Barkley Post Test Exam – 2026/2027 Verified Questions and Correct
Answers – Comprehensive Nurse Practitioner Board Review
OVERVIEW:
This comprehensive 100-item set is a mixed board-style review covering primary care,
pediatrics, women's health, cardiology, neurology, infectious disease, and professional ethics. It
emphasizes contraception counseling, growth and development, musculoskeletal exams,
dermatology, endocrinology, and health promotion. Questions integrate classic presentations, lab
interpretation, and safety concepts like reporting, credentialing, and the Patient Safety Act.
Designed for nurse practitioner exam prep, it tests clinical judgment, differential diagnosis, and
evidence-based management across the lifespan. Correct answers in bold Green.
Item 1 - DEXA Score in Osteoporosis
You are approached by 47-year-
old Emma, who is very concerned about osteoporosis. Which dual-energy x-
ray absorptiometry score is most relevant when comparing to others her age?
A. D-score
B. T-score
C. C-score
D. Z-score
ANS: D
RATIONALE: Z-score compares patient's bone density to age-matched peers. T-
score compares to healthy 30-year-old young adult. D and C-
scores do not exist. For a perimenopausal woman wanting to know how she compares t
o same age, Z-score is relevant.
Item 2 - Normal MCH Value
You have been treating Bernard, 43-year-
old male, for his anemia. For mean corpuscular hemoglobin levels, normal readings are
between which values?
A. 26 and 34 pg
B. 17 and 20 pg
C. 21 and 25 pg
D. 35 and 39 pg
ANS: A
RATIONALE: Normal MCH is 26-
34 pg. It reflects average hemoglobin per RBC. Low suggests microcytic anemia, high s
uggests macrocytic.
Item 3 - Major Manifestation of Rheumatic Fever
You are checking up on 6-year-
old Arnold after strep throat. Which is a major clinical manifestation of rheumatic fever?
A. Inflammatory changes in oral cavity
B. Polyarthritis
C. Polymorphous rash
,D. Bilateral conjunctival injection
ANS: B
RATIONALE: Jones Major criteria: Carditis, Polyarthritis, Chorea, Erythema marginatu
m, Subcutaneous nodules. Polymorphous rash, conjunctival injection, oral changes are
Kawasaki disease criteria.
Item 4 - Birth Control - Estrogen Sensitivity + Anemia
Kulap has estrogen sensitivity and history of iron deficiency anemia. Best recommendati
on?
A. Copper-containing IUD
B. Xulane
C. Depo-Provera
D. NuvaRing
ANS: C
RATIONALE: Depo-Provera is progestin-
only, no estrogen - good for estrogen sensitivity. Causes amenorrhea which reduces me
nstrual blood loss and helps anemia. Copper IUD increases bleeding. Xulane and Nuva
Ring contain estrogen.
Item 5 - Balanitis Treatment
51-year-
old male with inflammation of penile head, rash, malodorous discharge, painful glans.
A. Metronidazole
B. Griseofulvin
C. Ceftriaxone
D. Miconazole
ANS: D
RATIONALE: Candida balanitis presents with erythema of glans, rash, foul-
smelling discharge, pain. Treated with topical azole like miconazole. Ceftriaxone for gon
orrhea would have purulent urethral discharge. Griseofulvin for tinea capitis.
Item 6 - Cause of Delirium vs Dementia
NP caring for elderly female with sudden confusion. Which is NOT a cause of delirium?
A. Poor nutrition
B. Alzheimer's disease
C. Electrolyte imbalances
D. Impactions in elderly
ANS: B
RATIONALE: Alzheimer's causes gradual dementia, not acute delirium. Delirium is acut
e, fluctuating confusion due to reversible causes: infections, electrolyte imbalance, poor
nutrition, medications, fecal impaction, dehydration.
Item 7 - Long-
Acting Reversible Contraception + Family History Endometrial Cancer
Jen wants easy, long-lasting, no long-
term effect after removal, family history endometrial cancer.
A. Implanon
B. Oral contraceptives
C. Ortho-Evra
D. Depo-Provera
, ANS: A
RATIONALE: Implanon/Nexplanon etonogestrel implant lasts 3 years, failure rate 0.01
%, fertility returns quickly, protects against endometrial cancer, decreases cramps. Dep
o delays fertility return up to 12 months.
Item 8 - Risk Factor for Type 2 DM
Which is NOT a risk factor for DM type 2?
A. Family history of diabetes mellitus type 1
B. African American, Hispanic, Asian, Pacific islander, Native American ethnicity
C. Acanthosis nigricans
D. Family history of diabetes mellitus type 2
ANS: A
RATIONALE: Type 2 DM risk: obesity, family history Type 2, high-
risk ethnicity, acanthosis nigricans - sign of insulin resistance, HTN, dyslipidemia. Famil
y history Type 1 is not a risk for Type 2 screening.
Item 9 - Patient Safety and Quality Improvement Act Purpose
Which is NOT purpose of Patient Safety and Quality Improvement Act?
A. Resolve patient safety and health care quality issues
B. Analyze medical errors
C. Establish voluntary reporting system
D. Establish a database to which healthcare providers should access regularly
ANS: D
RATIONALE: PSQIA creates confidential, voluntary, non-
punitive reporting system to Patient Safety Organizations to analyze errors and improve
safety. It is NOT a database providers must access regularly for care.
Item 10 - Inpatient Cellulitis Leading Cause
Sarah, inpatient 2 weeks, painful spreading redness, warm skin, chills. Leading cause in
patient cellulitis?
A. Staphylococcus aureus
B. Staphylococcus
C. Staphylococcus pyogenes
D. Escherichia coli
ANS: D
RATIONALE: Outpatient cellulitis most often Strep pyogenes and Staph aureus. Inpatie
nt/nosocomial cellulitis more often gram-
negative like E. coli, Pseudomonas due to exposure, immunocompromise, wounds.
Item 11 - Not a Cause of Obesity in Child
Which is NOT a typical cause of obesity?
A. Diet high in simple carbohydrates
B. Side effects of medications
C. Gastrointestinal disorders
D. Endocrine disease
ANS: C
RATIONALE: Obesity causes: high simple carbs, endocrine - hypothyroidism, Cushing'
s, medications - antipsychotics, steroids. GI disorders cause malabsorption/weight loss,
not obesity.
Answers – Comprehensive Nurse Practitioner Board Review
OVERVIEW:
This comprehensive 100-item set is a mixed board-style review covering primary care,
pediatrics, women's health, cardiology, neurology, infectious disease, and professional ethics. It
emphasizes contraception counseling, growth and development, musculoskeletal exams,
dermatology, endocrinology, and health promotion. Questions integrate classic presentations, lab
interpretation, and safety concepts like reporting, credentialing, and the Patient Safety Act.
Designed for nurse practitioner exam prep, it tests clinical judgment, differential diagnosis, and
evidence-based management across the lifespan. Correct answers in bold Green.
Item 1 - DEXA Score in Osteoporosis
You are approached by 47-year-
old Emma, who is very concerned about osteoporosis. Which dual-energy x-
ray absorptiometry score is most relevant when comparing to others her age?
A. D-score
B. T-score
C. C-score
D. Z-score
ANS: D
RATIONALE: Z-score compares patient's bone density to age-matched peers. T-
score compares to healthy 30-year-old young adult. D and C-
scores do not exist. For a perimenopausal woman wanting to know how she compares t
o same age, Z-score is relevant.
Item 2 - Normal MCH Value
You have been treating Bernard, 43-year-
old male, for his anemia. For mean corpuscular hemoglobin levels, normal readings are
between which values?
A. 26 and 34 pg
B. 17 and 20 pg
C. 21 and 25 pg
D. 35 and 39 pg
ANS: A
RATIONALE: Normal MCH is 26-
34 pg. It reflects average hemoglobin per RBC. Low suggests microcytic anemia, high s
uggests macrocytic.
Item 3 - Major Manifestation of Rheumatic Fever
You are checking up on 6-year-
old Arnold after strep throat. Which is a major clinical manifestation of rheumatic fever?
A. Inflammatory changes in oral cavity
B. Polyarthritis
C. Polymorphous rash
,D. Bilateral conjunctival injection
ANS: B
RATIONALE: Jones Major criteria: Carditis, Polyarthritis, Chorea, Erythema marginatu
m, Subcutaneous nodules. Polymorphous rash, conjunctival injection, oral changes are
Kawasaki disease criteria.
Item 4 - Birth Control - Estrogen Sensitivity + Anemia
Kulap has estrogen sensitivity and history of iron deficiency anemia. Best recommendati
on?
A. Copper-containing IUD
B. Xulane
C. Depo-Provera
D. NuvaRing
ANS: C
RATIONALE: Depo-Provera is progestin-
only, no estrogen - good for estrogen sensitivity. Causes amenorrhea which reduces me
nstrual blood loss and helps anemia. Copper IUD increases bleeding. Xulane and Nuva
Ring contain estrogen.
Item 5 - Balanitis Treatment
51-year-
old male with inflammation of penile head, rash, malodorous discharge, painful glans.
A. Metronidazole
B. Griseofulvin
C. Ceftriaxone
D. Miconazole
ANS: D
RATIONALE: Candida balanitis presents with erythema of glans, rash, foul-
smelling discharge, pain. Treated with topical azole like miconazole. Ceftriaxone for gon
orrhea would have purulent urethral discharge. Griseofulvin for tinea capitis.
Item 6 - Cause of Delirium vs Dementia
NP caring for elderly female with sudden confusion. Which is NOT a cause of delirium?
A. Poor nutrition
B. Alzheimer's disease
C. Electrolyte imbalances
D. Impactions in elderly
ANS: B
RATIONALE: Alzheimer's causes gradual dementia, not acute delirium. Delirium is acut
e, fluctuating confusion due to reversible causes: infections, electrolyte imbalance, poor
nutrition, medications, fecal impaction, dehydration.
Item 7 - Long-
Acting Reversible Contraception + Family History Endometrial Cancer
Jen wants easy, long-lasting, no long-
term effect after removal, family history endometrial cancer.
A. Implanon
B. Oral contraceptives
C. Ortho-Evra
D. Depo-Provera
, ANS: A
RATIONALE: Implanon/Nexplanon etonogestrel implant lasts 3 years, failure rate 0.01
%, fertility returns quickly, protects against endometrial cancer, decreases cramps. Dep
o delays fertility return up to 12 months.
Item 8 - Risk Factor for Type 2 DM
Which is NOT a risk factor for DM type 2?
A. Family history of diabetes mellitus type 1
B. African American, Hispanic, Asian, Pacific islander, Native American ethnicity
C. Acanthosis nigricans
D. Family history of diabetes mellitus type 2
ANS: A
RATIONALE: Type 2 DM risk: obesity, family history Type 2, high-
risk ethnicity, acanthosis nigricans - sign of insulin resistance, HTN, dyslipidemia. Famil
y history Type 1 is not a risk for Type 2 screening.
Item 9 - Patient Safety and Quality Improvement Act Purpose
Which is NOT purpose of Patient Safety and Quality Improvement Act?
A. Resolve patient safety and health care quality issues
B. Analyze medical errors
C. Establish voluntary reporting system
D. Establish a database to which healthcare providers should access regularly
ANS: D
RATIONALE: PSQIA creates confidential, voluntary, non-
punitive reporting system to Patient Safety Organizations to analyze errors and improve
safety. It is NOT a database providers must access regularly for care.
Item 10 - Inpatient Cellulitis Leading Cause
Sarah, inpatient 2 weeks, painful spreading redness, warm skin, chills. Leading cause in
patient cellulitis?
A. Staphylococcus aureus
B. Staphylococcus
C. Staphylococcus pyogenes
D. Escherichia coli
ANS: D
RATIONALE: Outpatient cellulitis most often Strep pyogenes and Staph aureus. Inpatie
nt/nosocomial cellulitis more often gram-
negative like E. coli, Pseudomonas due to exposure, immunocompromise, wounds.
Item 11 - Not a Cause of Obesity in Child
Which is NOT a typical cause of obesity?
A. Diet high in simple carbohydrates
B. Side effects of medications
C. Gastrointestinal disorders
D. Endocrine disease
ANS: C
RATIONALE: Obesity causes: high simple carbs, endocrine - hypothyroidism, Cushing'
s, medications - antipsychotics, steroids. GI disorders cause malabsorption/weight loss,
not obesity.
