APEA 3P Exam Test Blueprint & Sample Answers

APEA 3P Exam Test Blueprint

The 3P examination is a competency-based exam that tests clinical knowledge in the three core courses: pathophysiology, pharmacotherapeutics, and physical assessment. This exam is administered after the core courses have been completed and is used as an assessment tool to determine clinical readiness.

A score of 67% or greater indicates adequate knowledge in the core courses. Exam results identify any knowledge deficits. These results assist students in creating an appropriate study plan for improving knowledge deficits.

Physical Assessment: 25 Questions

These questions evaluate the ability to obtain subjective information from a patient or caregiver when gathering a history. Questions encompass interviewing techniques, obtaining a chief complaint, reviewing past records, and identifying risk factors. The physical assessment questions also address the ability to obtain objective information from the patient. This includes conducting an assessment and recognizing normal and abnormal findings.

Students are encouraged to review notes from their Advanced Health Assessment course. Questions on the 3P Exam may be related to each body system and knowing what signs and symptoms relate to a certain condition or disease.

For example, questions may ask about the appropriate areas to auscultate for heart, breath or bowel sounds. Questions are related to basic information necessary to perform an assessment of each body system.

Pharmacotherapeutics: 25 Questions

These questions evaluate the ability to make prescribing choices that involve a specific medication or patient. This includes the ability to select the best medication for a specific patient based on factors such as drug side effects, efficacy, prescribing constraints (e.g., cost or insurance), allergies, and drug-drug and drug-disease interactions.

Students are encouraged to review notes from their Advanced Pharmacology course.

Students should review:

Drug classes
Prescribing: mechanism of action, brands, drug classes
Safety: adverse and toxic reactions
Pharmacokinetics: absorption, distribution, metabolism and excretion, and drug-drug and drug-disease interactions
Precautions, indications and contraindications
Patient education: delivery and monitoring
Evaluation: efficacy, side effects, and lab interpretation related to specific medications

The 3P exam focuses on the mechanisms of action for all major drug classes related to each knowledge area and may ask questions about all the bullet points listed above. For instance, what is a common side effect of angiotensin-converting enzyme inhibitors?

Questions are based on basic pharmacotherapeutic principles.

Pathophysiology: 25 Questions

These questions evaluate knowledge of developmental physiology, pathogenesis, manifestations, and the etiology of altered physical and psychological health or disease conditions. Based on this knowledge, the student should be able to relate clinical manifestations to certain diseases or conditions, provide a description of the disease or condition, and state the etiology and incidence.

An understanding of pathophysiology is important to assist in creating a differential list and arrive at a proper diagnosis. Questions may ask about diagnostic studies that need to be performed to aid in the diagnosis or detection of disease, injury or any other medical condition.

Questions on the exam may also ask about the interpretation of lab results. Students are encouraged to review their notes from the Advanced Pathophysiology course. Knowledge areas tested in the 3P exam include primary care diagnoses related to each body system across the age continuum.

Because the exam is computer generated, we are unable to assign a specific number of questions related to each diagnosis. Students are encouraged to review diseases or conditions in each knowledge area, including those described below.

Knowledge Areas (representing common knowledge areas required to deliver primary care and is not all-inclusive)

Cardiovascular: atrial fibrillation, peripheral artery disease, varicose veins, heart failure, peripheral edema, coronary artery disease, anticoagulation, hypertension, infectious endocarditis
Dermatology: psoriasis, tinea corporis, scabies, herpes zoster, dermal cyst, keloid, tinea capitis, atopic dermatitis, urticaria, melanoma, acne
Eye, Ear, Nose, and Throat: visual acuity, cataract, vertigo, diabetic retinopathy, papilledema, hyperopia, rhinitis, hearing loss, pterygium, ototoxicity, acute sinusitis
Endocrine: diabetes mellitus, hypothyroidism, hyperandrogenism, acromegaly, hyperthyroidism, myxedema, hyperprolactinemia, polycystic ovarian syndrome
Gastroenterology: giardiasis, cirrhosis, pancreatitis, abdominal pain, small bowel obstruction, hepatitis B, enterobiasis, Crohn’s disease, gastroesophageal reflux, gastroenteritis, pyloric stenosis
Hematology: anemia, acute lymphocytic leukemia, iron deficiency anemia, pernicious anemia, lymphatic system, Rh incompatibility, beta thalassemia, sickle cell disease
Men’s Health: benign prostatic hyperplasia, hydrocele, penile cancer, erectile dysfunction, prostatitis, testicular torsion, epididymitis
Neurology: seizures, meningitis, neural tube defects, migraine headaches, transient ischemia, headaches, Parkinson disease, tension headaches
Orthopedics: rheumatoid arthritis, meniscal tear, osteoarthritis, gout, rotator cuff, sprain/strain, spinal stenosis, scoliosis, muscle spasm, osteosarcoma
Pregnancy: fundal height, preeclampsia, birth defects, TPAL, fetal growth and development, Naegele’s rule, hypertension in pregnancy, placenta previa, UTI during pregnancy
Psychiatry: substance abuse, depression, serotonin syndrome, Munchausen by proxy, generalized anxiety disorder, bulimia, bipolar disorder
Respiratory: asthma, hemoptysis, COPD, empyema, pleural effusion, community-acquired pneumonia, pneumonia, tuberculosis, pertussis, croup
Sexually Transmitted Infections: all Urology: incontinence, UTI, renal insufficiency, enuresis, end stage renal disease
Women’s Health: breast cancer, premenstrual syndrome, menopause, contraception, dysmenorrhea, amenorrhea
Pediatric: growth and development, developmental milestones

APEA-3P-Exam

Question 1

A 3 year-old presents with a history of fever and cough over the past 24 hours. Findings on the exam reveal: temperature of 102°F, apical heart rate of 157 beats/minute, and respiratory rate of 40 breaths/minute. Tachypnea in this child is most likely related to

Question 2

When percussing the lower posterior chest, begin by:

Question 3

The palpation technique used to assess respiratory expansion of the chest is placing the hands on the eight or tenth ribs posteriorly with the thumbs close to the vertebrae, sliding the hand medially and grasping a small fold of skin between the thumbs. Then:

Question 4

When trying to differentiate between hemoptysis or blood streaked material, which one of the following observations is correct?

Question 5

When percussing the chest in a patient who has left sided heart failure, the sound emanated would be:

Question 6

The line that extends through the inferior angle of the scapula when the arms are at the sides of the body is the:

Question 7

A condition associated with a chronic cough that produces copious amounts of purulent sputum is most likely:

Question 8

A patient who walked into the examination room, may be observed to be sitting and leaning forward in his chair. Lips were pursed during exhalation and arms were supported on the table. This position could be consistent with patients who have:

Question 9

Breath sounds heard over the periphery of the lung fields are:

Question 10

When percussing the posterior chest, which one of the following techniques would be omitted? When comparing two areas on the chest, use the same percussion technique in both areas.

Question 11

When auscultating breath sounds in a patient who has left sided heart failure, the breath sounds are: vesicular with late inspiratory crackles in the dependent portions of the lungs and resonant on percussion.

Question 12

Breath sounds consisting of a full inspiratory phase and a shortened and softer expiratory phase normally audible over the hilar region of the chest are termed:

Answer: bronchovesicular

Explanation:

Bronchovesicular breath sounds consist of a full inspiratory phase with a shortened and softer expiratory phase. They are normally heard over the hilar region (center of the lungs near the heart). Vesicular breath sounds consist of a quiet, wispy inspiratory phase followed by a short, almost silent expiratory phase.

They are heard over the periphery of the lung field. Bronchial breath sounds consist of a full inspiratory and expiratory phase with the inspiratory phase usually being louder.

They are normally heard over the trachea and larynx.

13 An acute viral illness that presents with a burning retrosternal discomfort and a dry cough is suggestive of:

Question 14

One of the anterior thoracic landmarks is the costal angle. It is located:

Question 15

Atypical respiratory symptoms associated with gastroesophageal disease (GERD) may include all of the following except: coughing. wheezing aspiration pneumonia rhinitis. Correct

Explanation: Atypical respiratory symptoms associated with gastroesophageal disease may include coughing, wheezing, asthma, and aspiration pneumonia. Rhinitis is rarely associated with GERD.

Question 16

On auscultation of the chest, if the patient says “ninety-nine” and it is clearly heard, this is indicative of:

Question 17

Respiratory effort in the neonate is initiated at birth as a result of:

Answer: Crackles

Explanation:

Crackles are termed coarse, medium, or fine and usually produce a popping, frying sound. Coarse crackles are low-pitched while fine crackles are high-pitched. Coarse sounds are heard on inspiration and sometimes expiration, medium crackles in the middle of inspiration, and fine crackles at the end of inspiration. Rhonchi are continuous, low-pitched and heard on expiration. Wheezes are continuous, high-pitched and musical. A pleural friction rub produces a dry, grating sound.

Question 19

Breath sounds heard on chest over the hilar region are:

Question 20

Breath sounds consisting of a full inspiratory and expiratory phase with the inspiratory phase usually being louder and normally heard over the trachea and larynx are considered:

Question 21

Pain from pleurisy may be referred to the:

Right shoulder.

Retrosternal area.

Incorrect epigastric area.

Back. Correct

Question 22

When performing a respiratory assessment on a 4-year-old child, further evaluation is warranted in the presence of:

Question 23

Which technique best determines whether the tissues in the chest are air-filled, fluid-filled, or solid?

Question 24

Breath sounds auscultated over the periphery of the lung fields are quiet and wispy during the inspiratory phase followed by a short, almost silent expiratory phase. These breath sounds are considered:

Question 25

A patient who presents with a long history of cigarette smoking exhibits a dry to productive cough with dyspnea and weight loss. These symptoms could be consistent with:

Question 26

The hilar region of the lungs describes:

Question 27

The anterior surface landmark on the thorax that is denoted by a hollow U-shaped depression just above the sternum and between the clavicles is termed the:

Question 29

Factors that aggravate costochondritis may include:

Question 30

To locate the twelfth rib, palpate:

Question 31

To document chest findings located between the scapulae, which one of the following terms would be used?

Question 32

The midaxillary line:

Question 33

Retractions are observed in all the following areas except the:

Question 34

When examining a patient for chest expansion, begin by:

Question 35

The lower tip of the scapula is located:

Question 36

A patient presents with a productive cough. Which one of the following descriptions of the mucus is correct?

Question 37

Diminished breath sounds should be interpreted as:

Question 38

When inspecting the chest for respiratory effort, which one of the following is not part of the inspection?

Question 39

The angle of Louis is a useful place to start counting ribs. This landmark is located:

Question 40

When auscultating breath sounds, use the diaphragm of the stethoscope by placing it initially on the:

The line that bisects the center of each clavicle at a point halfway between the palpated sternoclavicular and acromioclavicular joints is the:

Question 42

When palpating the thorax, a crackling, popping noise under the skin is heard. On auscultation, a sound similar to hair being rubbed between the fingers is noted. These symptoms could be consistent with:

Question 43

To document chest findings located below the scapulae, which one of the following terms would be used?

Question 44

A 37-year-old female has an audible stridor. This type of stridor is consistent with:

Question 45

When percussing the right upper posterior area of the chest, a dullness replaces the resonance sound usually heard in the lung. This sound would be suggestive of:

Question 46

Orthopnea is typically associated with all of the following conditions except:

Question 47

Stridor heard louder in the neck than over the chest wall indicates:

Question 48

Increased anteroposterior diameter of the chest, purse-lipped breathing, and dyspnea with talking, suggest:

Question 49

The middle section of the thoracic cavity containing the esophagus, trachea, heart, and great vessels is the:

Question 50

To document chest findings located at the lowermost portion of the lungs, which one of the following terms would be used?

Question 51

Which one of the following infants should be seen immediately by the nurse practitioner?

APEA 3P Exam Test Blueprint & Sample Answers