BARKLEY EMERGENCY NURSE
PRACTITIONER (ENP-C)
COMPREHENSIVE PRACTICE EXAM
1. A 55-year-old male presents with sudden onset chest pain radiating to the back, described
as ‘tearing’. His BP is 190/110 mmHg in the right arm and 160/90 mmHg in the left arm. What
is the most likely diagnosis?
A. Acute Myocardial Infarction
B. Aortic Dissection
C. Pulmonary Embolism
D. Tension Pneumothorax
Answer: B
Conceptual Explanation: Aortic dissection typically presents with tearing chest pain
radiating to the back and a significant blood pressure discrepancy between arms.
2. Which Salter-Harris fracture classification involves a fracture through the growth plate and
the metaphysis?
A. Type I
,B. Type III
C. Type II
D. Type IV
Answer: C
Conceptual Explanation: Salter-Harris Type II fractures involve the physis (growth plate)
and the metaphysis. This is the most common type.
3. A patient presents with a ‘curtain-like’ loss of vision in the right eye. There is no pain or
redness. What is the most likely diagnosis?
A. Retinal Detachment
B. Central Retinal Artery Occlusion
C. Acute Angle-Closure Glaucoma
D. Hyphema
Answer: A
Conceptual Explanation: Retinal detachment is classically described as a painless ‘curtain’
or ‘shade’ coming down over the field of vision.
4. In a patient with suspected sepsis, which lactate level is most indicative of tissue
hypoperfusion and high mortality risk?
A. Lower than 1.0 mmol/L
B. Greater than 4.0 mmol/L
, C. 2.0 mmol/L
D. 1.5 mmol/L
Answer: B
Conceptual Explanation: A serum lactate level greater than 4.0 mmol/L is a significant
marker for tissue hypoxia and is associated with increased mortality in septic shock.
5. A 3-year-old child presents with a ‘barking’ cough and inspiratory stridor. X-ray shows the
‘steeple sign’. What is the primary treatment?
A. Albuterol nebulizer
B. Intravenous antibiotics
C. Dexamethasone and racemic epinephrine
D. Chest physiotherapy
Answer: C
Conceptual Explanation: The barking cough and steeple sign indicate Croup
(Laryngotracheobronchitis). Management includes steroids (Dexamethasone) and racemic
epinephrine for severe stridor.
6. Which of the following is the most sensitive physical exam finding for ruling out testicular
torsion?
A. Positive Prehn sign
B. Presence of the cremasteric reflex
PRACTITIONER (ENP-C)
COMPREHENSIVE PRACTICE EXAM
1. A 55-year-old male presents with sudden onset chest pain radiating to the back, described
as ‘tearing’. His BP is 190/110 mmHg in the right arm and 160/90 mmHg in the left arm. What
is the most likely diagnosis?
A. Acute Myocardial Infarction
B. Aortic Dissection
C. Pulmonary Embolism
D. Tension Pneumothorax
Answer: B
Conceptual Explanation: Aortic dissection typically presents with tearing chest pain
radiating to the back and a significant blood pressure discrepancy between arms.
2. Which Salter-Harris fracture classification involves a fracture through the growth plate and
the metaphysis?
A. Type I
,B. Type III
C. Type II
D. Type IV
Answer: C
Conceptual Explanation: Salter-Harris Type II fractures involve the physis (growth plate)
and the metaphysis. This is the most common type.
3. A patient presents with a ‘curtain-like’ loss of vision in the right eye. There is no pain or
redness. What is the most likely diagnosis?
A. Retinal Detachment
B. Central Retinal Artery Occlusion
C. Acute Angle-Closure Glaucoma
D. Hyphema
Answer: A
Conceptual Explanation: Retinal detachment is classically described as a painless ‘curtain’
or ‘shade’ coming down over the field of vision.
4. In a patient with suspected sepsis, which lactate level is most indicative of tissue
hypoperfusion and high mortality risk?
A. Lower than 1.0 mmol/L
B. Greater than 4.0 mmol/L
, C. 2.0 mmol/L
D. 1.5 mmol/L
Answer: B
Conceptual Explanation: A serum lactate level greater than 4.0 mmol/L is a significant
marker for tissue hypoxia and is associated with increased mortality in septic shock.
5. A 3-year-old child presents with a ‘barking’ cough and inspiratory stridor. X-ray shows the
‘steeple sign’. What is the primary treatment?
A. Albuterol nebulizer
B. Intravenous antibiotics
C. Dexamethasone and racemic epinephrine
D. Chest physiotherapy
Answer: C
Conceptual Explanation: The barking cough and steeple sign indicate Croup
(Laryngotracheobronchitis). Management includes steroids (Dexamethasone) and racemic
epinephrine for severe stridor.
6. Which of the following is the most sensitive physical exam finding for ruling out testicular
torsion?
A. Positive Prehn sign
B. Presence of the cremasteric reflex
