APEA 3P EVALUATED QUESTIONS AND
ANSWERS
Recommend a method or test to help assess a patient's cerebellar function. -
CORRECT ANSWER-Finger-nose-finger testing
Choose an accurate statement regarding deep tendon reflexes and their location of
assessment. - CORRECT ANSWER-Achilles reflex corresponds to L2-S2.
Brachioradialis reflex corresponds to C5-C6.
Determine a finding that would be abnormal in a motor assessment. - CORRECT
ANSWER-Presence of tremor
Muscle weakness
Propose an accurate statement regarding the sensory assessment. - CORRECT
ANSWER-Tactile discrimination of fine touch assesses the sensory cortex.
Decide what should be considered in assessing a patient's appearance and behavior. -
CORRECT ANSWER-Level of consciousness
Determine the accurate description regarding the strength of reflex. - CORRECT
ANSWER-Hypoactive or diminished response is classified as 1+.
Very brisk, hyperactive response is classified as 4+.
Determine a step or technique in the assessment of the trigeminal nerve. - CORRECT
ANSWER-Assess muscles of mastication.
Ask the patient to identify the location of the light touch sensation on the forehead while
eyes are closed.
Recommend an appropriate examination method to assess spinal accessory nerve
function. - CORRECT ANSWER-Ask the patient to shrug shoulders against resistance.
Ask the patient to rotate the head forcibly against resistance.
,Determine an important item to assess while testing a patient's language and
comprehension. - CORRECT ANSWER-Expressive or receptive aphasia
Language coherency
All of the following are components of the classic ophthalmological emergency except
. - CORRECT ANSWER-purulent eye discharge
Mrs. Murphy is a 58-year-old woman presenting with a sudden left-sided headache that
is most painful in her left eye. Her vision is blurred, and her left pupil is slightly dilated
and poorly reactive. The left conjunctiva is markedly injected, and the eyeball is firm.
Vision screen with the Snellen chart is 20/30 OD and 20/90 OS.
When caring for Mrs. Murphy, the most appropriate next action is .-
CORRECT ANSWER-prompt referral to an ophthalmologist
Recommend an appropriate question to ask when assessing a patient's mood and
affect. - CORRECT ANSWER-How are you?
Propose an accurate statement regarding the mental status examination. - CORRECT
ANSWER-A patient's overall appearance is part of the mental status examination.
Determine an appropriate question to ask when assessing a patient's perception. -
CORRECT ANSWER-Do you feel as if you're being watched?
How do people treat you?
Choose an accurate description of expressive aphasia. - CORRECT ANSWER-Having
difficulty in expressing words
Describe the technique to assess facial nerve function. - CORRECT ANSWER-Ask the
patient to smile.
Instruct the patient to lift eyebrows.
Ask the patient to close eyelids tightly against your attempt to open them.
What is a common vision problem in a person with untreated primary open-angle
glaucoma (POAG)? - CORRECT ANSWER-Peripheral vision loss
Propose a component of assessing the thought process of a patient. - CORRECT
ANSWER-Screening for suicidal thoughts
Which of the following is the most likely to be found on the funduscopic examination of a
patient with untreated POAG? - CORRECT ANSWER-Excessive cupping of the optic
disk
,Propose an indicator that a headache can be the presenting symptom of a serious
illness and may require neuroimaging. - CORRECT ANSWER-Headache causing
confusion, dizziness, or lack of coordination
Headache causing awakening from sleep
Sudden or new-onset headache
A clinician is performing a middle ear assessment on a 15-year-old patient. When
examining the right tympanic membrane, the clinician sees the presence of dense white
patches. The tympanic membrane is otherwise unremarkable. It is pearly, with the light
reflex at 5 o'clock and landmarks visible. Propose a statement that reflects this finding. -
CORRECT ANSWER-This is known as tympanosclerosis.
This is associated with calcification of the tympanic membrane.
There are scars caused from frequent ear infection.
This is associated with calcification of the tympanic membrane.
A clinician is testing the hearing of a 78-year-old man. Establish which of the following is
important to keep in mind in terms of changes in hearing that occur with aging. -
CORRECT ANSWER-The aging person may find it harder to hear consonants than
vowels.
Sounds may be garbled and difficult to localize.
The tympanic membrane thickens with age.
The progression is slow.
Propose a way to examine a patient who presents to your office with vertigo. -
CORRECT ANSWER-Ask the patient to close his or her eyes and march in place for 30
seconds.
Perform the Romberg test.
Check for nystagmus.
An 83-year-old male is in the clinic for a checkup. Determine a question that should be
considered before the clinician begins screening for a hearing deficit. - CORRECT
ANSWER-Is the evaluation for perceived hearing problems related to the hearing loss?
Has there been exposure to ototoxic agents?
, The clinician is assessing a patient who may have hearing loss. Determine the
statement concerning air conduction. - CORRECT ANSWER-It is the normal pathway
for hearing.
The Rinne test is used to determine normal conduction.
When hearing conduction is impaired, air conduction is less than bone conduction on
the affected side.
A clinician is performing an oral assessment. Determine which of the following findings
would cause the greatest concern. - CORRECT ANSWER-Ulceration on the side of the
tongue
Unexplained bleeding from the tongue
Rolled edges on the side of the tongue
When examining the ear with an otoscope, the clinician notes that the tympanic
membrane should appear . - CORRECT ANSWER-mobile with air inflation
with a visible cone of light
A male patient has been shown having a sensorineural hearing loss. Establish what
would be important for the clinician to do. - CORRECT ANSWER-Ask the patient if he
has difficulty understanding when others speak
Ask the patient what medications he is taking
A 70-year-old male patient tells the nurse that he has noticed that he is having trouble
hearing, especially in large groups. He says that he cannot always tell where the sound
is coming from and that the words often sound mixed up. Justify a cause for this
change. - CORRECT ANSWER-Degeneration of the acoustic nerve
Sensorineural hearing loss
Nerve degeneration in the inner ear
Degeneration of cranial nerve VII
A male patient has been shown having a sensorineural hearing loss. Establish what
would be important for the clinician to do during the assessment. - CORRECT
ANSWER-Ask the patient about exposure to loud noises
Ask the patient about exposure to mumps
Ask if there is anyone in the family who suffered from sensorineural hearing loss
ANSWERS
Recommend a method or test to help assess a patient's cerebellar function. -
CORRECT ANSWER-Finger-nose-finger testing
Choose an accurate statement regarding deep tendon reflexes and their location of
assessment. - CORRECT ANSWER-Achilles reflex corresponds to L2-S2.
Brachioradialis reflex corresponds to C5-C6.
Determine a finding that would be abnormal in a motor assessment. - CORRECT
ANSWER-Presence of tremor
Muscle weakness
Propose an accurate statement regarding the sensory assessment. - CORRECT
ANSWER-Tactile discrimination of fine touch assesses the sensory cortex.
Decide what should be considered in assessing a patient's appearance and behavior. -
CORRECT ANSWER-Level of consciousness
Determine the accurate description regarding the strength of reflex. - CORRECT
ANSWER-Hypoactive or diminished response is classified as 1+.
Very brisk, hyperactive response is classified as 4+.
Determine a step or technique in the assessment of the trigeminal nerve. - CORRECT
ANSWER-Assess muscles of mastication.
Ask the patient to identify the location of the light touch sensation on the forehead while
eyes are closed.
Recommend an appropriate examination method to assess spinal accessory nerve
function. - CORRECT ANSWER-Ask the patient to shrug shoulders against resistance.
Ask the patient to rotate the head forcibly against resistance.
,Determine an important item to assess while testing a patient's language and
comprehension. - CORRECT ANSWER-Expressive or receptive aphasia
Language coherency
All of the following are components of the classic ophthalmological emergency except
. - CORRECT ANSWER-purulent eye discharge
Mrs. Murphy is a 58-year-old woman presenting with a sudden left-sided headache that
is most painful in her left eye. Her vision is blurred, and her left pupil is slightly dilated
and poorly reactive. The left conjunctiva is markedly injected, and the eyeball is firm.
Vision screen with the Snellen chart is 20/30 OD and 20/90 OS.
When caring for Mrs. Murphy, the most appropriate next action is .-
CORRECT ANSWER-prompt referral to an ophthalmologist
Recommend an appropriate question to ask when assessing a patient's mood and
affect. - CORRECT ANSWER-How are you?
Propose an accurate statement regarding the mental status examination. - CORRECT
ANSWER-A patient's overall appearance is part of the mental status examination.
Determine an appropriate question to ask when assessing a patient's perception. -
CORRECT ANSWER-Do you feel as if you're being watched?
How do people treat you?
Choose an accurate description of expressive aphasia. - CORRECT ANSWER-Having
difficulty in expressing words
Describe the technique to assess facial nerve function. - CORRECT ANSWER-Ask the
patient to smile.
Instruct the patient to lift eyebrows.
Ask the patient to close eyelids tightly against your attempt to open them.
What is a common vision problem in a person with untreated primary open-angle
glaucoma (POAG)? - CORRECT ANSWER-Peripheral vision loss
Propose a component of assessing the thought process of a patient. - CORRECT
ANSWER-Screening for suicidal thoughts
Which of the following is the most likely to be found on the funduscopic examination of a
patient with untreated POAG? - CORRECT ANSWER-Excessive cupping of the optic
disk
,Propose an indicator that a headache can be the presenting symptom of a serious
illness and may require neuroimaging. - CORRECT ANSWER-Headache causing
confusion, dizziness, or lack of coordination
Headache causing awakening from sleep
Sudden or new-onset headache
A clinician is performing a middle ear assessment on a 15-year-old patient. When
examining the right tympanic membrane, the clinician sees the presence of dense white
patches. The tympanic membrane is otherwise unremarkable. It is pearly, with the light
reflex at 5 o'clock and landmarks visible. Propose a statement that reflects this finding. -
CORRECT ANSWER-This is known as tympanosclerosis.
This is associated with calcification of the tympanic membrane.
There are scars caused from frequent ear infection.
This is associated with calcification of the tympanic membrane.
A clinician is testing the hearing of a 78-year-old man. Establish which of the following is
important to keep in mind in terms of changes in hearing that occur with aging. -
CORRECT ANSWER-The aging person may find it harder to hear consonants than
vowels.
Sounds may be garbled and difficult to localize.
The tympanic membrane thickens with age.
The progression is slow.
Propose a way to examine a patient who presents to your office with vertigo. -
CORRECT ANSWER-Ask the patient to close his or her eyes and march in place for 30
seconds.
Perform the Romberg test.
Check for nystagmus.
An 83-year-old male is in the clinic for a checkup. Determine a question that should be
considered before the clinician begins screening for a hearing deficit. - CORRECT
ANSWER-Is the evaluation for perceived hearing problems related to the hearing loss?
Has there been exposure to ototoxic agents?
, The clinician is assessing a patient who may have hearing loss. Determine the
statement concerning air conduction. - CORRECT ANSWER-It is the normal pathway
for hearing.
The Rinne test is used to determine normal conduction.
When hearing conduction is impaired, air conduction is less than bone conduction on
the affected side.
A clinician is performing an oral assessment. Determine which of the following findings
would cause the greatest concern. - CORRECT ANSWER-Ulceration on the side of the
tongue
Unexplained bleeding from the tongue
Rolled edges on the side of the tongue
When examining the ear with an otoscope, the clinician notes that the tympanic
membrane should appear . - CORRECT ANSWER-mobile with air inflation
with a visible cone of light
A male patient has been shown having a sensorineural hearing loss. Establish what
would be important for the clinician to do. - CORRECT ANSWER-Ask the patient if he
has difficulty understanding when others speak
Ask the patient what medications he is taking
A 70-year-old male patient tells the nurse that he has noticed that he is having trouble
hearing, especially in large groups. He says that he cannot always tell where the sound
is coming from and that the words often sound mixed up. Justify a cause for this
change. - CORRECT ANSWER-Degeneration of the acoustic nerve
Sensorineural hearing loss
Nerve degeneration in the inner ear
Degeneration of cranial nerve VII
A male patient has been shown having a sensorineural hearing loss. Establish what
would be important for the clinician to do during the assessment. - CORRECT
ANSWER-Ask the patient about exposure to loud noises
Ask the patient about exposure to mumps
Ask if there is anyone in the family who suffered from sensorineural hearing loss
