Barkley Cardiovascular Exam PRACTICE
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP GRADED
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1. A 62-year-old patient presents with exertional substernal chest
pressure that resolves after resting for 5 minutes. Which diagnosis is
most likely?
A. Acute pericarditis
B. Stable angina
C. Aortic dissection
D. Pulmonary embolism
Answer: B. Stable angina
Stable angina typically causes predictable exertional chest discomfort
that improves with rest or nitroglycerin.
2. Which symptom is most characteristic of left-sided heart failure?
A. Peripheral edema
B. Ascites
C. Orthopnea
D. Hepatomegaly
Answer: C. Orthopnea
Left-sided heart failure causes pulmonary congestion, producing
dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.
,3. Which physical finding is most associated with right-sided heart
failure?
A. Pulmonary crackles
B. Jugular venous distention
C. Pink frothy sputum
D. Orthopnea
Answer: B. Jugular venous distention
Systemic venous congestion from right-sided heart failure commonly
produces JVD, peripheral edema, hepatomegaly, and ascites.
4. A patient has an S3 gallop. In an adult, this finding most strongly
suggests:
A. Increased ventricular compliance
B. Volume overload or systolic dysfunction
C. Aortic stenosis
D. Pericarditis
Answer: B. Volume overload or systolic dysfunction
An S3 in an adult is often associated with increased ventricular filling
and volume overload, particularly in systolic heart failure.
5. An S4 heart sound is most commonly associated with:
A. Ventricular volume overload
B. Reduced ventricular compliance
C. Severe tricuspid regurgitation
D. Complete heart block
Answer: B. Reduced ventricular compliance
S4 occurs when atrial contraction forces blood into a stiff ventricle
and is commonly associated with hypertension, LV hypertrophy, and
diastolic dysfunction.
,6. Which blood pressure reading meets the definition of stage 2
hypertension under current ACC/AHA classification?
A. 124/78 mmHg
B. 132/84 mmHg
C. 138/88 mmHg
D. 146/92 mmHg
Answer: D. 146/92 mmHg
Stage 2 hypertension is defined as systolic pressure ≥140 mmHg or
diastolic pressure ≥90 mmHg.
7. Which lifestyle intervention generally produces the greatest
reduction in blood pressure in a patient with overweight or obesity?
A. Increased dietary sodium
B. Weight loss
C. Increased caffeine intake
D. Avoiding all carbohydrates
Answer: B. Weight loss
Weight reduction can substantially lower blood pressure and also
improves several cardiovascular risk factors.
8. The preferred dietary pattern for patients with hypertension is
the:
A. Ketogenic diet
B. DASH diet
C. Carnivore diet
D. High-sodium diet
Answer: B. DASH diet
, The Dietary Approaches to Stop Hypertension pattern emphasizes
fruits, vegetables, whole grains, legumes, and low-fat dairy while
limiting sodium and saturated fat.
9. A patient with hypertension has persistent blood pressure of
168/96 mmHg. Which approach is generally appropriate when
pharmacologic therapy is indicated?
A. No treatment for 1 year
B. Lifestyle therapy only
C. Consider two first-line agents from different classes
D. Start a beta blocker in every case
Answer: C. Consider two first-line agents from different classes
Patients with substantially elevated blood pressure may require
combination therapy, often using two first-line medications from
different classes.
10. Which medication class is considered a first-line option for
uncomplicated hypertension?
A. Alpha blocker
B. Thiazide-type diuretic
C. Nitrate
D. Digoxin
Answer: B. Thiazide-type diuretic
Thiazide-type diuretics, ACE inhibitors/ARBs, and calcium channel
blockers are commonly used first-line agents.
11. A patient develops a persistent dry cough after starting lisinopril.
Which medication is the most appropriate alternative?
A. Losartan
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP GRADED
A+*INSTANT DOWNLOAD PDF
1. A 62-year-old patient presents with exertional substernal chest
pressure that resolves after resting for 5 minutes. Which diagnosis is
most likely?
A. Acute pericarditis
B. Stable angina
C. Aortic dissection
D. Pulmonary embolism
Answer: B. Stable angina
Stable angina typically causes predictable exertional chest discomfort
that improves with rest or nitroglycerin.
2. Which symptom is most characteristic of left-sided heart failure?
A. Peripheral edema
B. Ascites
C. Orthopnea
D. Hepatomegaly
Answer: C. Orthopnea
Left-sided heart failure causes pulmonary congestion, producing
dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.
,3. Which physical finding is most associated with right-sided heart
failure?
A. Pulmonary crackles
B. Jugular venous distention
C. Pink frothy sputum
D. Orthopnea
Answer: B. Jugular venous distention
Systemic venous congestion from right-sided heart failure commonly
produces JVD, peripheral edema, hepatomegaly, and ascites.
4. A patient has an S3 gallop. In an adult, this finding most strongly
suggests:
A. Increased ventricular compliance
B. Volume overload or systolic dysfunction
C. Aortic stenosis
D. Pericarditis
Answer: B. Volume overload or systolic dysfunction
An S3 in an adult is often associated with increased ventricular filling
and volume overload, particularly in systolic heart failure.
5. An S4 heart sound is most commonly associated with:
A. Ventricular volume overload
B. Reduced ventricular compliance
C. Severe tricuspid regurgitation
D. Complete heart block
Answer: B. Reduced ventricular compliance
S4 occurs when atrial contraction forces blood into a stiff ventricle
and is commonly associated with hypertension, LV hypertrophy, and
diastolic dysfunction.
,6. Which blood pressure reading meets the definition of stage 2
hypertension under current ACC/AHA classification?
A. 124/78 mmHg
B. 132/84 mmHg
C. 138/88 mmHg
D. 146/92 mmHg
Answer: D. 146/92 mmHg
Stage 2 hypertension is defined as systolic pressure ≥140 mmHg or
diastolic pressure ≥90 mmHg.
7. Which lifestyle intervention generally produces the greatest
reduction in blood pressure in a patient with overweight or obesity?
A. Increased dietary sodium
B. Weight loss
C. Increased caffeine intake
D. Avoiding all carbohydrates
Answer: B. Weight loss
Weight reduction can substantially lower blood pressure and also
improves several cardiovascular risk factors.
8. The preferred dietary pattern for patients with hypertension is
the:
A. Ketogenic diet
B. DASH diet
C. Carnivore diet
D. High-sodium diet
Answer: B. DASH diet
, The Dietary Approaches to Stop Hypertension pattern emphasizes
fruits, vegetables, whole grains, legumes, and low-fat dairy while
limiting sodium and saturated fat.
9. A patient with hypertension has persistent blood pressure of
168/96 mmHg. Which approach is generally appropriate when
pharmacologic therapy is indicated?
A. No treatment for 1 year
B. Lifestyle therapy only
C. Consider two first-line agents from different classes
D. Start a beta blocker in every case
Answer: C. Consider two first-line agents from different classes
Patients with substantially elevated blood pressure may require
combination therapy, often using two first-line medications from
different classes.
10. Which medication class is considered a first-line option for
uncomplicated hypertension?
A. Alpha blocker
B. Thiazide-type diuretic
C. Nitrate
D. Digoxin
Answer: B. Thiazide-type diuretic
Thiazide-type diuretics, ACE inhibitors/ARBs, and calcium channel
blockers are commonly used first-line agents.
11. A patient develops a persistent dry cough after starting lisinopril.
Which medication is the most appropriate alternative?
A. Losartan
