A+ Family Nurse Practitioner (FNP)
Barkley Post-Test Fall 2025
Comprehensive Final Exam with Verified
Rationales Practice Questions and
Answers 2026 with complete solution
Question 1
A 45-year-old male with a history of hypertension presents with a blood pressure of
148/92 mmHg on two separate occasions. He has no other comorbidities.
According to current guidelines, what is the most appropriate initial management?
A. Begin antihypertensive medication immediately
B. Recommend lifestyle modification and recheck in 3-6 months
C. Refer to cardiology for further evaluation
D. Start hydrochlorothiazide 12.5 mg daily
Correct Answer: B
Rational: For a patient with stage 1 hypertension (130-139/80-89) and no other
comorbidities or target organ damage, the initial recommendation is lifestyle
modifications (DASH diet, weight loss, exercise, sodium reduction) with re-
evaluation in 3-6 months. Pharmacotherapy is initiated if BP remains elevated after
this period or if the patient has stage 2 hypertension or comorbidities.
,Question 2
A patient with a blood pressure of 130/85 mmHg should be:
A. Started on antihypertensive medication immediately
B. Referred to primary care for prehypertension
C. Monitored with lifestyle modifications only
D. Started on a statin
Correct Answer: B
Rational: A blood pressure of 130/85 mmHg is considered prehypertension (or
elevated BP) and should be referred to primary care for evaluation and
management. While lifestyle modifications are appropriate, this finding warrants
medical follow-up.
Question 3
What is the desired LDL level for most patients?
A. Less than 70 mg/dL
B. Less than 100 mg/dL
C. Less than 130 mg/dL
D. Less than 160 mg/dL
Correct Answer: B
Rational: The desired LDL level for most patients is less than 100 mg/dL. For high-
risk patients (those with known cardiovascular disease or diabetes), the goal may
be less than 70 mg/dL. Any LDL over 100 mg/dL warrants evaluation and potential
referral.
,Question 4
A patient with heart failure has an ejection fraction of 35%. Which medication is
contraindicated?
A. Lisinopril
B. Carvedilol
C. Diltiazem
D. Spironolactone
Correct Answer: C
Rational: Diltiazem (a non-dihydropyridine calcium channel blocker) is
contraindicated in patients with HFrEF (ejection fraction < 40%) because it has
negative inotropic effects and can worsen heart failure. Lisinopril, carvedilol, and
spironolactone are all guideline-directed therapies for HFrEF.
Question 5
A patient with hypertension is started on hydrochlorothiazide. Which laboratory
value should be monitored?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. All of the above
Correct Answer: D
, Rational: Thiazide diuretics can cause hypokalemia, hyponatremia, and
hypercalcemia. All of these electrolytes should be monitored periodically.
Question 6
A patient with a history of DVT is started on warfarin. What is the therapeutic INR
goal?
A. 1.0-1.5
B. 2.0-3.0
C. 3.0-4.0
D. 4.0-5.0
Correct Answer: B
Rational: For most indications (DVT, PE, atrial fibrillation), the therapeutic INR goal
for warfarin is 2.0-3.0. For mechanical heart valves, the goal may be 2.5-3.5.
Question 7
Which of the following is a sign of digoxin toxicity?
A. Tachycardia
B. Visual disturbances (yellow-green halos)
C. Hypertension
D. Hyperkalemia
Correct Answer: B
Barkley Post-Test Fall 2025
Comprehensive Final Exam with Verified
Rationales Practice Questions and
Answers 2026 with complete solution
Question 1
A 45-year-old male with a history of hypertension presents with a blood pressure of
148/92 mmHg on two separate occasions. He has no other comorbidities.
According to current guidelines, what is the most appropriate initial management?
A. Begin antihypertensive medication immediately
B. Recommend lifestyle modification and recheck in 3-6 months
C. Refer to cardiology for further evaluation
D. Start hydrochlorothiazide 12.5 mg daily
Correct Answer: B
Rational: For a patient with stage 1 hypertension (130-139/80-89) and no other
comorbidities or target organ damage, the initial recommendation is lifestyle
modifications (DASH diet, weight loss, exercise, sodium reduction) with re-
evaluation in 3-6 months. Pharmacotherapy is initiated if BP remains elevated after
this period or if the patient has stage 2 hypertension or comorbidities.
,Question 2
A patient with a blood pressure of 130/85 mmHg should be:
A. Started on antihypertensive medication immediately
B. Referred to primary care for prehypertension
C. Monitored with lifestyle modifications only
D. Started on a statin
Correct Answer: B
Rational: A blood pressure of 130/85 mmHg is considered prehypertension (or
elevated BP) and should be referred to primary care for evaluation and
management. While lifestyle modifications are appropriate, this finding warrants
medical follow-up.
Question 3
What is the desired LDL level for most patients?
A. Less than 70 mg/dL
B. Less than 100 mg/dL
C. Less than 130 mg/dL
D. Less than 160 mg/dL
Correct Answer: B
Rational: The desired LDL level for most patients is less than 100 mg/dL. For high-
risk patients (those with known cardiovascular disease or diabetes), the goal may
be less than 70 mg/dL. Any LDL over 100 mg/dL warrants evaluation and potential
referral.
,Question 4
A patient with heart failure has an ejection fraction of 35%. Which medication is
contraindicated?
A. Lisinopril
B. Carvedilol
C. Diltiazem
D. Spironolactone
Correct Answer: C
Rational: Diltiazem (a non-dihydropyridine calcium channel blocker) is
contraindicated in patients with HFrEF (ejection fraction < 40%) because it has
negative inotropic effects and can worsen heart failure. Lisinopril, carvedilol, and
spironolactone are all guideline-directed therapies for HFrEF.
Question 5
A patient with hypertension is started on hydrochlorothiazide. Which laboratory
value should be monitored?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. All of the above
Correct Answer: D
, Rational: Thiazide diuretics can cause hypokalemia, hyponatremia, and
hypercalcemia. All of these electrolytes should be monitored periodically.
Question 6
A patient with a history of DVT is started on warfarin. What is the therapeutic INR
goal?
A. 1.0-1.5
B. 2.0-3.0
C. 3.0-4.0
D. 4.0-5.0
Correct Answer: B
Rational: For most indications (DVT, PE, atrial fibrillation), the therapeutic INR goal
for warfarin is 2.0-3.0. For mechanical heart valves, the goal may be 2.5-3.5.
Question 7
Which of the following is a sign of digoxin toxicity?
A. Tachycardia
B. Visual disturbances (yellow-green halos)
C. Hypertension
D. Hyperkalemia
Correct Answer: B
