Barkley AGPCNP Practice FLORIDA STATE
FIRE INSTRUCTOR 3 ACTUAL EXAM ALL
QUESTIONS AND ANSWERS ALREADY
GRADED A+. 100% VERIFIED SOLUTIONS
| UPDATED PER LATEST GUIDELINES |
GRADED A+
EXAM DOMAINS OVERVIEW
Domain Percentage
Patient Assessment Process 24%
Plan of Care 60%
Professional Practice 16%
SECTION 1: CARDIOVASCULAR DISORDERS (Questions
1-25)
Question 1
A 72-year-old male with a history of CAD presents with crushing substernal chest pain
radiating to the left arm. Which initial intervention is MOST appropriate?
,A) Administer morphine IV
B) Administer 325 mg aspirin PO
C) Start heparin infusion
D) Obtain cardiac enzymes
Answer: B) Administer 325 mg aspirin PO
Rationale: Aspirin should be administered immediately to inhibit platelet aggregation
and reduce mortality in acute MI. Other interventions (morphine, heparin, enzymes)
follow afterward .
Question 2
A patient with atrial fibrillation has a CHA₂DS₂-VASc score of 3. What is the best
management to reduce stroke risk?
A) No anticoagulation needed
B) Dual antiplatelet therapy
C) Oral anticoagulation (e.g., apixaban)
D) Rate control with beta-blocker
Answer: C) Oral anticoagulation (e.g., apixaban)
Rationale: A CHA₂DS₂-VASc score ≥2 in men (≥3 in women) warrants oral
anticoagulation to reduce stroke risk. Antiplatelet therapy alone is insufficient .
Question 3
In cardiogenic shock, which hemodynamic profile is expected?
,A) High CI, low SVR, high PCWP
B) Low CI, high SVR, high PCWP
C) Low CI, low SVR, low PCWP
D) High CI, high SVR, normal PCWP
Answer: B) Low CI, high SVR, high PCWP
Rationale: Cardiogenic shock presents with low cardiac index (reduced forward flow),
high afterload (compensatory vasoconstriction/SVR), and pulmonary congestion (high
wedge pressure/PCWP) .
Question 4
Which ECG finding is most suggestive of pericarditis?
A) ST elevation in V1-V4
B) Diffuse ST elevation and PR depression
C) ST depression in leads II, III, aVF
D) T-wave inversion only in V5-V6
Answer: B) Diffuse ST elevation and PR depression
Rationale: Pericarditis classically shows diffuse ST elevation and PR depression across
multiple leads (not localized like MI) .
Question 5
A patient with decompensated HFrEF is admitted. Which medication improves long-
term mortality?
, A) IV furosemide
B) Digoxin
C) Sacubitril/valsartan
D) IV milrinone
Answer: C) Sacubitril/valsartan
Rationale: ARNI (sacubitril/valsartan) improves survival in HFrEF, while diuretics and
inotropes only provide symptomatic relief without mortality benefit .
Question 6
A patient with hypertension and CKD has an eGFR of 25 mL/min. Which antihypertensive
should be avoided?
A) Lisinopril
B) Metoprolol
C) Hydrochlorothiazide
D) Amlodipine
Answer: C) Hydrochlorothiazide
Rationale: Hydrochlorothiazide is ineffective at GFR <30 mL/min. Loop diuretics should
be used instead. ACE inhibitors/ARBs can be used but require monitoring.
Question 7
A 68-year-old woman with type 2 diabetes and hypertension has an LDL-C of 140
mg/dL on atorvastatin 40 mg. What is the next step according to the 2018 AHA/ACC
cholesterol guidelines?
FIRE INSTRUCTOR 3 ACTUAL EXAM ALL
QUESTIONS AND ANSWERS ALREADY
GRADED A+. 100% VERIFIED SOLUTIONS
| UPDATED PER LATEST GUIDELINES |
GRADED A+
EXAM DOMAINS OVERVIEW
Domain Percentage
Patient Assessment Process 24%
Plan of Care 60%
Professional Practice 16%
SECTION 1: CARDIOVASCULAR DISORDERS (Questions
1-25)
Question 1
A 72-year-old male with a history of CAD presents with crushing substernal chest pain
radiating to the left arm. Which initial intervention is MOST appropriate?
,A) Administer morphine IV
B) Administer 325 mg aspirin PO
C) Start heparin infusion
D) Obtain cardiac enzymes
Answer: B) Administer 325 mg aspirin PO
Rationale: Aspirin should be administered immediately to inhibit platelet aggregation
and reduce mortality in acute MI. Other interventions (morphine, heparin, enzymes)
follow afterward .
Question 2
A patient with atrial fibrillation has a CHA₂DS₂-VASc score of 3. What is the best
management to reduce stroke risk?
A) No anticoagulation needed
B) Dual antiplatelet therapy
C) Oral anticoagulation (e.g., apixaban)
D) Rate control with beta-blocker
Answer: C) Oral anticoagulation (e.g., apixaban)
Rationale: A CHA₂DS₂-VASc score ≥2 in men (≥3 in women) warrants oral
anticoagulation to reduce stroke risk. Antiplatelet therapy alone is insufficient .
Question 3
In cardiogenic shock, which hemodynamic profile is expected?
,A) High CI, low SVR, high PCWP
B) Low CI, high SVR, high PCWP
C) Low CI, low SVR, low PCWP
D) High CI, high SVR, normal PCWP
Answer: B) Low CI, high SVR, high PCWP
Rationale: Cardiogenic shock presents with low cardiac index (reduced forward flow),
high afterload (compensatory vasoconstriction/SVR), and pulmonary congestion (high
wedge pressure/PCWP) .
Question 4
Which ECG finding is most suggestive of pericarditis?
A) ST elevation in V1-V4
B) Diffuse ST elevation and PR depression
C) ST depression in leads II, III, aVF
D) T-wave inversion only in V5-V6
Answer: B) Diffuse ST elevation and PR depression
Rationale: Pericarditis classically shows diffuse ST elevation and PR depression across
multiple leads (not localized like MI) .
Question 5
A patient with decompensated HFrEF is admitted. Which medication improves long-
term mortality?
, A) IV furosemide
B) Digoxin
C) Sacubitril/valsartan
D) IV milrinone
Answer: C) Sacubitril/valsartan
Rationale: ARNI (sacubitril/valsartan) improves survival in HFrEF, while diuretics and
inotropes only provide symptomatic relief without mortality benefit .
Question 6
A patient with hypertension and CKD has an eGFR of 25 mL/min. Which antihypertensive
should be avoided?
A) Lisinopril
B) Metoprolol
C) Hydrochlorothiazide
D) Amlodipine
Answer: C) Hydrochlorothiazide
Rationale: Hydrochlorothiazide is ineffective at GFR <30 mL/min. Loop diuretics should
be used instead. ACE inhibitors/ARBs can be used but require monitoring.
Question 7
A 68-year-old woman with type 2 diabetes and hypertension has an LDL-C of 140
mg/dL on atorvastatin 40 mg. What is the next step according to the 2018 AHA/ACC
cholesterol guidelines?
