Barkley Review Post-Test Practice Exam
Question and Answers with Rationales Top
rated Latest Version
Question 1
A 62-year-old man with type 2 diabetes presents for follow-up. His
blood pressure is 152/94 mmHg despite lifestyle modification. Which
medication is recommended as first-line therapy?
A. Hydrochlorothiazide
B. Lisinopril
C. Atenolol
D. Clonidine
Correct Answer: B. Lisinopril
Rationale
ACE inhibitors are recommended as first-line treatment in diabetic
patients because they:
• Reduce blood pressure
• Slow diabetic nephropathy progression
• Decrease proteinuria
• Reduce cardiovascular risk
Hydrochlorothiazide may be added later but is not preferred initially for
diabetic kidney protection.
,Question 2
A patient taking warfarin has an INR of 8.2 without bleeding. The best
management is:
A. Continue current dose
B. Increase dietary vitamin K
C. Hold warfarin and administer oral vitamin K
D. Start heparin
Correct Answer: C. Hold warfarin and administer oral vitamin K
Rationale
According to anticoagulation guidelines:
• INR >10 → oral vitamin K strongly recommended
• INR 4.5–10 → hold warfarin
• INR around 8 with elevated bleeding risk → oral vitamin K is
appropriate
No active bleeding means PCC or FFP is unnecessary.
Question 3
Which laboratory finding confirms iron deficiency anemia?
A. Elevated ferritin
B. Low ferritin
C. High MCV
,D. Elevated vitamin B12
Correct Answer: B. Low ferritin
Rationale
Low ferritin is the most specific laboratory indicator of iron deficiency.
Typical findings include:
• Low ferritin
• Low serum iron
• High TIBC
• Low transferrin saturation
• Microcytic, hypochromic RBCs
Question 4
A patient with COPD has worsening dyspnea, increased sputum volume,
and purulent sputum. Which treatment is indicated?
A. Oral corticosteroids only
B. Antibiotics and corticosteroids
C. Oxygen only
D. Nebulizer alone
Correct Answer: B. Antibiotics and corticosteroids
Rationale
The presence of the three cardinal symptoms:
• Increased dyspnea
• Increased sputum
, • Increased sputum purulence
indicates bacterial exacerbation requiring antibiotics plus systemic
corticosteroids.
Question 5
A diabetic patient develops albuminuria. Which medication provides
renal protection?
A. Metformin
B. Lisinopril
C. Aspirin
D. Furosemide
Correct Answer: B. Lisinopril
Rationale
ACE inhibitors:
• Reduce intraglomerular pressure
• Slow CKD progression
• Reduce proteinuria
• Protect kidney function
Question 6
Which vaccine should every adult receive annually?
A. HPV
Question and Answers with Rationales Top
rated Latest Version
Question 1
A 62-year-old man with type 2 diabetes presents for follow-up. His
blood pressure is 152/94 mmHg despite lifestyle modification. Which
medication is recommended as first-line therapy?
A. Hydrochlorothiazide
B. Lisinopril
C. Atenolol
D. Clonidine
Correct Answer: B. Lisinopril
Rationale
ACE inhibitors are recommended as first-line treatment in diabetic
patients because they:
• Reduce blood pressure
• Slow diabetic nephropathy progression
• Decrease proteinuria
• Reduce cardiovascular risk
Hydrochlorothiazide may be added later but is not preferred initially for
diabetic kidney protection.
,Question 2
A patient taking warfarin has an INR of 8.2 without bleeding. The best
management is:
A. Continue current dose
B. Increase dietary vitamin K
C. Hold warfarin and administer oral vitamin K
D. Start heparin
Correct Answer: C. Hold warfarin and administer oral vitamin K
Rationale
According to anticoagulation guidelines:
• INR >10 → oral vitamin K strongly recommended
• INR 4.5–10 → hold warfarin
• INR around 8 with elevated bleeding risk → oral vitamin K is
appropriate
No active bleeding means PCC or FFP is unnecessary.
Question 3
Which laboratory finding confirms iron deficiency anemia?
A. Elevated ferritin
B. Low ferritin
C. High MCV
,D. Elevated vitamin B12
Correct Answer: B. Low ferritin
Rationale
Low ferritin is the most specific laboratory indicator of iron deficiency.
Typical findings include:
• Low ferritin
• Low serum iron
• High TIBC
• Low transferrin saturation
• Microcytic, hypochromic RBCs
Question 4
A patient with COPD has worsening dyspnea, increased sputum volume,
and purulent sputum. Which treatment is indicated?
A. Oral corticosteroids only
B. Antibiotics and corticosteroids
C. Oxygen only
D. Nebulizer alone
Correct Answer: B. Antibiotics and corticosteroids
Rationale
The presence of the three cardinal symptoms:
• Increased dyspnea
• Increased sputum
, • Increased sputum purulence
indicates bacterial exacerbation requiring antibiotics plus systemic
corticosteroids.
Question 5
A diabetic patient develops albuminuria. Which medication provides
renal protection?
A. Metformin
B. Lisinopril
C. Aspirin
D. Furosemide
Correct Answer: B. Lisinopril
Rationale
ACE inhibitors:
• Reduce intraglomerular pressure
• Slow CKD progression
• Reduce proteinuria
• Protect kidney function
Question 6
Which vaccine should every adult receive annually?
A. HPV
