Page 1 of 83
APEA 3P 2026 EXAM (ORTHOPEDICS -
APEA) – COMPLETE (200) CURRENT
TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED
EXPLANATIONS|GUARANTEED PASS.
APEA
Prepare with confidence using this APEA 3P 202 Exam (Orthopedics
– APEA), designed to assess advanced clinical knowledge in
orthopedic assessment and management. It focuses on
musculoskeletal pathophysiology, physical examination
techniques, injury evaluation, fracture care, pharmacologic
management, and evidence-based treatment planning. Suitable for
nurse practitioner students preparing for APEA orthopedic-focused
advanced practice assessments.
MULTIPLE CHOICE
Exam Blueprint:
Musculoskeletal Assessment (20%) – 40 Qs
Fractures & Trauma (15%) – 30 Qs
Joint Disorders & Arthritis (20%) – 40 Qs
Back & Spinal Disorders (15%) – 30 Qs
Soft Tissue & Sports Injuries (15%) – 30 Qs
Metabolic Bone Disease & Orthopedic Emergencies (15%) – 30 Qs
SECTION 1: MUSCULOSKELETAL ASSESSMENT – Questions 1–40
1. A 58-year-old male with type 2 diabetes reports burning foot pain worse at
night. Exam reveals diminished pinprick sensation distal to the ankles and
absent Achilles reflexes. What is the most likely diagnosis?
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A) Peripheral artery disease
B) Lumbar radiculopathy
C) Diabetic peripheral neuropathy
D) Vitamin B12 deficiency
Answer: C
Rationale: Distal symmetric polyneuropathy in diabetes presents with
burning pain, nocturnal exacerbation, loss of sensation, and areflexia. PAD
causes intermittent claudication, not burning dysesthesia.
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2. A 45-year-old woman reports difficulty rising from a chair and climbing
stairs. Exam shows proximal muscle weakness, no sensory loss, and markedly
elevated creatine kinase (CK). What is the most likely diagnosis?
A) Polymyositis
B) Myasthenia gravis
C) Lambert-Eaton syndrome
D) Guillain-Barré syndrome
Answer: A
Rationale: Proximal symmetric muscle weakness with elevated CK suggests
polymyositis (or dermatomyositis if rash is present).
3. A 68-year-old woman with osteoporosis on alendronate for 5 years
develops severe thigh and groin pain. X-ray shows transverse cortical
thickening in the lateral femoral shaft. What is the most likely diagnosis?
A) Osteosarcoma
B) Atypical femoral fracture precursor
C) Paget’s disease of bone
D) Osteomalacia
Answer: B
Rationale: Atypical femoral fractures from bisphosphonates present with
prodromal thigh pain and radiographic cortical beaking/thickening.
4. A 65-year-old woman with sudden severe lumbar back pain after sneezing
has a history of osteoporosis. Exam reveals midline tenderness at L1 with
intact neurologic exam. What is the best initial imaging study?
A) MRI lumbar spine
B) CT lumbar spine
C) X-ray lumbar spine
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D) Bone scan
Answer: C
Rationale: Plain X-ray is first-line for suspected vertebral compression
fracture in osteoporosis; MRI is indicated if a neurologic deficit is present.
5. A 32-year-old man has recurrent episodes of unilateral, severe, pulsatile
headache with tearing, rhinorrhea, and restlessness lasting 30-60 minutes.
What is the best acute treatment?
A) Sumatriptan 6 mg subcutaneous
B) Naproxen 500 mg oral
C) Oxygen 15 L/min via non-rebreather mask
D) Ergotamine
Answer: C
Rationale: High-flow oxygen (100% at 12-15 L/min) is first-line for acute
cluster headache; it is highly effective and safe.
6. A 45-year-old woman with rheumatoid arthritis on methotrexate develops
dyspnea and non-productive cough. HRCT shows bilateral ground-glass
opacities. What is the most likely diagnosis?
A) Methotrexate pneumonitis
B) Rheumatoid lung nodules
C) Pulmonary embolism
D) Bacterial pneumonia
Answer: A
Rationale: Methotrexate-induced lung injury (hypersensitivity pneumonitis)
presents with subacute dyspnea, cough, and ground-glass opacities.
7. A 55-year-old man with chronic heavy alcohol use presents with
confusion, ataxia, and ophthalmoplegia. What is the most likely deficiency?
A) Vitamin B12
APEA 3P 2026 EXAM (ORTHOPEDICS -
APEA) – COMPLETE (200) CURRENT
TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED
EXPLANATIONS|GUARANTEED PASS.
APEA
Prepare with confidence using this APEA 3P 202 Exam (Orthopedics
– APEA), designed to assess advanced clinical knowledge in
orthopedic assessment and management. It focuses on
musculoskeletal pathophysiology, physical examination
techniques, injury evaluation, fracture care, pharmacologic
management, and evidence-based treatment planning. Suitable for
nurse practitioner students preparing for APEA orthopedic-focused
advanced practice assessments.
MULTIPLE CHOICE
Exam Blueprint:
Musculoskeletal Assessment (20%) – 40 Qs
Fractures & Trauma (15%) – 30 Qs
Joint Disorders & Arthritis (20%) – 40 Qs
Back & Spinal Disorders (15%) – 30 Qs
Soft Tissue & Sports Injuries (15%) – 30 Qs
Metabolic Bone Disease & Orthopedic Emergencies (15%) – 30 Qs
SECTION 1: MUSCULOSKELETAL ASSESSMENT – Questions 1–40
1. A 58-year-old male with type 2 diabetes reports burning foot pain worse at
night. Exam reveals diminished pinprick sensation distal to the ankles and
absent Achilles reflexes. What is the most likely diagnosis?
, Page 2 of 83
A) Peripheral artery disease
B) Lumbar radiculopathy
C) Diabetic peripheral neuropathy
D) Vitamin B12 deficiency
Answer: C
Rationale: Distal symmetric polyneuropathy in diabetes presents with
burning pain, nocturnal exacerbation, loss of sensation, and areflexia. PAD
causes intermittent claudication, not burning dysesthesia.
, Page 3 of 83
2. A 45-year-old woman reports difficulty rising from a chair and climbing
stairs. Exam shows proximal muscle weakness, no sensory loss, and markedly
elevated creatine kinase (CK). What is the most likely diagnosis?
A) Polymyositis
B) Myasthenia gravis
C) Lambert-Eaton syndrome
D) Guillain-Barré syndrome
Answer: A
Rationale: Proximal symmetric muscle weakness with elevated CK suggests
polymyositis (or dermatomyositis if rash is present).
3. A 68-year-old woman with osteoporosis on alendronate for 5 years
develops severe thigh and groin pain. X-ray shows transverse cortical
thickening in the lateral femoral shaft. What is the most likely diagnosis?
A) Osteosarcoma
B) Atypical femoral fracture precursor
C) Paget’s disease of bone
D) Osteomalacia
Answer: B
Rationale: Atypical femoral fractures from bisphosphonates present with
prodromal thigh pain and radiographic cortical beaking/thickening.
4. A 65-year-old woman with sudden severe lumbar back pain after sneezing
has a history of osteoporosis. Exam reveals midline tenderness at L1 with
intact neurologic exam. What is the best initial imaging study?
A) MRI lumbar spine
B) CT lumbar spine
C) X-ray lumbar spine
, Page 4 of 83
D) Bone scan
Answer: C
Rationale: Plain X-ray is first-line for suspected vertebral compression
fracture in osteoporosis; MRI is indicated if a neurologic deficit is present.
5. A 32-year-old man has recurrent episodes of unilateral, severe, pulsatile
headache with tearing, rhinorrhea, and restlessness lasting 30-60 minutes.
What is the best acute treatment?
A) Sumatriptan 6 mg subcutaneous
B) Naproxen 500 mg oral
C) Oxygen 15 L/min via non-rebreather mask
D) Ergotamine
Answer: C
Rationale: High-flow oxygen (100% at 12-15 L/min) is first-line for acute
cluster headache; it is highly effective and safe.
6. A 45-year-old woman with rheumatoid arthritis on methotrexate develops
dyspnea and non-productive cough. HRCT shows bilateral ground-glass
opacities. What is the most likely diagnosis?
A) Methotrexate pneumonitis
B) Rheumatoid lung nodules
C) Pulmonary embolism
D) Bacterial pneumonia
Answer: A
Rationale: Methotrexate-induced lung injury (hypersensitivity pneumonitis)
presents with subacute dyspnea, cough, and ground-glass opacities.
7. A 55-year-old man with chronic heavy alcohol use presents with
confusion, ataxia, and ophthalmoplegia. What is the most likely deficiency?
A) Vitamin B12
