Barkley FNP Predictor/Readiness Practice FLORIDA
STATE FIRE INSTRUCTOR 3 ACTUAL EXAM ALL
QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
VERIFIED SOLUTIONS | UPDATED PER LATEST
GUIDELINES | GRADED A+
Questions 1–20: Adult Primary Care & Cardiology
1. A 58-year-old patient has a blood pressure of 168/102 mmHg on two separate visits. Which
diagnosis is most appropriate?
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 hypertension
D. Stage 2 hypertension
Answer: D. Stage 2 hypertension
Rationale: A blood pressure ≥140/90 mmHg meets the conventional definition of stage 2
hypertension. Diagnosis should be based on appropriately obtained measurements and, when
appropriate, confirmation outside the office.
2. A patient with hypertension asks about lifestyle modifications. Which recommendation has
the strongest evidence for lowering blood pressure?
A. Increase sodium intake
B. Follow a DASH-style eating pattern
C. Eliminate all carbohydrates
D. Avoid physical activity
Answer: B. Follow a DASH-style eating pattern
Rationale: The DASH dietary pattern emphasizes fruits, vegetables, whole grains, legumes, and
low-fat dairy while reducing sodium and saturated fat.
,3. A 64-year-old patient has hypertension and diabetes with albuminuria. Which medication
class is particularly beneficial?
A. ACE inhibitor
B. Short-acting nitrate
C. Loop diuretic only
D. Alpha blocker only
Answer: A. ACE inhibitor
Rationale: ACE inhibitors or ARBs are commonly preferred in patients with hypertension and
diabetic kidney disease with albuminuria because they lower intraglomerular pressure and
reduce albuminuria.
4. A patient taking lisinopril develops persistent dry cough. Which medication is an
appropriate alternative?
A. Losartan
B. Digoxin
C. Verapamil only
D. Nitroglycerin
Answer: A. Losartan
Rationale: ACE inhibitors can cause cough due to bradykinin accumulation. An ARB such as
losartan is a common alternative.
5. A 52-year-old patient reports crushing chest pressure radiating to the left arm with
diaphoresis. What is the priority?
A. Schedule a routine appointment next month
B. Obtain immediate emergency evaluation
C. Recommend an antacid and observe
D. Start an exercise program
Answer: B. Obtain immediate emergency evaluation
Rationale: The presentation is highly concerning for acute coronary syndrome. Rapid
emergency evaluation is required.
,6. Which symptom is most concerning for heart failure?
A. Mild seasonal rhinitis
B. Orthopnea and paroxysmal nocturnal dyspnea
C. Occasional hiccups
D. Mild constipation
Answer: B. Orthopnea and paroxysmal nocturnal dyspnea
Rationale: Orthopnea and PND are classic symptoms of pulmonary congestion associated with
heart failure.
7. Which physical finding is associated with left-sided heart failure?
A. Pulmonary crackles
B. Isolated jaundice
C. Enlarged thyroid
D. Hyperactive bowel sounds
Answer: A. Pulmonary crackles
Rationale: Left ventricular dysfunction can cause elevated pulmonary venous pressure and
pulmonary congestion, producing crackles.
8. A patient with atrial fibrillation has a rapid ventricular response but is hemodynamically
stable. Which medication can be used for rate control?
A. Diltiazem
B. Epinephrine
C. Alteplase
D. Adenosine as chronic therapy
Answer: A. Diltiazem
Rationale: Diltiazem is a nondihydropyridine calcium-channel blocker that can slow AV nodal
conduction and control ventricular rate in appropriate patients.
, 9. Which patient with atrial fibrillation requires the greatest concern for thromboembolic
risk?
A. Young patient with no risk factors
B. Older adult with hypertension, diabetes, and prior stroke
C. Patient with seasonal allergies
D. Patient with isolated sinus tachycardia
Answer: B. Older adult with hypertension, diabetes, and prior stroke
Rationale: Stroke risk in AF increases with factors such as age, hypertension, diabetes, heart
failure, and previous stroke/TIA.
10. A patient reports intermittent calf pain while walking that resolves with rest. What
condition should be suspected?
A. Peripheral arterial disease
B. Cellulitis
C. Deep venous thrombosis
D. Neuropathic pain only
Answer: A. Peripheral arterial disease
Rationale: Intermittent claudication—exertional leg pain relieved by rest—is classic for
peripheral arterial disease.
11. Which test is commonly used as an initial noninvasive assessment for peripheral arterial
disease?
A. Ankle-brachial index
B. EEG
C. Colonoscopy
D. Spirometry
Answer: A. Ankle-brachial index
Rationale: ABI compares ankle and brachial systolic pressures and is a common initial test for
suspected lower-extremity PAD.
12. Which finding is characteristic of deep venous thrombosis?
STATE FIRE INSTRUCTOR 3 ACTUAL EXAM ALL
QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
VERIFIED SOLUTIONS | UPDATED PER LATEST
GUIDELINES | GRADED A+
Questions 1–20: Adult Primary Care & Cardiology
1. A 58-year-old patient has a blood pressure of 168/102 mmHg on two separate visits. Which
diagnosis is most appropriate?
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 hypertension
D. Stage 2 hypertension
Answer: D. Stage 2 hypertension
Rationale: A blood pressure ≥140/90 mmHg meets the conventional definition of stage 2
hypertension. Diagnosis should be based on appropriately obtained measurements and, when
appropriate, confirmation outside the office.
2. A patient with hypertension asks about lifestyle modifications. Which recommendation has
the strongest evidence for lowering blood pressure?
A. Increase sodium intake
B. Follow a DASH-style eating pattern
C. Eliminate all carbohydrates
D. Avoid physical activity
Answer: B. Follow a DASH-style eating pattern
Rationale: The DASH dietary pattern emphasizes fruits, vegetables, whole grains, legumes, and
low-fat dairy while reducing sodium and saturated fat.
,3. A 64-year-old patient has hypertension and diabetes with albuminuria. Which medication
class is particularly beneficial?
A. ACE inhibitor
B. Short-acting nitrate
C. Loop diuretic only
D. Alpha blocker only
Answer: A. ACE inhibitor
Rationale: ACE inhibitors or ARBs are commonly preferred in patients with hypertension and
diabetic kidney disease with albuminuria because they lower intraglomerular pressure and
reduce albuminuria.
4. A patient taking lisinopril develops persistent dry cough. Which medication is an
appropriate alternative?
A. Losartan
B. Digoxin
C. Verapamil only
D. Nitroglycerin
Answer: A. Losartan
Rationale: ACE inhibitors can cause cough due to bradykinin accumulation. An ARB such as
losartan is a common alternative.
5. A 52-year-old patient reports crushing chest pressure radiating to the left arm with
diaphoresis. What is the priority?
A. Schedule a routine appointment next month
B. Obtain immediate emergency evaluation
C. Recommend an antacid and observe
D. Start an exercise program
Answer: B. Obtain immediate emergency evaluation
Rationale: The presentation is highly concerning for acute coronary syndrome. Rapid
emergency evaluation is required.
,6. Which symptom is most concerning for heart failure?
A. Mild seasonal rhinitis
B. Orthopnea and paroxysmal nocturnal dyspnea
C. Occasional hiccups
D. Mild constipation
Answer: B. Orthopnea and paroxysmal nocturnal dyspnea
Rationale: Orthopnea and PND are classic symptoms of pulmonary congestion associated with
heart failure.
7. Which physical finding is associated with left-sided heart failure?
A. Pulmonary crackles
B. Isolated jaundice
C. Enlarged thyroid
D. Hyperactive bowel sounds
Answer: A. Pulmonary crackles
Rationale: Left ventricular dysfunction can cause elevated pulmonary venous pressure and
pulmonary congestion, producing crackles.
8. A patient with atrial fibrillation has a rapid ventricular response but is hemodynamically
stable. Which medication can be used for rate control?
A. Diltiazem
B. Epinephrine
C. Alteplase
D. Adenosine as chronic therapy
Answer: A. Diltiazem
Rationale: Diltiazem is a nondihydropyridine calcium-channel blocker that can slow AV nodal
conduction and control ventricular rate in appropriate patients.
, 9. Which patient with atrial fibrillation requires the greatest concern for thromboembolic
risk?
A. Young patient with no risk factors
B. Older adult with hypertension, diabetes, and prior stroke
C. Patient with seasonal allergies
D. Patient with isolated sinus tachycardia
Answer: B. Older adult with hypertension, diabetes, and prior stroke
Rationale: Stroke risk in AF increases with factors such as age, hypertension, diabetes, heart
failure, and previous stroke/TIA.
10. A patient reports intermittent calf pain while walking that resolves with rest. What
condition should be suspected?
A. Peripheral arterial disease
B. Cellulitis
C. Deep venous thrombosis
D. Neuropathic pain only
Answer: A. Peripheral arterial disease
Rationale: Intermittent claudication—exertional leg pain relieved by rest—is classic for
peripheral arterial disease.
11. Which test is commonly used as an initial noninvasive assessment for peripheral arterial
disease?
A. Ankle-brachial index
B. EEG
C. Colonoscopy
D. Spirometry
Answer: A. Ankle-brachial index
Rationale: ABI compares ankle and brachial systolic pressures and is a common initial test for
suspected lower-extremity PAD.
12. Which finding is characteristic of deep venous thrombosis?
