APEA Pre-Predictor Exam – FNP Board Review |
2026/ 2027 Update | 200 Questions and Correct
Answers | Complete Exam Material
2026/2027 | QUESTIONS &
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CORRECT ANSWERS | 100% VERIFIED STUDY MATERIAL
200 Questions • 3-Hour Limit • Case-Based Scenarios • Board Ready
Specialties Included:
Pediatrics • Women’s Health • Adult/Gerontology • Pharmacology • Pathophysiology • Clinical Management
Exam Overview
Exam Structure
• 200 High-Yield Questions
• Multiple-Choice + Clinical Scenarios
• Timed: 3 Hours
• Identifies Knowledge Gaps
• Designed for Board-Style Mastery
Core Domains
• Advanced Pathophysiology
• Advanced Pharmacology
• Advanced Physical Assessment
• Clinical Management
• Diagnostic Reasoning
Introduction
The Premium Predictor Exam is designed for students in the final stages of their certification
preparation. This comprehensive, high-difficulty exam mirrors the exact style, complexity, and structure of
board-certification testing. Scoring above 80% predicts first-attempt success, helping learners
pinpoint weaknesses and master essential concepts with confidence.
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Answer Format
All questions are presented in bold for clarity.
Correct answers appear in bold green, followed by a concise, clinically focused rationale in italic,
emphasizing:
✔ Advanced clinical reasoning
✔ Diagnostic accuracy
✔ Pharmacologic relevance
✔ Provider-level judgment
This format reinforces the decision-making skills required to excel on predictor exams and certification
boards.
First-Pass Effect 1. CYP450 metabolizes the drug in the liver to release the drug to the body where it
1. What cytochrome metabolizes a medication drug during can be used.
the FIRST-PASS Effect? 2. Active
2. CYP450 enzyme is the most . 3. True
3. It can either be induced or inhibited (T/F)
Pharmacokinetics
1. What are age-related changes?
(Distribution, Metabolism,
Excretion)?
1. Increase in fat-to-water ratio, decrease in liver function, decrease in GFR
Pharmacology: Cardiac Glycosides
1. What order of line of treatment is Digoxin?
2. Signs of Digoxin Overdose
3. Laboratory tests
4. Treatment
1. Second and Third
2. N/V, Hyperkalemia, Confusion, visual color changes
3. Digoxin level, CMP, EKG
4. Digoxin-specific antibodies
Pharmacology: Warfarin (Coumadin)
1. Category for pregnancy.
2. Target INR for patients without mitral prosthetic
valves? With prosthetic valves?
3. Referral to for initiation and stabilization
of warfarin dose.
4. How often do you check for consistently stable INR?
5. How often do you check for single out-of-range INR?
6. What do you educate the patient to do if the INR less
than 5 with no significant bleeding risk?
7. If one dose is missed, what do you do?
8. What kind of foods to avoid messing up the INR?
1. X
2. 2.0-3.0, 2.5-3.5
3. Cardiologist or anticoagulation clinic
4. Check every 2-4 weeks up to 12 weeks.
5. Continue warfarin dose, retest INR in 1-2 weeks.
6. Omit one dose, recheck INR.
7. Take the dose as soon as possible. Do not double dose.
8. Vitamin K foods
Pharmacology: Direct Oran Anticoagulants (DOAC)
1. Why are DOACs better than Warfarin?
2. Example of DOACs?
3. How long does it take for platelet function to return
to normal after a patient stops taking Plavix?
1. Less monitoring and less side effects
2. Apixaban (Eliquis)
3. 10 days
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Pharmacology: Thiazide Diuretics
1. Examples
2. Contraindication
3. Adverse effects
4. Patients with osteoporosis receive an extra benefit from
thiazide diuretics by reducing excretion (T/F)
1. HCTZ, Chlorthalidone
2. Sulfa allergy
3. Hykpokalemia, increases uric acid and increases LDL
4. Calcium, True
Pharmacology: Potassium-Sparing Diuretics
1. Examples
2. Contraindication
3. Adverse effects
4. Do not combine with which cardiac drugs to prevent
hyperkalemia?
1. Triamterene, Amiloride
2. Hyperkalemia
3. Elevates K+ levels
4. ACEIs and ARBs
Pharmacology: Loop Diuretics
1. Examples
2. Contraindication/Allergy
3. Adverse effects
4. Which toxicity with loop diuretics can occur?
1. Furosemide
2. Sulfa Allergy
3. Hypokalemia, Hyponatremia, hypomagnesemia
4. Ototoxicity
Pharmacology: ACEIs and ARBs
1. Examples
2. Black Box Warning/Contraindications
3. Adverse Effects
4. ACEIs are first-line therapy for
5. ACEIs and ARBs protect the kidneys. But if severe CKD,
should you continue ACEIs and ARBs? Why?
1. Lisinopril, Losartan
2. Pregnancy
3. Dry cough, Hyperkalemia, Angioedema
4. Heart Failure w/ left ventricular dysfinction (HFrEF)
5. No, because severe CKD and ACEIs and ARBs will lead to increased risk of
hyperkalemia.
Pharmacology: CCBs
1. Two types and Examples of both types
2. Cardiac contraindications for Nondihydropyridines
3. Why does pedal edema occur with dihydropyridines?
1. Dihydropyridines: Amlodipine, Nifedipine
Nondihydropyridines: Verapamil, Diltiazem
2. Heart block and Heart Failure
3. Vasodilation
Pharmacology: BBs
1. Contraindications
2. Adverse Effets
1. Asthma, COPD
2. Bronchospasm
Pharmacology: Tetracyclines
1. Examples:
2. Avoid use during pregnancy and breastfeeding due to
of teeth.
3. Sensitivity to what?
1. Doxycycline
2. Permanent Discoloration
3. Photosensitivity
Pharmacology: Macrolides
1. Examples:
2. Type of toxicity
3. Which is the most tolerated macrolide from GI side
effects of Nausea and vomiting?
1. Azithromycin, Erythromycin
2. Hepatotoxicity
3. Azithromycin
Pharmacology: Cephalosporins
1. Examples of each of the First, Second and Third
Generation
2. First line of treatment against gonorroheal infections?
3. Avoid ceftriaxone in hyperbilirubinemia infants
because it can cause
1. First: Cephalexin (Keflex), Second: Cefuroxime, Third: Cefdinir
2. Ceftriaxone (3rd Generation)
3. Kernicterus
Pharmacology: PCNs
1. Examples
2. Avoid using amoxicillin for patients with
mononucleosis because it can lead to a
1. PCN, Amoxicillin, Augmentin
2. Rash
Pharmacology: Fluoroquinolones
1. Examples
2. Complications
3. Avoid in which population
4. Patients should avoid sun exposure due to
with thix ABX (T/F)
1. Ciprofloxacin, Levofloxacin
2. Achilles-Tendon Rupture, Torsades de Pointes, Abnormal bone development
3. Pregnant women and growing children
4. Phototoxicity; True
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FDA Controlled Substances Act
1. Schedule 1 Drugs are legal to prescribe (T/F)
2. Schedule II drugs require a new prescription
written every month (T/F)
3. Testosterone is what scheduled drug number?
1. False; Illegal
2. True
3. III
Screening Tests
1. What is Sensitivity focused on?
2. What is Specificity focused on?
1. Sensitivity is focused on indentifying those who DO have the disease (True
Positive).
2. Specificity is focused on detecting those that DO NOT have the disease (True
Negative).
Health Promotion: Ty pes of Prevention
1. What is Primary Prevention?
2. What is Secondary Prevention?
3. What is Tertiary Prevention?
1. Prevention of disease and reducing risk factors (Individual actions, Promoting
healthy lifestyle)
2. Early Detection with Screening exams (Screenings and Interventions to deal
post-full recovery of a disease)
3. Reduce Impact of Current Disease
USPSTF Recommendations - Aspirin
1. At what age is a HCP to initiate a low-dose aspirin
use for CVD patients?
1. 50-59 years old with 10% CVD risk
USPSTF Recommendations - Breast Cancer
1. When do we start screenings? and how often?
2. If a patient has BRCA1 or BRCA2 gene, when you
start screening for breast cancer?
1. 50 Years of age, every 2 yers
2. 40 years of age
USPSTF Recommendations - Cervical Cancer
1. Aged 21-29 years should receive what screening? How
often?
2. Aged 30-65 years should receive what screening? How
often?
3. If prior hysterectomy,
1. Cervical cytology alone every 3 years
2. Cervical Cytology alone every 3 years, of Cervical Cytology with HPV every 5
years
3. No screening needs to be done.
USPSTF Recommendations - Colorectal Cancer
1. When do we start screenings?
2. How often should someone get a colonoscopy?
1. Age 45 years
2. Every 10 years
USPSTF Recommendations - Lung Cancer
1. When do we start screening for patients with a -
pack-year smoking history?
2. What screening exam do you use?
1. 50 years old; 20-pack-year smoking history
2. Low-dose annual CT scan
USPSTF Recommendations - Prostate Cancer
1. When do we start screening?
2. Ethnic race at risk
1. 55-69 years old
2. African
USPSTF Recommendations - ABD Aortic Aneurysm
1. Abdominal Aortic Aneurysm test and onset of
screening?
1. ABD ultrasound; 65-75 years old
Vaccines & Administrations - Hepatitis B Vaccine
1. Total of how many doses? When?
2. Requires a minimum of weeks between doses one
and two?
1. Three doses (0, 1st and 6th month)
2. 4 Weeks
Vaccines & Administrations - Influenza
1. Two types of Influenza Vaccines
2. LAIV Contraindications
3. All types of Influenza Vaccine should be avoided if
patient has allergic to gelatin (T/F)
1. Inactivated and Recombinant vs. Live Attenuated (LAIV)
2. Pregnancy and chronic pulmonary disease
3. True
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Vaccines & Administrations - Tetanus Vaccines (Tdap
and Td)
1. How often do we administer for lifetime?
2. Infants and children younger than 7 years should
receive what form of tetanus vaccine?
3. For dirty and contaminated wounds, give a
if the last dose was more than how many
years ago?
1. Every 10 years
2. DTaP
3. Tetanus booster; more than 5 years ago
Vaccines & Administrations - Pneumococcal Vaccine
1. Second dose should be given at the latest of
years after prior dose.
1. 5 years
Vaccines & Administrations - Shingles Vaccine
1. Given to adults who are at least years old and
older.
2. You can use Zostavax if the patient is to
Shingrix (Recombinant Zoster Vaccine).
3. Zostavax is a live virus vaccine (T/F)
4. Avoid in patients who are
1. 50 years or older
2. Allergic
3. True
4. Pregnant and immunocompromised
Vaccines & Administrations - Varicella Vaccine
1. Varicella (and MMR) are live vaccines (T/F)
2. Avoid giving to
1. True
2. Pregnant or immunosuppressed patients
HEENT - Corneal Ulcers
1. Patient Symptoms
2. Look for on the cornea by using a
or slit lamp exam and fluorescein dye
test. (Primarily prefer Fluorescein dye test)
3. Most common cause is
4. Refer to
1. Foreign body sensation, tearing and photophobia
2. Whitish Lesion; Penlight; (Primarily prefer Fluorescein dye test)
3. Infection
4. ED
HEENT - Herpes Keratitis
1. Patient Symptoms
2. What kind of lines are found on the corneal surface?
3. If infection due to shingles is caused by infection of the
trigeminal nerve, what is it called?
4. Refer to
1. Severe eye pain, tearing, photophobia, blurred vision
2. Fernlike lines
3. Herpes Zoster Ophthalmicus
4. ED
HEENT - Acute Angle-Closure Glaucoma
1. Patient symptoms
2. Patients with this type of glaucoma see of lights.
3. Cornea appears
4. There is of the optic nerve.
5. Refer to
1. Sudden and acute severe eye pain, Headache, N/V.
2. Halos
3. Cloudy
4. Cupping
5. ED
HEENT - Multiple Sclerosis (Optic Neuritis)
1. Reports loss of visual acuity over hours to days (T/F)
2. What two visions are affected?
3. May be accompanied by other neurological symptoms
such as
4. Complains of daily fatigue that worsens as the day goes
on (T/F)
5. Refer to
1. True
2. Color and Central Vision
3. Parenthesia, Aphasia
4. True
5. Neurologist
HEENT - Orbital Cellulitis
1. Acute onset of eyelids and eyeballs.
2. Unable to perform full ROM of .
3. Look for history of .
4. Refer to
1. Swollen eyelids and bulging eyeballs
2. Extraocular muscles
3. Infection (Rhinosinusitis or upper respiratory infection)
4. ED
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HEENT - Retinal Detachment
1. Sudden onset of associated with looking
through a -feel.
2. Sudden flashes of .
3. Refer to
1. Floaters; Curtain
2. Flashes of Light
3. ED
HEENT - Auricular Hematoma
1. Direct blunt trauma to the ear that can cause bleeding in
the .
2. This should be drained as soon as possible (T/F)
1. Auricular Cartilage
2. True
HEENT - Acoustic Neuroma (Vestibular Schwannoma)
1. Presents with unilateral or bilateral hearing loss?
2. Complains of movements.
3. Caused by of the acoustic nerve.
4. Refer to
5. If trigeminal nerve is compressed, can lead to symptoms
of
1. Unilateral Hearing Loss
2. Unsteady
3. Tumor
4. Neurologist
5. Facial numbness and pain
HEENT - Cholesteatoma
1. There is of tympanic membrane.
2. What kind of mass is found?
3. Tympanic membrane can be intact, and yet have the
behind the TM.
4. The mass is not cancerous (T/F)
5. Mass can erode to bones and damage which nerve?
6. Refer to
1. Perforation
2. White-Cauliflower like mass
3. White mass
4. True
5. CN VII - Facial Nerve
6. Otolaryngologist
HEENT - Battle Sign (Basilar Skull Fracture)
1. Which skull bone is most often fractured?
2. Search for what kind of drainage that is indicative of
cerebrospinal fluid?
3. Referral to
1. Parietal
2. Clear, golden fluid drainage
3. ED
HEENT - Avulsed Tooth
1. Considered a dental .
2. If a young child, determine if the avulsed tooth is a
.
3. Rinse tooth in what solution?
4. Refer to
1. Dental Emergency
2. Primary Tooth
3. Normal Saline
4. Dentist
HEENT - Peritonsillar Abscess
1. Patient symptoms
2. What kind of voice?
3. Accompanied by generalized symptoms of
4. Referral to
1. Severe sore throat, and odynophagia (pain on swa
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