Barkley Primary Care Practice Questions —
150 High-Yield Questions with Detailed
Answer Explanations and Rationales
Table of Contents
Domain Questions Core Content Areas
Health Promotion & Screening, immunizations,
1–25
Disease Prevention counseling, risk assessment
History, physical exam, differe
Assessment & Diagnosis 26–50
diagnosis, diagnostic reasonin
Hypertension, heart failure, CA
Cardiovascular Disorders 51–70
arrhythmias, lipid managemen
Endocrine & Metabolic Diabetes, thyroid, osteoporosi
71–90
Disorders obesity, adrenal disorders
COPD, asthma, pneumonia,
Pulmonary Disorders 91–105
pulmonary embolism
Gastrointestinal & Renal
106–120 GERD, PUD, CKD, UTI, BPH
Disorders
Neurological &
Stroke, dementia, Parkinson's,
Musculoskeletal 121–135
osteoarthritis, gout
Disorders
,Domain Questions Core Content Areas
Falls, delirium, polypharmacy,
Geriatric Syndromes 136–145
incontinence, frailty
Professional Practice & Scope of practice, reimbursem
146–150
Ethics ethics, quality improvement
Barkley's Curriculum Review for Adult–Gerontology Primary
Care Nurse Practitioners includes over 600 test questions
covering assessment, labs/diagnostics, management/treatment,
pharmacology, and professional practice. This practice set
reflects those domains.
Section 1: Health Promotion & Disease Prevention
(Questions 1–25)
1. A 65-year-old male with a 40-pack-year smoking history
presents for a wellness visit. He currently smokes and has
no symptoms. Which lung cancer screening
recommendation is most appropriate?
A) Annual chest X-ray
B) Annual low-dose CT (LDCT) of the chest
C) Sputum cytology every 6 months
D) No screening indicated
Correct Answer: B
Rationale: The USPSTF recommends annual LDCT for adults
aged 50–80 years with a ≥20 pack-year smoking history
who currently smoke or have quit within the past 15 years.
LDCT reduces lung-cancer mortality, while chest X-ray is
not recommended for screening.
,2. A 72-year-old woman asks about bone density screening.
Which test is recommended for osteoporosis screening in
women aged 65 and older?
A) Serum calcium
B) DEXA scan
C) Vitamin D level
D) Alkaline phosphatase
Correct Answer: B
Rationale: DEXA (dual-energy X-ray absorptiometry) is the
gold standard for osteoporosis screening. It is
recommended for all women aged 65 and older and
younger women with risk factors.
3. A 68-year-old man with no history of smoking and a 10-
year risk of cardiovascular disease of 8% asks about aspirin
for primary prevention. According to USPSTF guidelines,
what is the most appropriate recommendation?
A) Start aspirin 81 mg daily
B) Do not start aspirin
C) Start aspirin 325 mg daily
D) Refer to cardiology
Correct Answer: B
Rationale: The USPSTF recommends against initiating
aspirin for primary prevention of cardiovascular disease in
adults aged 60 or older. For adults aged 40–59 with a 10-
year CVD risk of 10% or greater, the decision should be
individualized.
4. A 75-year-old woman presents for a routine visit. Which
immunization is recommended for all adults aged 65 and
older?
, A) MMR
B) Pneumococcal vaccine (PCV20 or PCV15 followed by
PPSV23)
C) Varicella
D) Hepatitis A
Correct Answer: B
Rationale: Pneumococcal vaccination is recommended for
all adults aged 65 and older. MMR and varicella are
recommended for adults without evidence of immunity.
Hepatitis A is recommended for at-risk populations.
5. Which screening test is recommended annually for all
adults aged 65 and older?
A) Colonoscopy
B) Abdominal aortic aneurysm ultrasound
C) Falls risk assessment
D) Thyroid-stimulating hormone
Correct Answer: C
Rationale: Annual falls risk assessment is recommended for
all older adults by the USPSTF and geriatric guidelines.
Colonoscopy is typically recommended every 10 years, AAA
ultrasound is a one-time screening for men aged 65–75
who have ever smoked, and TSH is not recommended for
routine screening.
6. A 72-year-old woman is being counseled on fall
prevention. Which intervention is most effective in
reducing fall risk?
A) Vitamin D supplementation
B) Regular exercise (strength and balance training)
150 High-Yield Questions with Detailed
Answer Explanations and Rationales
Table of Contents
Domain Questions Core Content Areas
Health Promotion & Screening, immunizations,
1–25
Disease Prevention counseling, risk assessment
History, physical exam, differe
Assessment & Diagnosis 26–50
diagnosis, diagnostic reasonin
Hypertension, heart failure, CA
Cardiovascular Disorders 51–70
arrhythmias, lipid managemen
Endocrine & Metabolic Diabetes, thyroid, osteoporosi
71–90
Disorders obesity, adrenal disorders
COPD, asthma, pneumonia,
Pulmonary Disorders 91–105
pulmonary embolism
Gastrointestinal & Renal
106–120 GERD, PUD, CKD, UTI, BPH
Disorders
Neurological &
Stroke, dementia, Parkinson's,
Musculoskeletal 121–135
osteoarthritis, gout
Disorders
,Domain Questions Core Content Areas
Falls, delirium, polypharmacy,
Geriatric Syndromes 136–145
incontinence, frailty
Professional Practice & Scope of practice, reimbursem
146–150
Ethics ethics, quality improvement
Barkley's Curriculum Review for Adult–Gerontology Primary
Care Nurse Practitioners includes over 600 test questions
covering assessment, labs/diagnostics, management/treatment,
pharmacology, and professional practice. This practice set
reflects those domains.
Section 1: Health Promotion & Disease Prevention
(Questions 1–25)
1. A 65-year-old male with a 40-pack-year smoking history
presents for a wellness visit. He currently smokes and has
no symptoms. Which lung cancer screening
recommendation is most appropriate?
A) Annual chest X-ray
B) Annual low-dose CT (LDCT) of the chest
C) Sputum cytology every 6 months
D) No screening indicated
Correct Answer: B
Rationale: The USPSTF recommends annual LDCT for adults
aged 50–80 years with a ≥20 pack-year smoking history
who currently smoke or have quit within the past 15 years.
LDCT reduces lung-cancer mortality, while chest X-ray is
not recommended for screening.
,2. A 72-year-old woman asks about bone density screening.
Which test is recommended for osteoporosis screening in
women aged 65 and older?
A) Serum calcium
B) DEXA scan
C) Vitamin D level
D) Alkaline phosphatase
Correct Answer: B
Rationale: DEXA (dual-energy X-ray absorptiometry) is the
gold standard for osteoporosis screening. It is
recommended for all women aged 65 and older and
younger women with risk factors.
3. A 68-year-old man with no history of smoking and a 10-
year risk of cardiovascular disease of 8% asks about aspirin
for primary prevention. According to USPSTF guidelines,
what is the most appropriate recommendation?
A) Start aspirin 81 mg daily
B) Do not start aspirin
C) Start aspirin 325 mg daily
D) Refer to cardiology
Correct Answer: B
Rationale: The USPSTF recommends against initiating
aspirin for primary prevention of cardiovascular disease in
adults aged 60 or older. For adults aged 40–59 with a 10-
year CVD risk of 10% or greater, the decision should be
individualized.
4. A 75-year-old woman presents for a routine visit. Which
immunization is recommended for all adults aged 65 and
older?
, A) MMR
B) Pneumococcal vaccine (PCV20 or PCV15 followed by
PPSV23)
C) Varicella
D) Hepatitis A
Correct Answer: B
Rationale: Pneumococcal vaccination is recommended for
all adults aged 65 and older. MMR and varicella are
recommended for adults without evidence of immunity.
Hepatitis A is recommended for at-risk populations.
5. Which screening test is recommended annually for all
adults aged 65 and older?
A) Colonoscopy
B) Abdominal aortic aneurysm ultrasound
C) Falls risk assessment
D) Thyroid-stimulating hormone
Correct Answer: C
Rationale: Annual falls risk assessment is recommended for
all older adults by the USPSTF and geriatric guidelines.
Colonoscopy is typically recommended every 10 years, AAA
ultrasound is a one-time screening for men aged 65–75
who have ever smoked, and TSH is not recommended for
routine screening.
6. A 72-year-old woman is being counseled on fall
prevention. Which intervention is most effective in
reducing fall risk?
A) Vitamin D supplementation
B) Regular exercise (strength and balance training)
