, APEA 3P EXAM 1
1. An 86-year-old man with uncontrolled hypertension presents with sudden, intense left lower
abdominal pain that radiates to the back and is described as tearing. These findings are MOST
likely associated with:
A. Acute pancreatitis
B. Renal colic
C. Diverticulitis
D. Abdominal aortic aneurysm (AAA)
Answer: D. Abdominal aortic aneurysm (AAA)
Rationale: AAA typically presents with sudden, severe abdominal or back pain described as
“tearing,” especially in elderly patients with hypertension.
2. Ophthalmoscopic examination reveals dark specks noted between the fundus and the lens.
These specks are most likely:
A. Cataracts
B. Retinal hemorrhages
C. Vitreous floaters
D. Macular degeneration
,Answer: C. Vitreous floaters
Rationale: Floaters are small opacities in the vitreous humor that appear as dark specks moving
in the visual field.
3. When performing the first Leopold maneuver on a pregnant woman, if the buttocks and head
are not easily palpated at the fundus, the fetus is said to be in:
A. Cephalic presentation
B. Breech presentation
C. Longitudinal lie
D. Transverse lie
Answer: D. Transverse lie
Rationale: In a transverse lie, the fetus lies sideways, so neither the head nor buttocks are felt at
the fundus.
4. During a musculoskeletal exam, a patient is asked to move his arm in front of his body. This
motion of the shoulder girdle is an example of:
A. Extension
B. Abduction
C. Flexion
D. Rotation
, Answer: C. Flexion
Rationale: Flexion refers to movement that decreases the angle of a joint, such as raising the
arm forward.
5. To locate the twelfth rib, the examiner should palpate:
A. Along the sternum
B. At the clavicle
C. Between the spine and the lateral chest
D. Beneath the scapula
Answer: C. Between the spine and the lateral chest
Rationale: The 12th rib is best palpated posteriorly between the spine and lateral chest wall.
6. Walking on the toes and heels may reveal:
A. Proximal muscle weakness
B. Joint instability
C. Distal muscular weakness in the legs
D. Spinal cord injury
Answer: C. Distal muscular weakness in the legs
Rationale: Toe and heel walking tests distal muscle strength in the lower extremities.
1. An 86-year-old man with uncontrolled hypertension presents with sudden, intense left lower
abdominal pain that radiates to the back and is described as tearing. These findings are MOST
likely associated with:
A. Acute pancreatitis
B. Renal colic
C. Diverticulitis
D. Abdominal aortic aneurysm (AAA)
Answer: D. Abdominal aortic aneurysm (AAA)
Rationale: AAA typically presents with sudden, severe abdominal or back pain described as
“tearing,” especially in elderly patients with hypertension.
2. Ophthalmoscopic examination reveals dark specks noted between the fundus and the lens.
These specks are most likely:
A. Cataracts
B. Retinal hemorrhages
C. Vitreous floaters
D. Macular degeneration
,Answer: C. Vitreous floaters
Rationale: Floaters are small opacities in the vitreous humor that appear as dark specks moving
in the visual field.
3. When performing the first Leopold maneuver on a pregnant woman, if the buttocks and head
are not easily palpated at the fundus, the fetus is said to be in:
A. Cephalic presentation
B. Breech presentation
C. Longitudinal lie
D. Transverse lie
Answer: D. Transverse lie
Rationale: In a transverse lie, the fetus lies sideways, so neither the head nor buttocks are felt at
the fundus.
4. During a musculoskeletal exam, a patient is asked to move his arm in front of his body. This
motion of the shoulder girdle is an example of:
A. Extension
B. Abduction
C. Flexion
D. Rotation
, Answer: C. Flexion
Rationale: Flexion refers to movement that decreases the angle of a joint, such as raising the
arm forward.
5. To locate the twelfth rib, the examiner should palpate:
A. Along the sternum
B. At the clavicle
C. Between the spine and the lateral chest
D. Beneath the scapula
Answer: C. Between the spine and the lateral chest
Rationale: The 12th rib is best palpated posteriorly between the spine and lateral chest wall.
6. Walking on the toes and heels may reveal:
A. Proximal muscle weakness
B. Joint instability
C. Distal muscular weakness in the legs
D. Spinal cord injury
Answer: C. Distal muscular weakness in the legs
Rationale: Toe and heel walking tests distal muscle strength in the lower extremities.
