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BARKLEY 3P ACTUAL EXAM 2025/2026 COMPLETE 90
QUESTIONS & ANSWERS WITH DETAILED RATIONALES
GRADED A+ | UPDATED FOR 2025/2026 | PASS
GUARANTEED
EXAM OVERVIEW
The Barkley 3P Exam assesses competency in the three core areas of advanced
practice nursing: Pathophysiology, Pharmacology, and Physical Assessment . This
guide contains 90 verified exam questions with detailed rationales, updated for
the 2025/2026 testing cycle.
SECTION 1: CARDIOVASCULAR SYSTEM
Question 1
You are auscultating Jon's chest. When he sits up and leans forward, you can hear
a high-pitched, blowing murmur at S2. What does this type of murmur most likely
indicate?
• A) Mitral stenosis
• B) Aortic stenosis
• C) Mitral regurgitation
• D) Aortic regurgitation
Correct 100%Correct VERIFid Answer:: D
Rationale: Aortic regurgitation is a soft, high-pitched, blowing diastolic
decrescendo murmur best heard at the 3rd left interspace at the base when the
patient sits up and leans forward. Mitral stenosis is a low-pitched diastolic rumble
best heard at the apex in the left lateral position. Aortic stenosis is a loud, harsh
,2
murmur midsystole radiating to the neck. Mitral regurgitation is a loud blowing
murmur heard at the apex and is pansystolic .
Question 2
Which of the following is NOT part of Virchow's Triad?
• A) Hypercoagulability
• B) Damage to endothelial cells
• C) Sympathetic tone
• D) Turbulent blood flow
Correct 100%Correct VERIFid Answer:: C
Rationale: Virchow's triad describes the three main factors that lead to
thrombosis: hypercoagulability, endothelial damage, and turbulent blood flow
(circulatory stasis). Sympathetic tone is not a component of Virchow's triad and
does not directly affect blood clotting .
Question 3
Regarding the split S2 heart sound, which of these is false?
• A) It is a normal phenomenon
• B) The aortic valve closes significantly earlier than the pulmonic valve
• C) It is noted only in the aortic auscultatory area
• D) It occurs on end inspiration
Correct 100%Correct VERIFid Answer:: C
Rationale: A split S2 is a normal phenomenon that can be heard throughout the
precordium, not just in the aortic area. During inspiration, increased venous
return to the right ventricle delays pulmonic valve closure, causing the split .
,3
Question 4
Upon percussion of the chest, you notice hyperresonance. Which of the following
choices would most likely be the cause?
• A) Atelectasis
• B) Normal lung
• C) Pneumothorax
• D) Pulmonary embolism
Correct 100%Correct VERIFid Answer:: C
Rationale: Hyperresonance on chest percussion is a classic finding in
pneumothorax due to air trapped in the pleural space. Atelectasis produces
dullness, normal lung produces resonance, and pulmonary embolism typically
does not alter percussion notes .
SECTION 2: MUSCULOSKELETAL SYSTEM
Question 5
Which of the following is the most common clinical manifestation of
osteoporosis?
• A) Bone deformity
• B) Bone pain
• C) Pathologic fracture
• D) Fat embolism
Correct 100%Correct VERIFid Answer:: C
Rationale: Osteoporosis is a chronic, progressive, systemic metabolic bone
disease characterized by low bone mass and deterioration of bone tissue, leading
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to increased skeletal fragility and deformity. Osteoporosis is usually not apparent
until AFTER a fracture occurs .
Question 6
What is the proper order of steps to accurately perform the Ortolani maneuver?
• A) Extend the legs, adduct the legs, and abduct the knees
• B) Flex the knees, abduct the knees, and adduct the legs
• C) Flex the knees, adduct the legs, and abduct the legs
• D) Extend the knees, abduct the legs, and adduct the knees
Correct 100%Correct VERIFid Answer:: C
Rationale: The Ortolani maneuver is performed on a supine infant. The clinician
flexes the knees while holding the thighs, adducts the legs until the thumbs touch,
and then abducts the knees until the lateral part of the knee touches the table.
This tests for developmental dysplasia of the hip .
SECTION 3: ENDOCRINE SYSTEM
Question 7
A patient with kidney stones also presents with hypercalcemia and mental
confusion. The practitioner should evaluate the patient for which of the
following?
• A) Cushing Syndrome
• B) Conn's Syndrome
• C) Hyperparathyroidism
• D) Addison's disease
BARKLEY 3P ACTUAL EXAM 2025/2026 COMPLETE 90
QUESTIONS & ANSWERS WITH DETAILED RATIONALES
GRADED A+ | UPDATED FOR 2025/2026 | PASS
GUARANTEED
EXAM OVERVIEW
The Barkley 3P Exam assesses competency in the three core areas of advanced
practice nursing: Pathophysiology, Pharmacology, and Physical Assessment . This
guide contains 90 verified exam questions with detailed rationales, updated for
the 2025/2026 testing cycle.
SECTION 1: CARDIOVASCULAR SYSTEM
Question 1
You are auscultating Jon's chest. When he sits up and leans forward, you can hear
a high-pitched, blowing murmur at S2. What does this type of murmur most likely
indicate?
• A) Mitral stenosis
• B) Aortic stenosis
• C) Mitral regurgitation
• D) Aortic regurgitation
Correct 100%Correct VERIFid Answer:: D
Rationale: Aortic regurgitation is a soft, high-pitched, blowing diastolic
decrescendo murmur best heard at the 3rd left interspace at the base when the
patient sits up and leans forward. Mitral stenosis is a low-pitched diastolic rumble
best heard at the apex in the left lateral position. Aortic stenosis is a loud, harsh
,2
murmur midsystole radiating to the neck. Mitral regurgitation is a loud blowing
murmur heard at the apex and is pansystolic .
Question 2
Which of the following is NOT part of Virchow's Triad?
• A) Hypercoagulability
• B) Damage to endothelial cells
• C) Sympathetic tone
• D) Turbulent blood flow
Correct 100%Correct VERIFid Answer:: C
Rationale: Virchow's triad describes the three main factors that lead to
thrombosis: hypercoagulability, endothelial damage, and turbulent blood flow
(circulatory stasis). Sympathetic tone is not a component of Virchow's triad and
does not directly affect blood clotting .
Question 3
Regarding the split S2 heart sound, which of these is false?
• A) It is a normal phenomenon
• B) The aortic valve closes significantly earlier than the pulmonic valve
• C) It is noted only in the aortic auscultatory area
• D) It occurs on end inspiration
Correct 100%Correct VERIFid Answer:: C
Rationale: A split S2 is a normal phenomenon that can be heard throughout the
precordium, not just in the aortic area. During inspiration, increased venous
return to the right ventricle delays pulmonic valve closure, causing the split .
,3
Question 4
Upon percussion of the chest, you notice hyperresonance. Which of the following
choices would most likely be the cause?
• A) Atelectasis
• B) Normal lung
• C) Pneumothorax
• D) Pulmonary embolism
Correct 100%Correct VERIFid Answer:: C
Rationale: Hyperresonance on chest percussion is a classic finding in
pneumothorax due to air trapped in the pleural space. Atelectasis produces
dullness, normal lung produces resonance, and pulmonary embolism typically
does not alter percussion notes .
SECTION 2: MUSCULOSKELETAL SYSTEM
Question 5
Which of the following is the most common clinical manifestation of
osteoporosis?
• A) Bone deformity
• B) Bone pain
• C) Pathologic fracture
• D) Fat embolism
Correct 100%Correct VERIFid Answer:: C
Rationale: Osteoporosis is a chronic, progressive, systemic metabolic bone
disease characterized by low bone mass and deterioration of bone tissue, leading
, 4
to increased skeletal fragility and deformity. Osteoporosis is usually not apparent
until AFTER a fracture occurs .
Question 6
What is the proper order of steps to accurately perform the Ortolani maneuver?
• A) Extend the legs, adduct the legs, and abduct the knees
• B) Flex the knees, abduct the knees, and adduct the legs
• C) Flex the knees, adduct the legs, and abduct the legs
• D) Extend the knees, abduct the legs, and adduct the knees
Correct 100%Correct VERIFid Answer:: C
Rationale: The Ortolani maneuver is performed on a supine infant. The clinician
flexes the knees while holding the thighs, adducts the legs until the thumbs touch,
and then abducts the knees until the lateral part of the knee touches the table.
This tests for developmental dysplasia of the hip .
SECTION 3: ENDOCRINE SYSTEM
Question 7
A patient with kidney stones also presents with hypercalcemia and mental
confusion. The practitioner should evaluate the patient for which of the
following?
• A) Cushing Syndrome
• B) Conn's Syndrome
• C) Hyperparathyroidism
• D) Addison's disease
