APEA Predictor Exam Review for Chamberlain University |
Post-Predictor Analysis & Answers
Domain 1: Advanced Physical Assessment
1. Which cranial nerve is being assessed when the provider asks the patient to
shrug their shoulders against resistance?
• A. CN IX (Glossopharyngeal)
• B. CN X (Vagus)
• C. CN XI (Spinal Accessory)
• D. CN XII (Hypoglossal)
Answer: C
Rationale: CN XI (Spinal Accessory) innervates the trapezius and sternocleidomastoid
muscles. Shrugging shoulders tests the trapezius, while turning the head against
resistance tests the sternocleidomastoid .
2. A nurse practitioner notes a soft, mid-systolic murmur heard best at the second
right intercostal space which radiates to the neck. This most likely represents:
• A. Mitral regurgitation
• B. Aortic stenosis
• C. Pulmonic regurgitation
• D. Mitral stenosis
Answer: B
,Rationale: Aortic stenosis typically presents as a systolic ejection murmur at the right
upper sternal border (2nd ICS) with radiation to the carotid arteries .
3. A positive Murphy's sign is suggestive of which condition?
• A. Appendicitis
• B. Pancreatitis
• C. Acute cholecystitis
• D. Peptic ulcer disease
Answer: C
Rationale: Murphy's sign—pain and inspiratory arrest upon palpation of the right upper
quadrant—is highly suggestive of acute cholecystitis and gallbladder disease .
4. Which deep tendon reflex is mediated by spinal nerve roots L2, L3, and L4?
• A. Biceps reflex
• B. Brachioradialis reflex
• C. Triceps reflex
• D. Patellar reflex (knee jerk)
Answer: D
Rationale: The patellar reflex (knee jerk) is mediated by spinal nerve roots L2, L3, and
L4 .
,5. The test called "visual fields by confrontation" is used to evaluate for:
• A. Peripheral vision
• B. Central vision
• C. Visual acuity
• D. Accommodation
Answer: A
Rationale: Visual fields by confrontation testing evaluates peripheral vision .
6. A 65-year-old male with a 40-pack-year history presents with chronic cough and
dyspnea. PFT shows FEV1/FVC ratio of 0.62. Most consistent diagnosis?
• A. Restrictive lung disease
• B. COPD
• C. Asthma
• D. Pulmonary fibrosis
Answer: B
Rationale: An FEV1/FVC ratio less than 0.70 indicates airflow obstruction, which is
diagnostic for COPD. Restrictive diseases show reduced FVC with normal or increased
ratio .
7. The Rinne test in Meniere's disease shows:
• A. BC > AC (Bone conduction better)
• B. No response
, • C. AC > BC (Air conduction better)
• D. Equal in both ears
Answer: C
Rationale: In sensorineural hearing loss like Meniere's disease, the Rinne test remains
normal (air conduction greater than bone conduction), unlike conductive hearing loss
where bone conduction equals or exceeds air conduction .
8. What is the hallmark symptom of Peripheral Arterial Disease (PAD)?
• A. Edema
• B. Bruising
• C. Rash
• D. Intermittent claudication
Answer: D
Rationale: Intermittent claudication—reproducible muscle pain (calf, thigh, buttock)
induced by exercise and relieved by rest within 2-5 minutes—is the classic symptom of
PAD due to atherosclerosis .
9. Which test is best to confirm Peripheral Arterial Disease?
• A. ECG
• B. Ankle-Brachial Index (ABI)
• C. Echocardiogram
• D. Angiography
Post-Predictor Analysis & Answers
Domain 1: Advanced Physical Assessment
1. Which cranial nerve is being assessed when the provider asks the patient to
shrug their shoulders against resistance?
• A. CN IX (Glossopharyngeal)
• B. CN X (Vagus)
• C. CN XI (Spinal Accessory)
• D. CN XII (Hypoglossal)
Answer: C
Rationale: CN XI (Spinal Accessory) innervates the trapezius and sternocleidomastoid
muscles. Shrugging shoulders tests the trapezius, while turning the head against
resistance tests the sternocleidomastoid .
2. A nurse practitioner notes a soft, mid-systolic murmur heard best at the second
right intercostal space which radiates to the neck. This most likely represents:
• A. Mitral regurgitation
• B. Aortic stenosis
• C. Pulmonic regurgitation
• D. Mitral stenosis
Answer: B
,Rationale: Aortic stenosis typically presents as a systolic ejection murmur at the right
upper sternal border (2nd ICS) with radiation to the carotid arteries .
3. A positive Murphy's sign is suggestive of which condition?
• A. Appendicitis
• B. Pancreatitis
• C. Acute cholecystitis
• D. Peptic ulcer disease
Answer: C
Rationale: Murphy's sign—pain and inspiratory arrest upon palpation of the right upper
quadrant—is highly suggestive of acute cholecystitis and gallbladder disease .
4. Which deep tendon reflex is mediated by spinal nerve roots L2, L3, and L4?
• A. Biceps reflex
• B. Brachioradialis reflex
• C. Triceps reflex
• D. Patellar reflex (knee jerk)
Answer: D
Rationale: The patellar reflex (knee jerk) is mediated by spinal nerve roots L2, L3, and
L4 .
,5. The test called "visual fields by confrontation" is used to evaluate for:
• A. Peripheral vision
• B. Central vision
• C. Visual acuity
• D. Accommodation
Answer: A
Rationale: Visual fields by confrontation testing evaluates peripheral vision .
6. A 65-year-old male with a 40-pack-year history presents with chronic cough and
dyspnea. PFT shows FEV1/FVC ratio of 0.62. Most consistent diagnosis?
• A. Restrictive lung disease
• B. COPD
• C. Asthma
• D. Pulmonary fibrosis
Answer: B
Rationale: An FEV1/FVC ratio less than 0.70 indicates airflow obstruction, which is
diagnostic for COPD. Restrictive diseases show reduced FVC with normal or increased
ratio .
7. The Rinne test in Meniere's disease shows:
• A. BC > AC (Bone conduction better)
• B. No response
, • C. AC > BC (Air conduction better)
• D. Equal in both ears
Answer: C
Rationale: In sensorineural hearing loss like Meniere's disease, the Rinne test remains
normal (air conduction greater than bone conduction), unlike conductive hearing loss
where bone conduction equals or exceeds air conduction .
8. What is the hallmark symptom of Peripheral Arterial Disease (PAD)?
• A. Edema
• B. Bruising
• C. Rash
• D. Intermittent claudication
Answer: D
Rationale: Intermittent claudication—reproducible muscle pain (calf, thigh, buttock)
induced by exercise and relieved by rest within 2-5 minutes—is the classic symptom of
PAD due to atherosclerosis .
9. Which test is best to confirm Peripheral Arterial Disease?
• A. ECG
• B. Ankle-Brachial Index (ABI)
• C. Echocardiogram
• D. Angiography
