The APEP Written Assessment is where many internationally qualified physiotherapists realise that knowing physiotherapy isn't the same as passing the Australian exam. Every year, candidates walk in expecting straightforward anatomy, orthopaedics, and neurology questions, only to find case-based scenarios that demand clinical reasoning, evidence-based decision-making, and safe practice aligned with Australian healthcare standards.
The challenge isn't simply remembering textbook facts. It's deciding what you would do as a practising physiotherapist in Australia. That's why many candidates who have years of clinical experience still need more than one attempt to clear the Written Assessment.
The stakes are high. The Written Assessment is the gateway to the rest of the Australian Physiotherapy Council's Assessment of Physiotherapy Practice Expertise (APEP) pathway. Until you pass it, you cannot progress to the Capability Assessment, delaying both your registration and migration plans. With the complete APEP pathway costing around AUD $7,814 before AHPRA registration fees (approximately AUD $330 annually for physiotherapists), every additional attempt means extra time, money, and uncertainty.
The good news is that the exam follows a predictable style once you understand how questions are written. Rather than testing rote memorisation, it evaluates whether you can apply your knowledge to realistic clinical situations, prioritise patient safety, and make sound professional decisions under exam conditions.
In this blog, you'll find APEP sample questions with detailed answers and explanations, understand the reasoning expected by the examiners, and learn how to approach scenario-based MCQs with confidence so you're better prepared for the 2026 APEP Written Assessment.
Brief Overview of APEP Written Assessment?
The Australian Physiotherapy Council (APC) replaced the old Standard Pathway with the Australian Physiotherapy Entry Pathway (APEP) in October 2025. It's now a five-stage pathway:
- Eligibility Assessment- confirms your degree and registration are recognised
- Cultural Safety Training- mandatory online module
- Written Assessment- the focus of this guide
- Capability Assessment- a remote oral case-discussion exam (replaced the old clinical simulation stations)
- Clinical Workshop- the only in-person component, held in Melbourne
Once you clear all five stages, you receive your APC Final Certificate, which is what you submit to AHPRA for General Registration.
Written Assessment: Exam Pattern at a Glance
| Feature | Detail |
| Format | Computer-based, multiple-choice questions (MCQ) |
| Total questions | 120 questions |
| Papers | 2 papers × 60 questions each |
| Duration | 2 hours per paper (4 hours total) |
| Question structure | 15 clinical case scenarios per paper, 4 MCQs per case |
| Scoring model | Rasch scaled score (not raw percentage). Your result is based on a scaled score using the Rasch measurement model, where question difficulty adjusts based on your responses rather than a simple percentage of correct answers |
| Negative marking | None: attempt every question |
| Sittings per year | Held four times a year |
| Where | Remote (from home) or in-person: candidate's choice |
| Content basis | The Physiotherapy Practice Thresholds for Australia and Aotearoa New Zealand (updated 2024) |
The single biggest format shift candidates underestimate: this isn't a "memorise-the-textbook" exam. Every four-question block hangs off one detailed clinical vignette, a patient history, presenting complaint, comorbidities, and sometimes social context, and you're expected to reason through assessment, red flags, intervention choice, and safety/discharge planning exactly as an entry-level Australian physiotherapist would on the ward.
That's precisely the format the 15 questions below reproduce.
Expert-Curated 15 APEP Written Exam Sample Questions with Answers & Explanations
These case-based MCQs mirror the actual structure candidates encounter. One clinical scenario, several linked questions, and reasoning-based (not recall-based) correct answers. All these questionnaires are
Case 1: Post-Total Knee Replacement (Orthopaedics)
Q1. A 68-year-old male, 2 weeks post-total knee replacement (TKR), presents with moderate swelling, flexion limited to ~70°, extension lag of 10°, pain 4/10, using a walker. He lives alone with stairs at home and wants to drive in 4 weeks. What is the best next step in his rehab plan?
A. Initiate high-intensity open kinetic chain leg extensions (90°→0°) B. Emphasise closed kinetic chain functional tasks (sit-to-stand, mini-squats) C. Delay any strengthening until full flexion is achieved (>100°) D. Focus only on passive range of motion until swelling resolves
Answer: B
Explanation: Closed kinetic chain exercises like sit-to-stand and mini-squats load the joint functionally while protecting the healing extensor mechanism, exactly the kind of low-risk, high-transfer exercise appropriate at 2 weeks post-TKR. Waiting for full flexion (option C) or restricting to passive ROM (option D) would unnecessarily delay functional recovery given his 4-week driving goal.
Q2. His knee swelling is persistent and limiting flexion. Which adjunct intervention is most appropriate?
A. Continuous heat pack for 30 minutes pre-exercise B. Cryotherapy combined with compression and elevation post-exercise C. Ignore swelling and proceed regardless D. Iontophoresis only for swelling reduction
Answer: B
Explanation: Ice, compression, and elevation (ICE) post-exercise is the standard evidence-based combination for managing post-operative effusion, reducing inflammatory response without compromising the exercise dose delivered that session.
Q3. Considering his goal of driving in 4 weeks, what is the most appropriate functional milestone at week 4?
A. Unassisted walking with full ROM and pain ≤2/10 B. Return to unlimited running and jumping C. Walking only indoors with a tube stick, no stairs D. Being able to get into/out of a standard car and press pedals safely
Answer: D
Explanation: Driving requires a very specific functional capacity, safe transfers in/out of a vehicle and adequate knee flexion/control to operate pedals, not full ROM or unrestricted athletic activity. Milestones should always map directly onto the patient's stated functional goal.
Q4. Given he lives alone with stairs at home, which safety/education component is most essential?
A. Advise him to avoid stairs entirely B. Teach correct walker use on stairs and simulate home stairs during the session C. Provide no advice since he has used a walker before D. Recommend a ramp instead of stairs
Answer: B
Explanation: Environmental and home-safety education is a core competency domain in APEP, assessing the actual environment the patient will return to (stairs, no live-in support) and rehearsing the specific task (stair negotiation with a walker) before discharge.
Case 2: Cardiac Rehabilitation: Post-Myocardial Infarction
Q5. Mr M, 10 days post-MI, is in Phase I inpatient cardiac rehab. Resting HR 72 bpm, BP 118/76. He rates his exertion as 9 on the Borg RPE 6–20 scale. What does an RPE of 9 indicate?
A. Very light B. Somewhat hard C. Hard D. Very hard
Answer: A
Explanation: On the 6-20 Borg scale, a rating of 9 corresponds to "very light" exertion, appropriate and expected for early Phase I mobilisation, where the goal is low-intensity monitored activity, not exercise stress.
Q6. The cardiologist restricts his intensity to ≤7 METs. Which activity is contraindicated?
A. Riding a stationary bike at 8 km/h B. Ascending stairs with assistance C. Descending stairs independently D. Ambulating independently at 8–10 km/h
Answer: D
Explanation: Independent ambulation at 8–10 km/h is a brisk pace that exceeds the 7 MET ceiling for this patient, making it the contraindicated option relative to the supervised, lower-intensity alternatives.
Q7. During the session, his BP drops from 118/76 to 92/64 mmHg with dizziness. What is your immediate action?
A. Continue and recheck BP after B. Stop exercise, assist to a safe seated position, monitor vitals C. Encourage deep breathing and resume once dizziness subsides D. Call emergency assistance only if he loses consciousness
Answer: B
Explanation: A drop in systolic BP during exertion accompanied by symptoms (dizziness) is a red flag for exertion hypotension. Immediate cessation and safe positioning with vital monitoring is the correct first-line safety response. You don't wait for loss of consciousness to act.
Case 3: Pushing Behaviour After Right Cortical Stroke (Neurology)
Q8. A 60-year-old man post-large right cortical hemorrhagic stroke pushes with his unaffected left arm and leans toward his affected right side, unaware of the imbalance risk, and resists correction. He is alert, oriented, with mild right-side weakness but no significant sensory loss. What neurological deficit most likely explains this pushing behaviour?
A. Homonymous hemianopia B. Dyspraxia C. Dysmetria D. Hemi-sensory loss (impaired perception of body position/postural vertical)
Answer: D
Explanation: This clinical picture, pushing toward the affected side, resistance to correction, and lack of insight reflects a disturbance in the perception of postural vertical (a hemi-perceptual/sensory processing deficit), classically described in "pusher syndrome" after right hemisphere stroke, rather than a visual field, motor planning, or coordination deficit.
Q9. Which intervention is the most appropriate initial strategy to improve weight-bearing and postural control in sitting?
A. Ask the patient to visually scan the room, focusing on objects on both sides B. Decrease thigh support C. Increase thigh support D. No intervention
Answer: C
Explanation: Increasing thigh support gives the patient a stable, wider base of support to build confidence and control in midline sitting before progressing to more dynamic visual and postural-realignment strategies.
Case 4: Fall Risk in an Aged-Care Resident
Q10. Mr Lee, 75, with osteoarthritis, mild CHF, type 2 diabetes, and 2 falls in the past year, uses a walking frame with moderate cognitive decline (MMSE 24/30). What is the primary physiotherapy goal?
A. Olympic-style lifting to reverse aging B. Improve functional mobility, reduce falls risk, maximise independence C. Ignore mobility and focus only on arm strength D. Bed-bound passive movements only
Answer: B
Explanation: For a multi-comorbid, falls-risk aged-care resident, the physiotherapy goal is always functional and safety-oriented, sit-to-stand, transfers, and safe walking, not high-intensity training or passive-only care, both of which ignore his actual clinical priorities.
Q11. Which is the most significant modifiable risk factor for his falls that physiotherapy should address?
A. Age B. History of falls C. Lower limb weakness and poor balance D. Having a walking frame
Answer: C
Explanation: Age and prior falls history are non-modifiable risk markers. Lower limb weakness and poor balance are the modifiable impairments physiotherapy can directly target through strength and balance training. The correct focus for an intervention-based question.
Case 5: Low Back Pain with Neural Symptoms
Q12. A 38-year-old male with low back pain radiating to the right buttock/thigh and intermittent paraesthesia on the medial dorsum of the right foot. The physiotherapist uses the slump test. Why?
A. It indicates the range of spinal movement available B. It is useful for evaluating treatment progress C. Absence of symptoms during the full test rules out any neural element D. By changing the patient's position passively and actively, the physiotherapist can identify whether a neural element contributes to the pain
Answer: D
Explanation: The slump test is a neurodynamic test specifically designed to differentiate neural tissue involvement from purely musculoskeletal pain by sequentially adding tension (trunk flexion, neck flexion, knee extension, ankle dorsiflexion) and observing symptom reproduction or relief, not simply measuring ROM.
Q13. The paraesthesia is on the medial side of the foot. Which structures should the exam evaluate?
A. L4 nerve root and saphenous nerve B. L5 nerve root and saphenous nerve C. L4 nerve root and posterior tibial nerve D. L5 nerve root and saphenous nerve (duplicate distractor pattern, correct clinical reasoning below)
Answer: The medial foot/lower leg sensory distribution corresponds to the L4 nerve root and saphenous nerve territory, both worth screening whenever medial-sided paraesthesia is reported, since the saphenous nerve (a terminal branch of the femoral nerve) also supplies this exact region and is a commonly missed differential.
Case 6: Paediatric Asthma
Q14. Lachie, a 4-year-old, had an acute asthma exacerbation and is now being discharged with an outpatient physiotherapy referral. Which statement about asthma is INCORRECT?
A. Hypersecretion of mucus B. Hyperplasia of goblet cells C. Thinning or destruction of the alveolar wall D. Oedema of the upper respiratory tract
Answer: C
Explanation: Destruction of the alveolar wall is the hallmark of emphysema, not asthma. Asthma pathophysiology centres on airway inflammation, bronchoconstriction, mucus hypersecretion, and goblet cell hyperplasia, the alveoli themselves remain structurally intact. This is a classic "identify the false statement" trap testing whether you can distinguish obstructive disease subtypes.
Case 7: Post-partum Pelvic Floor
Q15. A 34-year-old woman, 10 weeks post-partum, reports urinary leakage with coughing/sneezing (stress-type symptoms) plus sudden urgency with mild leakage. What overlapping condition should you be screened for?
A. Overflow incontinence B. Faecal incontinence C. Mixed urinary incontinence D. Functional incontinence
Answer: C
Explanation: The combination of stress symptoms (leakage on coughing/sneezing) and urge symptoms (sudden urgency with leakage) in the same patient defines mixed urinary incontinence, a common and frequently under-screened post-partum presentation that changes the treatment plan from pelvic floor strengthening alone to include bladder training as well.
Why Case-Based Reasoning (Not Rote Learning) Is the Real Skill APEP Tests
Notice the pattern across all 15 questions above. None of them ask "define plantar fasciitis" in isolation. Every question embeds a full clinical picture, age, occupation, comorbidities, red flags, patient goals and asks you to apply reasoning, not recall a definition. This mirrors exactly what the Physiotherapy Practice Thresholds document expects of an entry-level Australian physiotherapist, and it's why candidates who prepare only from textbooks (rather than practising against realistic, scenario-based mock papers) often underperform relative to their actual clinical knowledge.
This is also the exact reason the Written Assessment sits before the Capability Assessment in the APEP sequence. APC wants to confirm your clinical reasoning is sound on paper before assessing it live in an oral case-discussion format.
Want the Rest of the Question Bank?
The 15 questions above are a sample from a much larger, exam-style mock test covering orthopaedics, cardiorespiratory, neurology, musculoskeletal, paediatrics, women's health, and vestibular rehabilitation, the full spread of domains the actual APEP Written Assessment draws from.
What's Next after APEP Written Assessment?
Passing the Written Assessment only gets you halfway. The next step is the Capability Assessment. It is a remote, open-book oral exam where you talk through real physiotherapy cases with an assessor across defined competency domains, and you must be judged competent in every single domain to pass, not just on average. It's a fundamentally different skill from MCQ test-taking. Structured verbal clinical reasoning under time pressure, in real time, with no multiple-choice scaffolding to fall back on.
If the Written Assessment tests whether you can recognise the right answer, the Capability Assessment tests whether you can construct and defend it out loud, which is why candidates who've only ever answered MCQs often need a completely separate layer of preparation once they clear the written stage.
Academically's Capability Assessment preparation course is built specifically around this oral, domain-by-domain format, with mock case discussions and structured feedback from mentors who have been through APEP themselves. It is worth exploring once your Written Assessment date is locked in, so the two stages of preparation don't collide against your exam calendar.
What's Next After Getting Registered by Australian Physiotherapy Council?
It's worth zooming out to why candidates go through this in the first place. Entry-level physiotherapist salaries in Australia start around AUD 80,000 per year (≈₹46 lakh), rising to AUD 112,618 (≈₹65 lakh) for experienced practitioners with entry-level positions starting at AUD 80,000 per year and experienced physiotherapists earning up to AUD 112,618 per year.
It is a meaningful step up for most internationally trained physios, alongside better work-life balance and a clear pathway to permanent residency through skilled visa subclasses.
Once your AHPRA registration comes through, the next practical step is actually landing the right role and this is where a platform like Jobslly.in becomes genuinely useful. It's built specifically to connect internationally registered healthcare professionals, including physiotherapists, with verified Australian employers, so you're not cold-emailing clinics the week your registration lands.
Worth bookmarking well before your Clinical Workshop, so your job search timeline overlaps with your registration timeline instead of starting from zero afterwards.
Common Mistakes Candidates Make Preparing for the APEP Written Exam
- Studying isolated facts instead of case reasoning: the exam is built on 15 clinical vignettes per paper, not 60 standalone questions
- Ignoring the Rasch scoring model: since difficulty is scaled, panicking over one hard question wastes time better spent on the next case
- Skipping practice under real time pressure: 60 questions in 2 hours means under 2 minutes per question, including reading the vignette
- Not covering the full breadth: cardiorespiratory, neurology, women's health, paediatrics, and musculoskeletal domains all appear; narrow preparation in only orthopaedics leaves major gaps
- Leaving questions blank: there is no negative marking, so every question should be attempted
- Underestimating home-safety and discharge-planning questions: these recur across nearly every case type and are frequently missed by candidates who focus purely on clinical technique
To Conclude with...
The APEP Written Assessment isn't a memory test. It's a clinical reasoning test wearing an MCQ costume. The 15 questions above should give you a real feel for the case-based format, the reasoning APC expects, and exactly where most candidates' preparation falls short. With a AUD $7,814 total pathway cost and only four sittings a year, there's real financial and time pressure to get this right on the first attempt.
