Barkley Respiratory Exam PRACTICE
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP
GRADED A+*INSTANT DOWNLOAD PDF
1. A 68-year-old patient with COPD has worsening dyspnea,
increased sputum volume, and purulent sputum for 3 days. Which
finding most strongly supports an acute COPD exacerbation?
A. Stable exertional dyspnea
B. Increased sputum purulence
C. Chronic morning cough
D. Barrel-shaped chest
Answer: B. Increased sputum purulence
Increased dyspnea, sputum volume, and especially sputum purulence
are classic features of an acute COPD exacerbation.
2. Which spirometric finding confirms persistent airflow obstruction
consistent with COPD?
A. FEV₁/FVC >0.80
B. FEV₁/FVC = 0.75
C. Post-bronchodilator FEV₁/FVC <0.70
D. Increased FVC after bronchodilator
Answer: C. Post-bronchodilator FEV₁/FVC <0.70
Persistent post-bronchodilator airflow obstruction is defined by an
FEV₁/FVC ratio below 0.70 in the appropriate clinical context.
,3. A patient with asthma uses albuterol four times daily. What is the
most appropriate interpretation?
A. Asthma is well controlled
B. Rescue medication use suggests inadequate control
C. Albuterol should be discontinued permanently
D. The patient has COPD
Answer: B. Rescue medication use suggests inadequate control
Frequent short-acting bronchodilator use suggests poor asthma
control and the need to reassess controller therapy, adherence,
triggers, and technique.
4. Which medication is considered a controller therapy for persistent
asthma?
A. Albuterol
B. Ipratropium
C. Inhaled corticosteroid
D. Epinephrine
Answer: C. Inhaled corticosteroid
Inhaled corticosteroids reduce airway inflammation and are
foundational controller medications for persistent asthma.
5. A patient with asthma develops wheezing and dyspnea after
exposure to cat dander. What type of hypersensitivity reaction is
most characteristic?
A. Type I
B. Type II
,C. Type III
D. Type IV
Answer: A. Type I
Allergic asthma commonly involves IgE-mediated type I
hypersensitivity with mast-cell activation and release of
inflammatory mediators.
6. Which physical examination finding is most characteristic of a
pleural effusion?
A. Hyperresonance to percussion
B. Increased tactile fremitus
C. Dullness to percussion
D. Bronchial breath sounds throughout the lung
Answer: C. Dullness to percussion
Pleural fluid produces dullness to percussion and typically decreases
breath sounds and tactile fremitus over the affected area.
7. A patient suddenly develops pleuritic chest pain and dyspnea after
a long-haul flight. Which diagnosis should be considered?
A. Pulmonary embolism
B. Chronic bronchitis
C. Stable angina
D. Pulmonary fibrosis
Answer: A. Pulmonary embolism
Recent prolonged immobilization is a risk factor for venous
thromboembolism, and acute pleuritic chest pain and dyspnea are
common manifestations of pulmonary embolism.
, 8. Which ECG finding may be associated with pulmonary embolism?
A. ST elevation in all leads
B. S1Q3T3 pattern
C. Complete heart block in every case
D. Persistent ventricular fibrillation
Answer: B. S1Q3T3 pattern
An S1Q3T3 pattern reflects right-heart strain but is neither sensitive
nor specific for pulmonary embolism.
9. What is the most common symptom of obstructive sleep apnea?
A. Hemoptysis
B. Loud snoring
C. Pleuritic chest pain
D. Productive cough
Answer: B. Loud snoring
Loud habitual snoring, witnessed apneas, and excessive daytime
sleepiness are common features of obstructive sleep apnea.
10. Which patient has the strongest risk factor for obstructive sleep
apnea?
A. BMI 19 kg/m²
B. Obesity with increased neck circumference
C. Chronic allergic rhinitis alone
D. Low resting heart rate
Answer: B. Obesity with increased neck circumference
Obesity and increased neck circumference substantially increase the
risk of upper-airway collapse during sleep.
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP
GRADED A+*INSTANT DOWNLOAD PDF
1. A 68-year-old patient with COPD has worsening dyspnea,
increased sputum volume, and purulent sputum for 3 days. Which
finding most strongly supports an acute COPD exacerbation?
A. Stable exertional dyspnea
B. Increased sputum purulence
C. Chronic morning cough
D. Barrel-shaped chest
Answer: B. Increased sputum purulence
Increased dyspnea, sputum volume, and especially sputum purulence
are classic features of an acute COPD exacerbation.
2. Which spirometric finding confirms persistent airflow obstruction
consistent with COPD?
A. FEV₁/FVC >0.80
B. FEV₁/FVC = 0.75
C. Post-bronchodilator FEV₁/FVC <0.70
D. Increased FVC after bronchodilator
Answer: C. Post-bronchodilator FEV₁/FVC <0.70
Persistent post-bronchodilator airflow obstruction is defined by an
FEV₁/FVC ratio below 0.70 in the appropriate clinical context.
,3. A patient with asthma uses albuterol four times daily. What is the
most appropriate interpretation?
A. Asthma is well controlled
B. Rescue medication use suggests inadequate control
C. Albuterol should be discontinued permanently
D. The patient has COPD
Answer: B. Rescue medication use suggests inadequate control
Frequent short-acting bronchodilator use suggests poor asthma
control and the need to reassess controller therapy, adherence,
triggers, and technique.
4. Which medication is considered a controller therapy for persistent
asthma?
A. Albuterol
B. Ipratropium
C. Inhaled corticosteroid
D. Epinephrine
Answer: C. Inhaled corticosteroid
Inhaled corticosteroids reduce airway inflammation and are
foundational controller medications for persistent asthma.
5. A patient with asthma develops wheezing and dyspnea after
exposure to cat dander. What type of hypersensitivity reaction is
most characteristic?
A. Type I
B. Type II
,C. Type III
D. Type IV
Answer: A. Type I
Allergic asthma commonly involves IgE-mediated type I
hypersensitivity with mast-cell activation and release of
inflammatory mediators.
6. Which physical examination finding is most characteristic of a
pleural effusion?
A. Hyperresonance to percussion
B. Increased tactile fremitus
C. Dullness to percussion
D. Bronchial breath sounds throughout the lung
Answer: C. Dullness to percussion
Pleural fluid produces dullness to percussion and typically decreases
breath sounds and tactile fremitus over the affected area.
7. A patient suddenly develops pleuritic chest pain and dyspnea after
a long-haul flight. Which diagnosis should be considered?
A. Pulmonary embolism
B. Chronic bronchitis
C. Stable angina
D. Pulmonary fibrosis
Answer: A. Pulmonary embolism
Recent prolonged immobilization is a risk factor for venous
thromboembolism, and acute pleuritic chest pain and dyspnea are
common manifestations of pulmonary embolism.
, 8. Which ECG finding may be associated with pulmonary embolism?
A. ST elevation in all leads
B. S1Q3T3 pattern
C. Complete heart block in every case
D. Persistent ventricular fibrillation
Answer: B. S1Q3T3 pattern
An S1Q3T3 pattern reflects right-heart strain but is neither sensitive
nor specific for pulmonary embolism.
9. What is the most common symptom of obstructive sleep apnea?
A. Hemoptysis
B. Loud snoring
C. Pleuritic chest pain
D. Productive cough
Answer: B. Loud snoring
Loud habitual snoring, witnessed apneas, and excessive daytime
sleepiness are common features of obstructive sleep apnea.
10. Which patient has the strongest risk factor for obstructive sleep
apnea?
A. BMI 19 kg/m²
B. Obesity with increased neck circumference
C. Chronic allergic rhinitis alone
D. Low resting heart rate
Answer: B. Obesity with increased neck circumference
Obesity and increased neck circumference substantially increase the
risk of upper-airway collapse during sleep.
