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APEA Predictor Exam Questions with Correct
Verified Answers 2024/2025
General & Professional Practice
Q1. All of the following are classified as activities of daily living (ADLs) except:
A. Ability to feed self
B. Ability to manage bladder and bowel elimination
C. Personal hygiene and grooming
D. Grocery Shopping
Answer: D. Grocery shopping
Rationale: ADLs are basic self-care tasks necessary for independent living, including
feeding, toileting, dressing, bathing, and transferring . Grocery shopping is classified as
an Instrumental Activity of Daily Living (IADL) , which are more complex skills
needed for community living .
Q2. According to the ANA, the role of the NP who provides primary health care is
the:
A. Direct nursing care role
B. Educator role
C. Administrator role
D. Consultant role
Answer: A. Direct nursing care role
Rationale: The nurse practitioner in primary care functions as a direct primary
healthcare provider. While NPs may assume indirect roles (educator, researcher,
administrator), the ANA recognizes direct care as the foundational role for those
providing primary health services .
Q3. The mechanism by which nurses are held accountable for practice, based on
the quality of nursing care in a given situation with established standards of
practice, is:
A. Outcome criteria
B. Process criteria
,2
C. Peer review
D. Quality assurance
Answer: C. Peer review
Rationale: Peer review is the evaluation of professional practice by colleagues working
in the same field. It ensures accountability by comparing actual care delivery against
established standards of practice .
Q4. The nurse practitioner is following a child with juvenile rheumatoid arthritis
(JRA) who is being managed by a specialist. The mother asks about long-term
prognosis. The appropriate reply is that:
A. Most children achieve complete remission with no lasting effects
B. Active disease typically continues into adulthood but can be managed
C. Most children achieve remission by adulthood, but lifelong limitations may remain
D. The disease is progressive and will require lifelong intensive treatment
Answer: C. Most children achieve remission by adulthood, but lifelong limitations
may remain
Rationale: Although active JRA often remits by adulthood, contractures, growth
retardation, bone deformities, and visual impairment may lead to lifelong functional
limitations. A comprehensive treatment program can limit residual disability .
Q5. A 25-year-old female presents for a routine well-woman exam. The NP notes a
scant nipple discharge, absence of a palpable mass, and absence of lymph node
enlargement. What is the most likely diagnosis?
A. Breast cancer
B. Fibrocystic breast disease
C. Intraductal papilloma
D. Chest wall syndrome
Answer: C. Intraductal papilloma
Rationale: Intraductal papilloma typically presents with serous or bloody nipple
discharge without a palpable mass. It is located in the ductal system near the areola.
Breast cancer may present with discharge but is often associated with a mass .
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🧠 Physical Assessment & Diagnostic Techniques (Questions 6-
25)
Q6. A test called the "visual fields by confrontation" is used to evaluate for:
A. Peripheral vision
B. Central vision
C. Visual acuity
D. Accommodation
Answer: A. Peripheral vision
Rationale: Confrontation visual field testing compares the patient's peripheral vision to
the examiner's. It is a screening test for peripheral vision defects .
Q7. 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. CN XI (Spinal Accessory)
Rationale: Cranial Nerve XI (Spinal Accessory) innervates the trapezius and
sternocleidomastoid muscles. Shoulder shrug tests the trapezius, while turning the head
against resistance tests the sternocleidomastoid .
Q8. The deep tendon reflex (DTR) for the knee (patellar reflex) is mediated by
which spinal nerve roots?
A. L2, L3, L4
B. S1
C. C5, C6
D. C6, C7
Answer: A. L2, L3, L4
Rationale: The patellar reflex (knee jerk) is mediated by spinal nerve roots L2, L3, and
L4. The ankle reflex (Achilles) is S1 primarily; biceps and triceps reflexes are mediated by
C5-C7 .
Q9. A patient presents with distorted areas and blind spots in the visual field. The
painless condition was first noticed on awakening this morning. What condition
, 4
should be suspected?
A. Retinal detachment
B. Anterior ischemic optic neuropathy (eye stroke)
C. Optic neuritis
D. Glaucoma
Answer: B. Anterior ischemic optic neuropathy (eye stroke)
Rationale: An eye stroke occurs when blood flow becomes blocked or reduced to the
optic nerve. It can cause sudden, painless loss of peripheral vision, distorted vision, and
blind spots. Prompt medical attention can prevent or limit vision loss. The NP should
examine for edema, infarcts, exudates, and retinal detachment, and screen for diabetes
mellitus .
Q10. A positive Murphy's sign is suggestive of which condition?
A. Appendicitis
B. Pancreatitis
C. Acute cholecystitis
D. Peptic ulcer disease
Answer: C. Acute cholecystitis
Rationale: Murphy's sign—pain and inspiratory arrest upon palpation of the right upper
quadrant—is highly suggestive of acute cholecystitis and gallbladder disease .
Q11. What is the hallmark symptom of Peripheral Arterial Disease (PAD)?
A. Edema
B. Intermittent claudication
C. Rest pain
D. Cyanosis
Answer: B. Intermittent claudication
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 .
Q12. Which test is best to confirm Peripheral Arterial Disease?
A. ECG
B. Ankle-Brachial Index (ABI)
C. Echocardiogram
D. Doppler ultrasound
APEA Predictor Exam Questions with Correct
Verified Answers 2024/2025
General & Professional Practice
Q1. All of the following are classified as activities of daily living (ADLs) except:
A. Ability to feed self
B. Ability to manage bladder and bowel elimination
C. Personal hygiene and grooming
D. Grocery Shopping
Answer: D. Grocery shopping
Rationale: ADLs are basic self-care tasks necessary for independent living, including
feeding, toileting, dressing, bathing, and transferring . Grocery shopping is classified as
an Instrumental Activity of Daily Living (IADL) , which are more complex skills
needed for community living .
Q2. According to the ANA, the role of the NP who provides primary health care is
the:
A. Direct nursing care role
B. Educator role
C. Administrator role
D. Consultant role
Answer: A. Direct nursing care role
Rationale: The nurse practitioner in primary care functions as a direct primary
healthcare provider. While NPs may assume indirect roles (educator, researcher,
administrator), the ANA recognizes direct care as the foundational role for those
providing primary health services .
Q3. The mechanism by which nurses are held accountable for practice, based on
the quality of nursing care in a given situation with established standards of
practice, is:
A. Outcome criteria
B. Process criteria
,2
C. Peer review
D. Quality assurance
Answer: C. Peer review
Rationale: Peer review is the evaluation of professional practice by colleagues working
in the same field. It ensures accountability by comparing actual care delivery against
established standards of practice .
Q4. The nurse practitioner is following a child with juvenile rheumatoid arthritis
(JRA) who is being managed by a specialist. The mother asks about long-term
prognosis. The appropriate reply is that:
A. Most children achieve complete remission with no lasting effects
B. Active disease typically continues into adulthood but can be managed
C. Most children achieve remission by adulthood, but lifelong limitations may remain
D. The disease is progressive and will require lifelong intensive treatment
Answer: C. Most children achieve remission by adulthood, but lifelong limitations
may remain
Rationale: Although active JRA often remits by adulthood, contractures, growth
retardation, bone deformities, and visual impairment may lead to lifelong functional
limitations. A comprehensive treatment program can limit residual disability .
Q5. A 25-year-old female presents for a routine well-woman exam. The NP notes a
scant nipple discharge, absence of a palpable mass, and absence of lymph node
enlargement. What is the most likely diagnosis?
A. Breast cancer
B. Fibrocystic breast disease
C. Intraductal papilloma
D. Chest wall syndrome
Answer: C. Intraductal papilloma
Rationale: Intraductal papilloma typically presents with serous or bloody nipple
discharge without a palpable mass. It is located in the ductal system near the areola.
Breast cancer may present with discharge but is often associated with a mass .
,3
🧠 Physical Assessment & Diagnostic Techniques (Questions 6-
25)
Q6. A test called the "visual fields by confrontation" is used to evaluate for:
A. Peripheral vision
B. Central vision
C. Visual acuity
D. Accommodation
Answer: A. Peripheral vision
Rationale: Confrontation visual field testing compares the patient's peripheral vision to
the examiner's. It is a screening test for peripheral vision defects .
Q7. 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. CN XI (Spinal Accessory)
Rationale: Cranial Nerve XI (Spinal Accessory) innervates the trapezius and
sternocleidomastoid muscles. Shoulder shrug tests the trapezius, while turning the head
against resistance tests the sternocleidomastoid .
Q8. The deep tendon reflex (DTR) for the knee (patellar reflex) is mediated by
which spinal nerve roots?
A. L2, L3, L4
B. S1
C. C5, C6
D. C6, C7
Answer: A. L2, L3, L4
Rationale: The patellar reflex (knee jerk) is mediated by spinal nerve roots L2, L3, and
L4. The ankle reflex (Achilles) is S1 primarily; biceps and triceps reflexes are mediated by
C5-C7 .
Q9. A patient presents with distorted areas and blind spots in the visual field. The
painless condition was first noticed on awakening this morning. What condition
, 4
should be suspected?
A. Retinal detachment
B. Anterior ischemic optic neuropathy (eye stroke)
C. Optic neuritis
D. Glaucoma
Answer: B. Anterior ischemic optic neuropathy (eye stroke)
Rationale: An eye stroke occurs when blood flow becomes blocked or reduced to the
optic nerve. It can cause sudden, painless loss of peripheral vision, distorted vision, and
blind spots. Prompt medical attention can prevent or limit vision loss. The NP should
examine for edema, infarcts, exudates, and retinal detachment, and screen for diabetes
mellitus .
Q10. A positive Murphy's sign is suggestive of which condition?
A. Appendicitis
B. Pancreatitis
C. Acute cholecystitis
D. Peptic ulcer disease
Answer: C. Acute cholecystitis
Rationale: Murphy's sign—pain and inspiratory arrest upon palpation of the right upper
quadrant—is highly suggestive of acute cholecystitis and gallbladder disease .
Q11. What is the hallmark symptom of Peripheral Arterial Disease (PAD)?
A. Edema
B. Intermittent claudication
C. Rest pain
D. Cyanosis
Answer: B. Intermittent claudication
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 .
Q12. Which test is best to confirm Peripheral Arterial Disease?
A. ECG
B. Ankle-Brachial Index (ABI)
C. Echocardiogram
D. Doppler ultrasound
