHA₂DS₂-VASc score of 4 indicates a significant risk of stroke, and oral
anticoagulation is generally recommended unless contraindicated.
Question 7
A 45-year-old woman reports fatigue, cold intolerance, constipation, and
weight gain. Laboratory testing shows elevated thyroid-stimulating hormone
(TSH) and low free thyroxine (T4).
Which diagnosis is most likely?
A. Hyperthyroidism
4|Page
