Barkley NP Post Test Exam Study Guide & DRT
Diagnostic Readiness Test Review
Question 1
A patient experiences a sudden onset of pain in her lower leg. The area is
erythematous and warm to the touch but not swollen, and the patient has
a consistent temperature. Based on these findings, which measure is NOT
a correct form of treatment?
A) Elevating the leg
B) Applying warm compresses
C) Prescribing non-steroidal anti-inflammatory drugs
D) Ordering bed rest
Answer: D) Ordering bed rest
Explanation: Based on sudden pain, heat, and erythema without
swelling, the patient is most likely experiencing superficial
thrombosis. Mobility is encouraged in superficial thrombosis,
whereas bed rest is standard for deep thrombosis. Elevation, warm
compresses, and NSAIDs are all effective management strategies.
Question 2
Which of the following is NOT a common finding of acute left-sided heart
failure?
,A) Coarse rales in all lung fields
B) Hepatomegaly
C) Wheezing, frothy cough
D) An S3 gallop sound
Answer: B) Hepatomegaly
Explanation: Hepatomegaly is common in chronic right-sided heart
failure but is much less common in acute heart failure. Coarse rales,
wheezing frothy cough, and an S3 gallop are all common findings of
acute left-sided heart failure.
Question 3
With regard to S3 and S4 heart sounds, which statement is true?
A) An S3 sounds like "Kentucky" and is expected during pregnancy but
otherwise is not a normal finding in the adult
B) An S3 is an atrial gallop and sounds like "Tennessee"
C) An S4 sounds like "Kentucky" and is expected during pregnancy but
otherwise is not a normal finding in the adult
D) An S4 is a ventricular gallop and sounds like "Tennessee"
Answer: A) An S3 sounds like "Kentucky" and is expected during
pregnancy but otherwise is not a normal finding in the adult
Explanation: An S3 is a ventricular gallop matching "Kentucky" and
presents with increased fluid states; it may be normal during
pregnancy but otherwise indicates conditions like chronic heart
,failure. An S4 is an atrial gallop matching "Tennessee" and is
associated with stiff ventricular wall conditions.
Question 4
Which statement is NOT typical of the heart murmur with which it is
associated?
A) A grade I murmur is barely audible
B) A grade II murmur is associated with a thrill
C) A grade III murmur can easily be heard
D) A grade V murmur can be heard off the chest wall with one corner of
the stethoscope
Answer: B) A grade II murmur is associated with a thrill
Explanation: A grade IV murmur, not grade II, is often accompanied
by a palpable thrill. Grade I is barely audible, grade II is audible but
faint, grade III can easily be heard, and grade V is loud enough to be
heard off the chest wall.
Question 5
You hear a low-pitched diastolic rumble at the fifth intercostal space with
the patient in the left lateral position. The murmur does not radiate. You
refer the patient to cardiology to "rule out" which condition?
A) Aortic regurgitation
B) Mitral stenosis
, C) Aortic stenosis
D) Mitral regurgitation
Answer: B) Mitral stenosis
Explanation: A low-pitched diastolic rumble best heard at the apex in
the left lateral position is characteristic of mitral stenosis. Aortic
regurgitation is a diastolic murmur heard at the left sternal border.
Aortic stenosis is a systolic murmur. Mitral regurgitation is a
systolic murmur.
Question 6
A patient presents with a holosystolic murmur heard best at the apex and
radiating to the axilla. Which condition is most likely?
A) Mitral regurgitation
B) Aortic stenosis
C) Mitral stenosis
D) Aortic regurgitation
Answer: A) Mitral regurgitation
Explanation: Mitral regurgitation is a holosystolic murmur heard
best at the apex and radiating to the axilla. Aortic stenosis radiates
to the carotids. Mitral stenosis is a diastolic rumble. Aortic
regurgitation is a diastolic murmur.
Diagnostic Readiness Test Review
Question 1
A patient experiences a sudden onset of pain in her lower leg. The area is
erythematous and warm to the touch but not swollen, and the patient has
a consistent temperature. Based on these findings, which measure is NOT
a correct form of treatment?
A) Elevating the leg
B) Applying warm compresses
C) Prescribing non-steroidal anti-inflammatory drugs
D) Ordering bed rest
Answer: D) Ordering bed rest
Explanation: Based on sudden pain, heat, and erythema without
swelling, the patient is most likely experiencing superficial
thrombosis. Mobility is encouraged in superficial thrombosis,
whereas bed rest is standard for deep thrombosis. Elevation, warm
compresses, and NSAIDs are all effective management strategies.
Question 2
Which of the following is NOT a common finding of acute left-sided heart
failure?
,A) Coarse rales in all lung fields
B) Hepatomegaly
C) Wheezing, frothy cough
D) An S3 gallop sound
Answer: B) Hepatomegaly
Explanation: Hepatomegaly is common in chronic right-sided heart
failure but is much less common in acute heart failure. Coarse rales,
wheezing frothy cough, and an S3 gallop are all common findings of
acute left-sided heart failure.
Question 3
With regard to S3 and S4 heart sounds, which statement is true?
A) An S3 sounds like "Kentucky" and is expected during pregnancy but
otherwise is not a normal finding in the adult
B) An S3 is an atrial gallop and sounds like "Tennessee"
C) An S4 sounds like "Kentucky" and is expected during pregnancy but
otherwise is not a normal finding in the adult
D) An S4 is a ventricular gallop and sounds like "Tennessee"
Answer: A) An S3 sounds like "Kentucky" and is expected during
pregnancy but otherwise is not a normal finding in the adult
Explanation: An S3 is a ventricular gallop matching "Kentucky" and
presents with increased fluid states; it may be normal during
pregnancy but otherwise indicates conditions like chronic heart
,failure. An S4 is an atrial gallop matching "Tennessee" and is
associated with stiff ventricular wall conditions.
Question 4
Which statement is NOT typical of the heart murmur with which it is
associated?
A) A grade I murmur is barely audible
B) A grade II murmur is associated with a thrill
C) A grade III murmur can easily be heard
D) A grade V murmur can be heard off the chest wall with one corner of
the stethoscope
Answer: B) A grade II murmur is associated with a thrill
Explanation: A grade IV murmur, not grade II, is often accompanied
by a palpable thrill. Grade I is barely audible, grade II is audible but
faint, grade III can easily be heard, and grade V is loud enough to be
heard off the chest wall.
Question 5
You hear a low-pitched diastolic rumble at the fifth intercostal space with
the patient in the left lateral position. The murmur does not radiate. You
refer the patient to cardiology to "rule out" which condition?
A) Aortic regurgitation
B) Mitral stenosis
, C) Aortic stenosis
D) Mitral regurgitation
Answer: B) Mitral stenosis
Explanation: A low-pitched diastolic rumble best heard at the apex in
the left lateral position is characteristic of mitral stenosis. Aortic
regurgitation is a diastolic murmur heard at the left sternal border.
Aortic stenosis is a systolic murmur. Mitral regurgitation is a
systolic murmur.
Question 6
A patient presents with a holosystolic murmur heard best at the apex and
radiating to the axilla. Which condition is most likely?
A) Mitral regurgitation
B) Aortic stenosis
C) Mitral stenosis
D) Aortic regurgitation
Answer: A) Mitral regurgitation
Explanation: Mitral regurgitation is a holosystolic murmur heard
best at the apex and radiating to the axilla. Aortic stenosis radiates
to the carotids. Mitral stenosis is a diastolic rumble. Aortic
regurgitation is a diastolic murmur.
