100% FAMILY NURSE PRACTITIONER (FNP)
BARKLEY POST-TEST Comprehensive Final Exam
with Verified Rationales Fall 2025 | Practice Questions
with Answers & Detailed Explanations Updated for
2026 | 100% Certified | A+ Graded
Leave your honest rating⭐⭐⭐⭐⭐
Question 1
What does a positive posterior drawer sign in a 10-year-old soccer player signify?
A) Normal knee
B) Instability of the knee
C) Swelling on the knee
D) Injury to the meniscus
Correct Answer: B. Instability of the knee
Rationale: The drawer test is used to identify mediolateral or anteroposterior plane
instability of the knee. The anterior drawer test evaluates the anterior cruciate
ligament (ACL). To perform the test, the patient lies supine with the knee at 90-
degree flexion. Grasping the posterior aspect of the tibia and applying steady force
to push the lower leg forward and backward; anterior or posterior movement is a
positive finding. A positive posterior drawer sign specifically indicates posterior
cruciate ligament (PCL) injury and knee instability.
Question 2
What is the significance of a positive Lachman sign?
A) Instability of the knee caused by damage to the anterior cruciate ligament
B) Posterior cruciate ligament laxity which may cause locking of the knee
C) Achilles tendon rupture
D) Patellar tendon rupture
Correct Answer: A. Instability of the knee caused by damage to the anterior
cruciate ligament
,Rationale: A positive Lachman sign is highly suggestive of damage to (i.e.,
rupture of) the anterior cruciate ligament (ACL) of the knee. The anterior drawer
sign may also be positive. The Lachman test is considered the most sensitive
physical examination test for ACL injury, performed with the patient supine and
the knee flexed at 20-30 degrees.
Question 3
A patient injures an ankle while playing soccer and reports rolling the foot inward
while falling with immediate pain and swelling of the lateral part of the joint. The
patient is able to bear weight and denies hearing an audible sound at the time of
injury. What does this history indicate?
A) Likely ankle sprain with a possible fracture
B) Mild ankle injury without fracture
C) Mild soft tissue injury only
D) Serious ankle injury with certain fracture
Correct Answer: A. Likely ankle sprain with a possible fracture
Rationale: Immediate swelling of the joint raises the index of suspicion for a
fracture or a substantial amount of joint involvement. Without radiographs, none of
these possibilities can be confirmed. The mechanism described (inversion injury) is
classic for lateral ankle sprain affecting the anterior talofibular ligament, but
weight-bearing ability does not rule out fracture. Ottawa ankle rules should be
applied to determine the need for radiography.
Question 4
A distance runner reports pain in one heel that is worse in the morning and seems
to improve with exercise. The provider notes localized swelling and a bony
prominence at the heel. What is the initial treatment for this condition?
A) Cessation of all sports activities and exercise
B) Crutches and partial weight bearing
C) Physical therapy for ultrasound therapy
D) Referral to an orthopedist for MRI and evaluation
Correct Answer: A. Cessation of all sports activities and exercise
,Rationale: This presentation is classic for plantar fasciitis, characterized by heel
pain that is worst with the first steps in the morning and improves with activity.
Initial treatment includes rest, activity modification, ice, stretching exercises, and
supportive footwear. Cessation of aggravating activities is the first step in
management.
Question 5
A 36-year-old woman complains of fatigue and headaches with widespread muscle
and joint pain for 6 months. She reports insomnia and feeling tired even with
adequate sleep. She was diagnosed with major depression 1 year ago. Physical
exam reveals bilateral tender points on neck, jaw, shoulders, chest, upper back, and
greater trochanter. These findings are highly suggestive of:
A) Rheumatoid arthritis
B) Osteoarthritis
C) Fatigue syndrome
D) Fibromyalgia
Correct Answer: D. Fibromyalgia
Rationale: Fibromyalgia is characterized by widespread pain index and symptoms
present at a similar level for at least 3 months, with presence of pain or tenderness
at certain body sites. The locations in the body (widespread pain index) include
neck, jaw, shoulder girdle, upper and lower arm, chest, abdomen, upper and lower
back, upper and lower leg, and hip (trochanters). Other criteria include fatigue,
sleep problems, and cognitive symptoms. The exact cause of fibromyalgia is
unknown, and treatment is symptomatic.
Question 6
Lab results show increased ESR, negative ANA, and negative rheumatoid factor in
a young adult with lower back pain and stiffness that improves with exercise.
Which condition is best described?
A) Rheumatoid arthritis
B) Lupus erythematosus
C) Degenerative joint disease of the spine
D) Ankylosing spondylitis
, Correct Answer: D. Ankylosing spondylitis
Rationale: Ankylosing spondylitis (AS) is a lifelong autoimmune disease causing
inflammation, pain, and stiffness, mainly in the spinal joints. The typical patient is
a young adult. In early stages, pain and stiffness often start in the lower back but
may move up the spine. There is no specific lab test for AS; ESR is increased by
inflammation. There is a high risk of uveitis (red eyes, blurred vision, photophobia,
floaters).
Question 7
A 55-year-old patient presents with gradual onset of knee pain that worsens with
activity and improves with rest. There is no swelling or warmth. Crepitus is noted
on movement. What is the most likely diagnosis?
A) Rheumatoid arthritis
B) Osteoarthritis
C) Gout
D) Septic arthritis
Correct Answer: B. Osteoarthritis
Rationale: Osteoarthritis (OA) is a degenerative joint disease characterized by
gradual onset of pain, absence of systemic symptoms, and crepitus. Pain worsens
with activity and improves with rest. Unlike rheumatoid arthritis, OA does not
typically present with swelling, warmth, or systemic symptoms. OA is the most
common form of arthritis, typically affecting weight-bearing joints.
Question 8
Which of the following is the most sensitive test for ACL injury?
A) Anterior drawer test
B) Lachman test
C) Posterior drawer test
D) McMurray test
Correct Answer: B. Lachman test
Rationale: The Lachman test is considered the most sensitive physical
examination test for ACL injury. It is performed with the patient supine and the
BARKLEY POST-TEST Comprehensive Final Exam
with Verified Rationales Fall 2025 | Practice Questions
with Answers & Detailed Explanations Updated for
2026 | 100% Certified | A+ Graded
Leave your honest rating⭐⭐⭐⭐⭐
Question 1
What does a positive posterior drawer sign in a 10-year-old soccer player signify?
A) Normal knee
B) Instability of the knee
C) Swelling on the knee
D) Injury to the meniscus
Correct Answer: B. Instability of the knee
Rationale: The drawer test is used to identify mediolateral or anteroposterior plane
instability of the knee. The anterior drawer test evaluates the anterior cruciate
ligament (ACL). To perform the test, the patient lies supine with the knee at 90-
degree flexion. Grasping the posterior aspect of the tibia and applying steady force
to push the lower leg forward and backward; anterior or posterior movement is a
positive finding. A positive posterior drawer sign specifically indicates posterior
cruciate ligament (PCL) injury and knee instability.
Question 2
What is the significance of a positive Lachman sign?
A) Instability of the knee caused by damage to the anterior cruciate ligament
B) Posterior cruciate ligament laxity which may cause locking of the knee
C) Achilles tendon rupture
D) Patellar tendon rupture
Correct Answer: A. Instability of the knee caused by damage to the anterior
cruciate ligament
,Rationale: A positive Lachman sign is highly suggestive of damage to (i.e.,
rupture of) the anterior cruciate ligament (ACL) of the knee. The anterior drawer
sign may also be positive. The Lachman test is considered the most sensitive
physical examination test for ACL injury, performed with the patient supine and
the knee flexed at 20-30 degrees.
Question 3
A patient injures an ankle while playing soccer and reports rolling the foot inward
while falling with immediate pain and swelling of the lateral part of the joint. The
patient is able to bear weight and denies hearing an audible sound at the time of
injury. What does this history indicate?
A) Likely ankle sprain with a possible fracture
B) Mild ankle injury without fracture
C) Mild soft tissue injury only
D) Serious ankle injury with certain fracture
Correct Answer: A. Likely ankle sprain with a possible fracture
Rationale: Immediate swelling of the joint raises the index of suspicion for a
fracture or a substantial amount of joint involvement. Without radiographs, none of
these possibilities can be confirmed. The mechanism described (inversion injury) is
classic for lateral ankle sprain affecting the anterior talofibular ligament, but
weight-bearing ability does not rule out fracture. Ottawa ankle rules should be
applied to determine the need for radiography.
Question 4
A distance runner reports pain in one heel that is worse in the morning and seems
to improve with exercise. The provider notes localized swelling and a bony
prominence at the heel. What is the initial treatment for this condition?
A) Cessation of all sports activities and exercise
B) Crutches and partial weight bearing
C) Physical therapy for ultrasound therapy
D) Referral to an orthopedist for MRI and evaluation
Correct Answer: A. Cessation of all sports activities and exercise
,Rationale: This presentation is classic for plantar fasciitis, characterized by heel
pain that is worst with the first steps in the morning and improves with activity.
Initial treatment includes rest, activity modification, ice, stretching exercises, and
supportive footwear. Cessation of aggravating activities is the first step in
management.
Question 5
A 36-year-old woman complains of fatigue and headaches with widespread muscle
and joint pain for 6 months. She reports insomnia and feeling tired even with
adequate sleep. She was diagnosed with major depression 1 year ago. Physical
exam reveals bilateral tender points on neck, jaw, shoulders, chest, upper back, and
greater trochanter. These findings are highly suggestive of:
A) Rheumatoid arthritis
B) Osteoarthritis
C) Fatigue syndrome
D) Fibromyalgia
Correct Answer: D. Fibromyalgia
Rationale: Fibromyalgia is characterized by widespread pain index and symptoms
present at a similar level for at least 3 months, with presence of pain or tenderness
at certain body sites. The locations in the body (widespread pain index) include
neck, jaw, shoulder girdle, upper and lower arm, chest, abdomen, upper and lower
back, upper and lower leg, and hip (trochanters). Other criteria include fatigue,
sleep problems, and cognitive symptoms. The exact cause of fibromyalgia is
unknown, and treatment is symptomatic.
Question 6
Lab results show increased ESR, negative ANA, and negative rheumatoid factor in
a young adult with lower back pain and stiffness that improves with exercise.
Which condition is best described?
A) Rheumatoid arthritis
B) Lupus erythematosus
C) Degenerative joint disease of the spine
D) Ankylosing spondylitis
, Correct Answer: D. Ankylosing spondylitis
Rationale: Ankylosing spondylitis (AS) is a lifelong autoimmune disease causing
inflammation, pain, and stiffness, mainly in the spinal joints. The typical patient is
a young adult. In early stages, pain and stiffness often start in the lower back but
may move up the spine. There is no specific lab test for AS; ESR is increased by
inflammation. There is a high risk of uveitis (red eyes, blurred vision, photophobia,
floaters).
Question 7
A 55-year-old patient presents with gradual onset of knee pain that worsens with
activity and improves with rest. There is no swelling or warmth. Crepitus is noted
on movement. What is the most likely diagnosis?
A) Rheumatoid arthritis
B) Osteoarthritis
C) Gout
D) Septic arthritis
Correct Answer: B. Osteoarthritis
Rationale: Osteoarthritis (OA) is a degenerative joint disease characterized by
gradual onset of pain, absence of systemic symptoms, and crepitus. Pain worsens
with activity and improves with rest. Unlike rheumatoid arthritis, OA does not
typically present with swelling, warmth, or systemic symptoms. OA is the most
common form of arthritis, typically affecting weight-bearing joints.
Question 8
Which of the following is the most sensitive test for ACL injury?
A) Anterior drawer test
B) Lachman test
C) Posterior drawer test
D) McMurray test
Correct Answer: B. Lachman test
Rationale: The Lachman test is considered the most sensitive physical
examination test for ACL injury. It is performed with the patient supine and the
