100% Family Nurse Practitioner
(FNP) Barkley Post-Test Fall 2026
Comprehensive Final Exam Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A |
Instant Download Pdf
1. A 56-year-old man presents for an annual examination. He has
hypertension controlled with medication and a 30-pack-year
smoking history. He reports no respiratory symptoms. Which
intervention is most appropriate regarding lung cancer screening?
A. Obtain a chest radiograph annually
B. Obtain a baseline chest CT and repeat every 5 years
C. Recommend sputum cytology annually
D. Recommend annual low-dose CT screening
Answer: D. Recommend annual low-dose CT screening
Rationale: Adults at increased risk for lung cancer because of age and
substantial cigarette exposure may benefit from annual low-dose
computed tomography screening. A standard chest radiograph and
sputum cytology have not demonstrated comparable effectiveness for
reducing lung-cancer mortality. Screening eligibility should be
determined using current age, smoking exposure, and smoking-
cessation history criteria.
2. A 67-year-old woman reports fatigue and intermittent dizziness.
Her examination is normal except for pale conjunctivae.
, Laboratory testing demonstrates hemoglobin 9.2 g/dL,
microcytosis, and low ferritin. Which diagnosis is most likely?
A. Iron-deficiency anemia
B. Vitamin B12 deficiency
C. Aplastic anemia
D. Hemolytic anemia
Answer: A. Iron-deficiency anemia
Rationale: Low hemoglobin accompanied by microcytosis and depleted
ferritin is characteristic of iron deficiency. In an older adult,
identifying the cause is essential because chronic gastrointestinal
blood loss, including occult gastrointestinal malignancy, must be
considered. Treatment with iron should occur alongside evaluation for
the source of blood loss.
3. A 28-year-old woman presents with dysuria and urinary frequency
for 2 days. She has no fever, flank pain, vaginal discharge, or
pregnancy risk. Urinalysis demonstrates leukocyte esterase and
nitrites. Which diagnosis is most likely?
A. Pyelonephritis
B. Acute uncomplicated cystitis
C. Vaginitis
D. Nephrolithiasis
Answer: B. Acute uncomplicated cystitis
Rationale: Dysuria and frequency without systemic symptoms strongly
suggest acute uncomplicated cystitis. Positive leukocyte esterase and
nitrites further support a bacterial urinary tract infection, commonly
caused by Escherichia coli. Absence of fever and flank pain makes
pyelonephritis less likely.
, 4. A 45-year-old patient with type 2 diabetes has an A1C of 9.1%
despite adherence to metformin and lifestyle recommendations. He
has obesity and established atherosclerotic cardiovascular disease.
Which medication class is particularly appropriate to consider?
A. Sulfonylurea
B. Thiazolidinedione
C. GLP-1 receptor agonist
D. Alpha-glucosidase inhibitor
Answer: C. GLP-1 receptor agonist
Rationale: A GLP-1 receptor agonist can substantially lower glucose
while promoting weight loss and providing cardiovascular benefit in
appropriate patients with type 2 diabetes and established
cardiovascular disease. Treatment selection should consider
comorbidities, adverse effects, cost, patient preferences, and
contraindications.
5. A 72-year-old man reports sudden painless loss of vision in his
right eye. He describes a curtain-like shadow descending across his
visual field. What is the priority action?
A. Reassure the patient and schedule routine ophthalmology follow-up
B. Recommend artificial tears
C. Treat empirically for bacterial conjunctivitis
D. Arrange immediate ophthalmologic evaluation
Answer: D. Arrange immediate ophthalmologic evaluation
Rationale: A sudden painless curtain-like visual-field defect is highly
concerning for retinal detachment. Retinal detachment can
permanently impair vision and requires urgent ophthalmologic
assessment. Primary care management should focus on rapid
, recognition and immediate referral rather than delaying evaluation for
routine testing or treatment.
6. A 34-year-old woman reports episodic unilateral throbbing
headaches associated with nausea and photophobia. Neurologic
examination is normal, and symptoms have occurred in a
stereotyped pattern for several years. Which diagnosis is most
likely?
A. Migraine without aura
B. Cluster headache
C. Tension-type headache
D. Temporal arteritis
Answer: A. Migraine without aura
Rationale: Recurrent unilateral pulsating headaches accompanied by
nausea and photophobia are characteristic of migraine. A normal
neurologic examination and stable stereotyped pattern without red
flags support a primary headache disorder. New neurologic findings,
abrupt onset, systemic symptoms, or major changes in pattern would
require additional evaluation.
7. A 62-year-old woman has persistent blood pressure readings
around 168/96 mm Hg despite lifestyle modification. She has no
evidence of acute end-organ injury. Which approach is most
appropriate?
A. Diagnose hypertensive emergency
B. Initiate or intensify antihypertensive therapy and address
cardiovascular risk
C. Send her immediately to the emergency department solely because of
the blood pressure value
D. Avoid treatment unless symptoms develop
(FNP) Barkley Post-Test Fall 2026
Comprehensive Final Exam Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A |
Instant Download Pdf
1. A 56-year-old man presents for an annual examination. He has
hypertension controlled with medication and a 30-pack-year
smoking history. He reports no respiratory symptoms. Which
intervention is most appropriate regarding lung cancer screening?
A. Obtain a chest radiograph annually
B. Obtain a baseline chest CT and repeat every 5 years
C. Recommend sputum cytology annually
D. Recommend annual low-dose CT screening
Answer: D. Recommend annual low-dose CT screening
Rationale: Adults at increased risk for lung cancer because of age and
substantial cigarette exposure may benefit from annual low-dose
computed tomography screening. A standard chest radiograph and
sputum cytology have not demonstrated comparable effectiveness for
reducing lung-cancer mortality. Screening eligibility should be
determined using current age, smoking exposure, and smoking-
cessation history criteria.
2. A 67-year-old woman reports fatigue and intermittent dizziness.
Her examination is normal except for pale conjunctivae.
, Laboratory testing demonstrates hemoglobin 9.2 g/dL,
microcytosis, and low ferritin. Which diagnosis is most likely?
A. Iron-deficiency anemia
B. Vitamin B12 deficiency
C. Aplastic anemia
D. Hemolytic anemia
Answer: A. Iron-deficiency anemia
Rationale: Low hemoglobin accompanied by microcytosis and depleted
ferritin is characteristic of iron deficiency. In an older adult,
identifying the cause is essential because chronic gastrointestinal
blood loss, including occult gastrointestinal malignancy, must be
considered. Treatment with iron should occur alongside evaluation for
the source of blood loss.
3. A 28-year-old woman presents with dysuria and urinary frequency
for 2 days. She has no fever, flank pain, vaginal discharge, or
pregnancy risk. Urinalysis demonstrates leukocyte esterase and
nitrites. Which diagnosis is most likely?
A. Pyelonephritis
B. Acute uncomplicated cystitis
C. Vaginitis
D. Nephrolithiasis
Answer: B. Acute uncomplicated cystitis
Rationale: Dysuria and frequency without systemic symptoms strongly
suggest acute uncomplicated cystitis. Positive leukocyte esterase and
nitrites further support a bacterial urinary tract infection, commonly
caused by Escherichia coli. Absence of fever and flank pain makes
pyelonephritis less likely.
, 4. A 45-year-old patient with type 2 diabetes has an A1C of 9.1%
despite adherence to metformin and lifestyle recommendations. He
has obesity and established atherosclerotic cardiovascular disease.
Which medication class is particularly appropriate to consider?
A. Sulfonylurea
B. Thiazolidinedione
C. GLP-1 receptor agonist
D. Alpha-glucosidase inhibitor
Answer: C. GLP-1 receptor agonist
Rationale: A GLP-1 receptor agonist can substantially lower glucose
while promoting weight loss and providing cardiovascular benefit in
appropriate patients with type 2 diabetes and established
cardiovascular disease. Treatment selection should consider
comorbidities, adverse effects, cost, patient preferences, and
contraindications.
5. A 72-year-old man reports sudden painless loss of vision in his
right eye. He describes a curtain-like shadow descending across his
visual field. What is the priority action?
A. Reassure the patient and schedule routine ophthalmology follow-up
B. Recommend artificial tears
C. Treat empirically for bacterial conjunctivitis
D. Arrange immediate ophthalmologic evaluation
Answer: D. Arrange immediate ophthalmologic evaluation
Rationale: A sudden painless curtain-like visual-field defect is highly
concerning for retinal detachment. Retinal detachment can
permanently impair vision and requires urgent ophthalmologic
assessment. Primary care management should focus on rapid
, recognition and immediate referral rather than delaying evaluation for
routine testing or treatment.
6. A 34-year-old woman reports episodic unilateral throbbing
headaches associated with nausea and photophobia. Neurologic
examination is normal, and symptoms have occurred in a
stereotyped pattern for several years. Which diagnosis is most
likely?
A. Migraine without aura
B. Cluster headache
C. Tension-type headache
D. Temporal arteritis
Answer: A. Migraine without aura
Rationale: Recurrent unilateral pulsating headaches accompanied by
nausea and photophobia are characteristic of migraine. A normal
neurologic examination and stable stereotyped pattern without red
flags support a primary headache disorder. New neurologic findings,
abrupt onset, systemic symptoms, or major changes in pattern would
require additional evaluation.
7. A 62-year-old woman has persistent blood pressure readings
around 168/96 mm Hg despite lifestyle modification. She has no
evidence of acute end-organ injury. Which approach is most
appropriate?
A. Diagnose hypertensive emergency
B. Initiate or intensify antihypertensive therapy and address
cardiovascular risk
C. Send her immediately to the emergency department solely because of
the blood pressure value
D. Avoid treatment unless symptoms develop
