NUR 634 (Grand Canyon University) – APEA 3P
Practice Exam Questions with Answers &
Rationales Graded A+
Questions
1. The groove of the metacarpophalangeal joint can be palpated by having the
patient:
a. Flex his hand
b. Extend his wrist
c. Pronate the forearm
d. Make a fist
Answer: a. Flex his hand
Rationale: Flexion of the hand relaxes the extensor tendons and allows palpation
of the metacarpophalangeal joint groove.
2. When auscultating breath sounds in a patient who has left sided heart failure, the
breath sounds are:
a. Vesicular with late inspiratory crackles in the dependent portions of the lungs
and resonant on percussion
b. Diminished with expiratory wheezes and hyperresonant on percussion
c. Bronchial with early inspiratory crackles and dull on percussion
d. Absent with egophony and flat on percussion
Answer: a. Vesicular with late inspiratory crackles in the dependent portions
of the lungs and resonant on percussion
Rationale: Left heart failure causes pulmonary congestion with late inspiratory
crackles in dependent lung zones; percussion remains resonant.
3. The ankle-brachial index is a screening test used to assess a person’s risk for:
a. Peripheral artery disease
b. Deep vein thrombosis
c. Venous stasis ulcers
d. Diabetic neuropathy
Answer: a. Peripheral artery disease
Rationale: ABI <0.90 indicates peripheral artery disease by comparing ankle and
brachial systolic pressures.
,4. Olecranon bursitis may be caused by all of the following except:
a. Frozen shoulder
b. Trauma
c. Gout
d. Infection
Answer: a. Frozen shoulder
Rationale: Frozen shoulder (adhesive capsulitis) affects the glenohumeral joint,
not the olecranon bursa.
5. In patients who have allergic rhinitis, the nasal mucosa appears:
a. Pale
b. Erythematous
c. Yellowish
d. Cyanotic
Answer: a. Pale
Rationale: Allergic rhinitis causes pale, boggy, bluish-gray mucosa due to edema
and eosinophilia.
6. A term used to describe an increase in muscular bulk with diminished strength
is:
a. Pseudohypertrophy
b. Hypertrophy
c. Hyperplasia
d. Dystrophy
Answer: a. Pseudohypertrophy
Rationale: Pseudohypertrophy (e.g., Duchenne muscular dystrophy) shows
enlarged muscles due to fat/fibrosis but weak strength.
7. If abdominal pain persists when the patient raises his head and shoulders, the
origin of the tenderness is probably:
a. In the abdominal wall
b. Visceral
c. Retroperitoneal
d. Referred
Answer: a. In the abdominal wall
Rationale: Carnett’s sign – pain that persists or worsens with head raise suggests
abdominal wall origin.
,8. On auscultation of the abdomen, rushes of high-pitched sounds are audible and
coincide with abdominal cramps. These findings are most consistent with:
a. Intestinal obstruction
b. Gastroenteritis
c. Paralytic ileus
d. Peritonitis
Answer: a. Intestinal obstruction
Rationale: High-pitched rushes (borborygmi) with cramps suggest mechanical
bowel obstruction.
9. Ophthalmoscopic examination of the fundus reveals tiny, round, red spots in and
around the macular area. These findings are consistent with:
a. Microaneurysms
b. Hemorrhages
c. Cotton wool spots
d. Drusen
Answer: a. Microaneurysms
Rationale: Tiny red dots in posterior pole are microaneurysms, hallmark of
nonproliferative diabetic retinopathy.
10. Symptoms of a subdural hematoma include:
a. Noticeable bleeding between the dura and the cerebrum on x-ray
b. Lucid interval then declining consciousness
c. Immediate unconsciousness without recovery
d. Scalp laceration with clear fluid
Answer: a. Noticeable bleeding between the dura and the cerebrum on x-ray
11. On examination of the adult patient, symptoms of flexed posture, tremor,
rigidity, and shuffling gait are observed. These findings are consistent with:
a. Parkinson’s disease
b. Huntington’s disease
c. Multiple sclerosis
d. Amyotrophic lateral sclerosis
Answer: a. Parkinson’s disease
Rationale: Parkinsonism includes resting tremor, cogwheel rigidity, bradykinesia,
shuffling gait, and flexed posture.
, 12. When discussing the musculoskeletal system, all of the following statements
related to articular structure disease are true except which one?
a. Articular disease is usually due to stiffness or pain
b. Articular disease involves joint space narrowing
c. Articular disease may have crepitus
d. Articular disease always has systemic symptoms
Answer: d. Articular disease always has systemic symptoms
Rationale: Many articular diseases (e.g., OA) are localized without systemic
features.
13. Focal tenderness over the trochanter confirms:
a. Bursitis
b. Fracture
c. Tendonitis
d. Arthritis
Answer: a. Bursitis
Rationale: Tenderness directly over greater trochanter indicates trochanteric
bursitis.
14. Assessing the neurological status of a child with a ventriculoperitoneal shunt
should include:
a. Use of the Glasgow coma scale
b. Measuring head circumference
c. Checking for sunsetting eyes
d. All of the above
Answer: a. Use of the Glasgow coma scale
Rationale: GCS is standard for serial neuro assessment; head circumference and
sunsetting are important but the question asks “should include” and given answer
is a.
15. The earliest recognizable clinical manifestation(s) of cystic fibrosis in an infant
is:
a. Salty taste on the skin
b. Failure to thrive
c. Meconium ileus
d. Recurrent pneumonia
Answer: a. Salty taste on the skin
Practice Exam Questions with Answers &
Rationales Graded A+
Questions
1. The groove of the metacarpophalangeal joint can be palpated by having the
patient:
a. Flex his hand
b. Extend his wrist
c. Pronate the forearm
d. Make a fist
Answer: a. Flex his hand
Rationale: Flexion of the hand relaxes the extensor tendons and allows palpation
of the metacarpophalangeal joint groove.
2. When auscultating breath sounds in a patient who has left sided heart failure, the
breath sounds are:
a. Vesicular with late inspiratory crackles in the dependent portions of the lungs
and resonant on percussion
b. Diminished with expiratory wheezes and hyperresonant on percussion
c. Bronchial with early inspiratory crackles and dull on percussion
d. Absent with egophony and flat on percussion
Answer: a. Vesicular with late inspiratory crackles in the dependent portions
of the lungs and resonant on percussion
Rationale: Left heart failure causes pulmonary congestion with late inspiratory
crackles in dependent lung zones; percussion remains resonant.
3. The ankle-brachial index is a screening test used to assess a person’s risk for:
a. Peripheral artery disease
b. Deep vein thrombosis
c. Venous stasis ulcers
d. Diabetic neuropathy
Answer: a. Peripheral artery disease
Rationale: ABI <0.90 indicates peripheral artery disease by comparing ankle and
brachial systolic pressures.
,4. Olecranon bursitis may be caused by all of the following except:
a. Frozen shoulder
b. Trauma
c. Gout
d. Infection
Answer: a. Frozen shoulder
Rationale: Frozen shoulder (adhesive capsulitis) affects the glenohumeral joint,
not the olecranon bursa.
5. In patients who have allergic rhinitis, the nasal mucosa appears:
a. Pale
b. Erythematous
c. Yellowish
d. Cyanotic
Answer: a. Pale
Rationale: Allergic rhinitis causes pale, boggy, bluish-gray mucosa due to edema
and eosinophilia.
6. A term used to describe an increase in muscular bulk with diminished strength
is:
a. Pseudohypertrophy
b. Hypertrophy
c. Hyperplasia
d. Dystrophy
Answer: a. Pseudohypertrophy
Rationale: Pseudohypertrophy (e.g., Duchenne muscular dystrophy) shows
enlarged muscles due to fat/fibrosis but weak strength.
7. If abdominal pain persists when the patient raises his head and shoulders, the
origin of the tenderness is probably:
a. In the abdominal wall
b. Visceral
c. Retroperitoneal
d. Referred
Answer: a. In the abdominal wall
Rationale: Carnett’s sign – pain that persists or worsens with head raise suggests
abdominal wall origin.
,8. On auscultation of the abdomen, rushes of high-pitched sounds are audible and
coincide with abdominal cramps. These findings are most consistent with:
a. Intestinal obstruction
b. Gastroenteritis
c. Paralytic ileus
d. Peritonitis
Answer: a. Intestinal obstruction
Rationale: High-pitched rushes (borborygmi) with cramps suggest mechanical
bowel obstruction.
9. Ophthalmoscopic examination of the fundus reveals tiny, round, red spots in and
around the macular area. These findings are consistent with:
a. Microaneurysms
b. Hemorrhages
c. Cotton wool spots
d. Drusen
Answer: a. Microaneurysms
Rationale: Tiny red dots in posterior pole are microaneurysms, hallmark of
nonproliferative diabetic retinopathy.
10. Symptoms of a subdural hematoma include:
a. Noticeable bleeding between the dura and the cerebrum on x-ray
b. Lucid interval then declining consciousness
c. Immediate unconsciousness without recovery
d. Scalp laceration with clear fluid
Answer: a. Noticeable bleeding between the dura and the cerebrum on x-ray
11. On examination of the adult patient, symptoms of flexed posture, tremor,
rigidity, and shuffling gait are observed. These findings are consistent with:
a. Parkinson’s disease
b. Huntington’s disease
c. Multiple sclerosis
d. Amyotrophic lateral sclerosis
Answer: a. Parkinson’s disease
Rationale: Parkinsonism includes resting tremor, cogwheel rigidity, bradykinesia,
shuffling gait, and flexed posture.
, 12. When discussing the musculoskeletal system, all of the following statements
related to articular structure disease are true except which one?
a. Articular disease is usually due to stiffness or pain
b. Articular disease involves joint space narrowing
c. Articular disease may have crepitus
d. Articular disease always has systemic symptoms
Answer: d. Articular disease always has systemic symptoms
Rationale: Many articular diseases (e.g., OA) are localized without systemic
features.
13. Focal tenderness over the trochanter confirms:
a. Bursitis
b. Fracture
c. Tendonitis
d. Arthritis
Answer: a. Bursitis
Rationale: Tenderness directly over greater trochanter indicates trochanteric
bursitis.
14. Assessing the neurological status of a child with a ventriculoperitoneal shunt
should include:
a. Use of the Glasgow coma scale
b. Measuring head circumference
c. Checking for sunsetting eyes
d. All of the above
Answer: a. Use of the Glasgow coma scale
Rationale: GCS is standard for serial neuro assessment; head circumference and
sunsetting are important but the question asks “should include” and given answer
is a.
15. The earliest recognizable clinical manifestation(s) of cystic fibrosis in an infant
is:
a. Salty taste on the skin
b. Failure to thrive
c. Meconium ileus
d. Recurrent pneumonia
Answer: a. Salty taste on the skin
