Barkley Post Test Exam – 2026/2027 Verified Questions and Correct
Answers – Comprehensive Nurse Practitioner Board Review
OVERVIEW:
This 100-question set is a high-yield clinical review for nurse practitioner exams. It covers
dermatology, cardiology, pediatrics, OB/GYN, infectious disease, neurology, musculoskeletal,
endocrine, psychiatry, and professional issues. Questions test recognition of classic
presentations, physical exam tests, lab interpretation, and evidence-based management.
Emphasis on pediatric milestones, women's health, contraception, and urgent conditions prepares
learners for board-style critical thinking. Correct answers in bold Green.
Question 1
A 12-year-old boy reports to your office with his mother. The mother tells you that, 1
week ago, a rash formed that initially presented as an oval with a crinkled appearance.
Upon today's examination, you find that the boy has a pruritic rash in the form of a
Christmas tree pattern on his trunk. Which of the following is the most likely cause?
A. Coxsackie virus
B. Erythema infectiosum
C. Lyme disease
D. Pityriasis rosea
ANS: D
RATIONALE: Pityriasis rosea starts with a single herald patch - oval, salmon-colored
with collarette scaling and crinkled center, followed by secondary eruption along
Langer's lines giving a Christmas tree distribution on the trunk. Pruritic and self-limited.
Coxsackie causes hand-foot-mouth, erythema infectiosum is slapped cheek, Lyme is
erythema migrans.
Question 2
A 17-year-old male visits your office for a physical exam. He is tall in stature and has a
long, narrow face, as well as thin extremities and fingers. During the physical
examination, you confirm that his arm span exceeds his height. These physical
characteristics are consistent with which of the following disorders?
A. Marfan syndrome
B. Martin-Bell syndrome
C. Klinefelter syndrome
D. Precocious puberty
ANS: A
RATIONALE: Marfan syndrome is connective tissue disorder due to fibrillin-1 mutation.
Hallmarks: tall stature, arachnodactyly, arm span > height, dolichocephaly, pectus
deformity, aortic root dilation, ectopia lentis. Klinefelter also tall but with small testes,
gynecomastia. Martin-Bell is Fragile X.
Question 3
A 20-year-old college student tells you that he developed an itch in his ear canal that is
sometimes painful and is especially noticeable when he chews. Although he has not
,noticed any hearing loss, his ear is scaly and itchy. Upon physical exam, you notice
swelling in the outer third of his ear canal. He claims that he regularly cleans his ears
and has never swum or played any water sports in his life. Of the following, which is the
most likely diagnosis for his condition?
A. Cholesteatoma
B. Otitis externa
C. Serous otitis media
D. Acute otitis media
ANS: B
RATIONALE: Otitis externa is infection/inflammation of outer ear canal. Pain on
chewing due to temporomandibular joint proximity, pruritus, swelling of cartilaginous
outer 1/3, scaly debris. Over-cleaning predisposes. No middle ear findings. Otitis media
would have bulging TM and hearing loss.
Question 4
A 21-year-old soccer player presents to your office with a swollen, painful knee. He
recently sustained a painful injury during the game when, during a sprint, he quickly and
sharply shifted directions. Which of the following would you use to test for an
anterior/posterior cruciate ligament tear?
A. Phalen's test
B. Apley grind test
C. Lachman's test
D. McMurray's test
ANS: C
RATIONALE: Lachman's test is most sensitive for ACL tear - anterior translation of tibia
with knee in 20-30 degree flexion. Phalen's for carpal tunnel, Apley grind and McMurray
for meniscal tear.
Question 5
A 25-year-old woman comes into your practice complaining of recurring headaches, as
well as fatigue and difficulty breathing during exercise. A physical examination reveals
tachycardia and pallor, and lab results show low mean corpuscular volume, low mean
corpuscular hemoglobin concentration, low serum ferritin, and high red cell distribution
width. What is the best treatment for the patient's most likely condition?
A. Folate
B. Ferrous sulfate
C. Hydroxyurea
D. Cyanocobalamin
ANS: B
RATIONALE: Microcytic, hypochromic anemia with low ferritin, low MCV/MCHC, high
RDW = iron deficiency anemia. Common in young women due to menstruation.
Treatment is oral ferrous sulfate, plus workup for source. Folate/B12 for macrocytic.
Question 6
A 32-year-old man comes to you with raised, round, flesh-colored bumps covering part
of his lower right abdomen and right inner thigh. A physical exam indicates the lesions
are around 2-4 mm in diameter, are smooth, rounded, and firm; and vary from white to
"fleshy" color. Which of the following is the most popular method of treatment for the
most likely condition?
, A. Cryoanesthesia
B. Topical acyclovir
C. Imiquimod
D. Topical erythromycin
ANS: A
RATIONALE: Lesions are molluscum contagiosum caused by poxvirus. Umbilicated,
flesh-colored papules 2-5mm. Most popular/effective destructive therapy is cryotherapy
with liquid nitrogen, also curettage. Acyclovir for herpes.
Question 7
A 47-year-old man presents to your clinic with complaints of dizziness and vomiting.
Upon checking his ears, you note a local inflammation in his left ear, erythema with
diminished light reflexes, fluid in the middle ear, and a bulging tympanic membrane. You
suspect a bacterial pathogen. Which of the following is the most likely cause?
A. Enterococcus faecium
B. Moraxella catarrhalis
C. Haemophilus influenzae
D. Streptococcus pneumoniae
ANS: D
RATIONALE: Acute otitis media with bulging TM, erythema, effusion, decreased light
reflex. Most common bacterial cause in adults is Streptococcus pneumoniae, followed
by H. influenzae and M. catarrhalis. S. pneumoniae is leading.
Question 8
A 55-year-old woman comes to your office and explains that she has been experiencing
severe pain when moving her elbow, along with swelling and tenderness. She has been
a secretary for more than 30 years and believes her signs and symptoms are the result
of having to type for prolonged periods. Which of the following is the patient's most likely
condition?
A. Osteoporosis
B. Polymyalgia rheumatica
C. Bursitis
D. Carpal tunnel syndrome
ANS: C
RATIONALE: Repetitive microtrauma causes inflammation of bursa - bursitis. Elbow
olecranon bursitis presents with pain on movement, swelling, tenderness. Carpal tunnel
is wrist/hand paresthesia, osteoporosis is asymptomatic until fracture.
Question 9
A 62-year-old male comes to your office with concerns about a general feeling of
dizziness and lightheadedness. He states that he has been feeling a pulsating pain right
below the back of his head; this pain often occurs early in the morning and resolves
throughout the day. The patient's findings are most consistent with which of the
following cardiovascular conditions?
A. Hypertension
B. Aortic stenosis
C. Angina
D. Myocardial infarction
ANS: A
Answers – Comprehensive Nurse Practitioner Board Review
OVERVIEW:
This 100-question set is a high-yield clinical review for nurse practitioner exams. It covers
dermatology, cardiology, pediatrics, OB/GYN, infectious disease, neurology, musculoskeletal,
endocrine, psychiatry, and professional issues. Questions test recognition of classic
presentations, physical exam tests, lab interpretation, and evidence-based management.
Emphasis on pediatric milestones, women's health, contraception, and urgent conditions prepares
learners for board-style critical thinking. Correct answers in bold Green.
Question 1
A 12-year-old boy reports to your office with his mother. The mother tells you that, 1
week ago, a rash formed that initially presented as an oval with a crinkled appearance.
Upon today's examination, you find that the boy has a pruritic rash in the form of a
Christmas tree pattern on his trunk. Which of the following is the most likely cause?
A. Coxsackie virus
B. Erythema infectiosum
C. Lyme disease
D. Pityriasis rosea
ANS: D
RATIONALE: Pityriasis rosea starts with a single herald patch - oval, salmon-colored
with collarette scaling and crinkled center, followed by secondary eruption along
Langer's lines giving a Christmas tree distribution on the trunk. Pruritic and self-limited.
Coxsackie causes hand-foot-mouth, erythema infectiosum is slapped cheek, Lyme is
erythema migrans.
Question 2
A 17-year-old male visits your office for a physical exam. He is tall in stature and has a
long, narrow face, as well as thin extremities and fingers. During the physical
examination, you confirm that his arm span exceeds his height. These physical
characteristics are consistent with which of the following disorders?
A. Marfan syndrome
B. Martin-Bell syndrome
C. Klinefelter syndrome
D. Precocious puberty
ANS: A
RATIONALE: Marfan syndrome is connective tissue disorder due to fibrillin-1 mutation.
Hallmarks: tall stature, arachnodactyly, arm span > height, dolichocephaly, pectus
deformity, aortic root dilation, ectopia lentis. Klinefelter also tall but with small testes,
gynecomastia. Martin-Bell is Fragile X.
Question 3
A 20-year-old college student tells you that he developed an itch in his ear canal that is
sometimes painful and is especially noticeable when he chews. Although he has not
,noticed any hearing loss, his ear is scaly and itchy. Upon physical exam, you notice
swelling in the outer third of his ear canal. He claims that he regularly cleans his ears
and has never swum or played any water sports in his life. Of the following, which is the
most likely diagnosis for his condition?
A. Cholesteatoma
B. Otitis externa
C. Serous otitis media
D. Acute otitis media
ANS: B
RATIONALE: Otitis externa is infection/inflammation of outer ear canal. Pain on
chewing due to temporomandibular joint proximity, pruritus, swelling of cartilaginous
outer 1/3, scaly debris. Over-cleaning predisposes. No middle ear findings. Otitis media
would have bulging TM and hearing loss.
Question 4
A 21-year-old soccer player presents to your office with a swollen, painful knee. He
recently sustained a painful injury during the game when, during a sprint, he quickly and
sharply shifted directions. Which of the following would you use to test for an
anterior/posterior cruciate ligament tear?
A. Phalen's test
B. Apley grind test
C. Lachman's test
D. McMurray's test
ANS: C
RATIONALE: Lachman's test is most sensitive for ACL tear - anterior translation of tibia
with knee in 20-30 degree flexion. Phalen's for carpal tunnel, Apley grind and McMurray
for meniscal tear.
Question 5
A 25-year-old woman comes into your practice complaining of recurring headaches, as
well as fatigue and difficulty breathing during exercise. A physical examination reveals
tachycardia and pallor, and lab results show low mean corpuscular volume, low mean
corpuscular hemoglobin concentration, low serum ferritin, and high red cell distribution
width. What is the best treatment for the patient's most likely condition?
A. Folate
B. Ferrous sulfate
C. Hydroxyurea
D. Cyanocobalamin
ANS: B
RATIONALE: Microcytic, hypochromic anemia with low ferritin, low MCV/MCHC, high
RDW = iron deficiency anemia. Common in young women due to menstruation.
Treatment is oral ferrous sulfate, plus workup for source. Folate/B12 for macrocytic.
Question 6
A 32-year-old man comes to you with raised, round, flesh-colored bumps covering part
of his lower right abdomen and right inner thigh. A physical exam indicates the lesions
are around 2-4 mm in diameter, are smooth, rounded, and firm; and vary from white to
"fleshy" color. Which of the following is the most popular method of treatment for the
most likely condition?
, A. Cryoanesthesia
B. Topical acyclovir
C. Imiquimod
D. Topical erythromycin
ANS: A
RATIONALE: Lesions are molluscum contagiosum caused by poxvirus. Umbilicated,
flesh-colored papules 2-5mm. Most popular/effective destructive therapy is cryotherapy
with liquid nitrogen, also curettage. Acyclovir for herpes.
Question 7
A 47-year-old man presents to your clinic with complaints of dizziness and vomiting.
Upon checking his ears, you note a local inflammation in his left ear, erythema with
diminished light reflexes, fluid in the middle ear, and a bulging tympanic membrane. You
suspect a bacterial pathogen. Which of the following is the most likely cause?
A. Enterococcus faecium
B. Moraxella catarrhalis
C. Haemophilus influenzae
D. Streptococcus pneumoniae
ANS: D
RATIONALE: Acute otitis media with bulging TM, erythema, effusion, decreased light
reflex. Most common bacterial cause in adults is Streptococcus pneumoniae, followed
by H. influenzae and M. catarrhalis. S. pneumoniae is leading.
Question 8
A 55-year-old woman comes to your office and explains that she has been experiencing
severe pain when moving her elbow, along with swelling and tenderness. She has been
a secretary for more than 30 years and believes her signs and symptoms are the result
of having to type for prolonged periods. Which of the following is the patient's most likely
condition?
A. Osteoporosis
B. Polymyalgia rheumatica
C. Bursitis
D. Carpal tunnel syndrome
ANS: C
RATIONALE: Repetitive microtrauma causes inflammation of bursa - bursitis. Elbow
olecranon bursitis presents with pain on movement, swelling, tenderness. Carpal tunnel
is wrist/hand paresthesia, osteoporosis is asymptomatic until fracture.
Question 9
A 62-year-old male comes to your office with concerns about a general feeling of
dizziness and lightheadedness. He states that he has been feeling a pulsating pain right
below the back of his head; this pain often occurs early in the morning and resolves
throughout the day. The patient's findings are most consistent with which of the
following cardiovascular conditions?
A. Hypertension
B. Aortic stenosis
C. Angina
D. Myocardial infarction
ANS: A
