MUSCULOSKELETAL EXAM- APEA Q
BANK ASSESSMENT 2.0 QUESTIONS
AND ANSWERS 2026/2027 UPDATE.
An NP is evaluating an adult patient who presents with joint pain. Which of the following
descriptions is most commonly associated with joint pain associated with an underlying dx of
gouty arthritis? - Answer Pain in a single affected joint, most often the first
metatarsophalangeal (MTP) joint
An NP is assessing a patient following a lower leg injury with an audible "pop" and suspects an
Achilles tendon rupture. Which of the following tests is a reliable indicator of this condition? -
Answer The Thompson test (squeeze the calf to plantar flex the ankle)
Which of the following physical exam findings would be characteristic of grade 5 on the scale of
grading muscle strength? - Answer Movement against full resistance without fatigue
Which of the following descriptions is most commonly associated with the joint pain associated
with an underlying diagnosis of rheumatoid arthritis? - Answer Chronic, symmetrical,
polyarticular joint pain, often in the hands (PIP, MCP) with warmth and swelling
Which of the following is the most likely risk factor for the development of the patient's
suspected osteoarthritis? - Answer BMI > 30kg/m < sup > 2 </sup>
When performing a spinal exam, unequal height of the iliac crests is most likely associated with
which of the following conditions? - Answer Scoliosis
An NP is assessing a patient with acute nocturnal onset of joint pain in the first
metatarsophalangeal (MTP) joint. Inspection reveals edema, warmth, and erythema of the joint.
Which of the following diagnostic results is recommended to confirm the most likely differential
dx? - Answer The presence of monosodium urate (MSU) crystals in synovial fluid
Which assessment findings would an NP suspect to see in an adult patient with a hip fracture? -
Answer External rotation of the hip and leg shortening
An NP is evaluating an adult patient and notes genu varum on the physical exam. Which of the
following best describes this term? - Answer Bow leggedness
The NP is examining the shoulder joint of a patient and suspects subscapularis disorder. The NP
brings the dorsum of the right hand behind the patient's lower back. With the elbow flexed at
, 90 degrees, the NP grips the wrist and lifts the patient's hand off their back. How would the NP
document this finding in the patient's record? - Answer Positive internal rotation lag test
An NP is evaluating a patient following a traumatic ankle injury. During exam, the NP notes point
tenderness over the posterior aspects of the malleolus. The patient reports being unable to
bear weight. According to the Ottawa ankle and foot rules, which of the following diagnostic
tests is indicated to assess for the most likely differential dx? - Answer 3-view radiographic
images of the ankle (AP, lateral, and internal oblique)
Which of the following conditions should be included on the list of most likely differential dx for
a patient who presents with decreased spinal mobility? - Answer Osteoarthritis
An audible and palpable crunching during exam on the left wrist is described as which of the
following? - Answer Crepitus
An NP is assessing an adult patient with nocturnal hand numbness. On exam, there is obvious
weakness when the NP asks the patient to point their thumb upward as the NP applies
downward resistance. How should the NP document this finding? - Answer Positive thumb
abduction test
An NP is assessing the hand of an adult patient and observes thenar atrophy. Which of the
following conditions does this finding typically suggest? - Answer A median nerve disorder
An NP is evaluating an adult patient who reports shoulder pain and a hx of repetitive overhead
activity. Which of the following descriptions of the pain is most commonly associated with an
underlying dx of rotator cuff tendinopathy? - Answer Sharp "catches" of shoulder pain and
grating when lifting the arm overhead
An NP is assessing a pt with gradual onset foot pain. The patient reports wearing high heels
often for work. The NP recognizes this patient is at greatest risk for? - Answer Hallux valgus
An NP is performing scoliosis screenings in school-aged children. Which of the following
techniques is indicated for scoliosis screening? - Answer Assess for symmetry as the child
bends forward with knees straight, head down, and arms extended
An NP is assessing an adult patient with a painful left knee and palpates bogginess over the
area. Which of the following is this finding likely associated with? - Answer Synovitis
An NP is assessing a patient who reports lower back pain that radiates down to their posterior
calf. How should the NP document this? - Answer Radicular low back pain
BANK ASSESSMENT 2.0 QUESTIONS
AND ANSWERS 2026/2027 UPDATE.
An NP is evaluating an adult patient who presents with joint pain. Which of the following
descriptions is most commonly associated with joint pain associated with an underlying dx of
gouty arthritis? - Answer Pain in a single affected joint, most often the first
metatarsophalangeal (MTP) joint
An NP is assessing a patient following a lower leg injury with an audible "pop" and suspects an
Achilles tendon rupture. Which of the following tests is a reliable indicator of this condition? -
Answer The Thompson test (squeeze the calf to plantar flex the ankle)
Which of the following physical exam findings would be characteristic of grade 5 on the scale of
grading muscle strength? - Answer Movement against full resistance without fatigue
Which of the following descriptions is most commonly associated with the joint pain associated
with an underlying diagnosis of rheumatoid arthritis? - Answer Chronic, symmetrical,
polyarticular joint pain, often in the hands (PIP, MCP) with warmth and swelling
Which of the following is the most likely risk factor for the development of the patient's
suspected osteoarthritis? - Answer BMI > 30kg/m < sup > 2 </sup>
When performing a spinal exam, unequal height of the iliac crests is most likely associated with
which of the following conditions? - Answer Scoliosis
An NP is assessing a patient with acute nocturnal onset of joint pain in the first
metatarsophalangeal (MTP) joint. Inspection reveals edema, warmth, and erythema of the joint.
Which of the following diagnostic results is recommended to confirm the most likely differential
dx? - Answer The presence of monosodium urate (MSU) crystals in synovial fluid
Which assessment findings would an NP suspect to see in an adult patient with a hip fracture? -
Answer External rotation of the hip and leg shortening
An NP is evaluating an adult patient and notes genu varum on the physical exam. Which of the
following best describes this term? - Answer Bow leggedness
The NP is examining the shoulder joint of a patient and suspects subscapularis disorder. The NP
brings the dorsum of the right hand behind the patient's lower back. With the elbow flexed at
, 90 degrees, the NP grips the wrist and lifts the patient's hand off their back. How would the NP
document this finding in the patient's record? - Answer Positive internal rotation lag test
An NP is evaluating a patient following a traumatic ankle injury. During exam, the NP notes point
tenderness over the posterior aspects of the malleolus. The patient reports being unable to
bear weight. According to the Ottawa ankle and foot rules, which of the following diagnostic
tests is indicated to assess for the most likely differential dx? - Answer 3-view radiographic
images of the ankle (AP, lateral, and internal oblique)
Which of the following conditions should be included on the list of most likely differential dx for
a patient who presents with decreased spinal mobility? - Answer Osteoarthritis
An audible and palpable crunching during exam on the left wrist is described as which of the
following? - Answer Crepitus
An NP is assessing an adult patient with nocturnal hand numbness. On exam, there is obvious
weakness when the NP asks the patient to point their thumb upward as the NP applies
downward resistance. How should the NP document this finding? - Answer Positive thumb
abduction test
An NP is assessing the hand of an adult patient and observes thenar atrophy. Which of the
following conditions does this finding typically suggest? - Answer A median nerve disorder
An NP is evaluating an adult patient who reports shoulder pain and a hx of repetitive overhead
activity. Which of the following descriptions of the pain is most commonly associated with an
underlying dx of rotator cuff tendinopathy? - Answer Sharp "catches" of shoulder pain and
grating when lifting the arm overhead
An NP is assessing a pt with gradual onset foot pain. The patient reports wearing high heels
often for work. The NP recognizes this patient is at greatest risk for? - Answer Hallux valgus
An NP is performing scoliosis screenings in school-aged children. Which of the following
techniques is indicated for scoliosis screening? - Answer Assess for symmetry as the child
bends forward with knees straight, head down, and arms extended
An NP is assessing an adult patient with a painful left knee and palpates bogginess over the
area. Which of the following is this finding likely associated with? - Answer Synovitis
An NP is assessing a patient who reports lower back pain that radiates down to their posterior
calf. How should the NP document this? - Answer Radicular low back pain
