Barkley Comprehensive Nurse
Practitioner Certification PRACTICE
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP
GRADED A+*INSTANT DOWNLOAD PDF
1. A 52-year-old patient presents for a routine examination. Which
finding is most concerning for secondary hypertension?
A. BMI of 31 kg/m²
B. Family history of hypertension
C. Hypertension beginning at age 25
D. Abrupt onset of severe hypertension at age 52
Answer: D. Abrupt onset of severe hypertension at age 52
Abrupt or severe hypertension developing later in life raises concern
for a secondary cause such as renal artery stenosis, endocrine
disease, or medication effects.
2. Which physical finding is most consistent with hypothyroidism?
A. Warm, moist skin
B. Fine tremor
C. Delayed relaxation of deep tendon reflexes
D. Hyperreflexia
**Answer: C. Delayed relaxation of deep tendon reflexes
Hypothyroidism commonly causes fatigue, cold intolerance, dry skin,
bradycardia, and delayed relaxation of deep tendon reflexes.
3. Which laboratory test is generally the initial screening test for
thyroid dysfunction?
,A. Total T3
B. TSH
C. Thyroglobulin
D. Reverse T3
**Answer: B. TSH
TSH is typically the initial test used to evaluate suspected primary
thyroid dysfunction.
4. A patient reports fatigue, pallor, and exertional dyspnea. CBC
shows microcytosis and low hemoglobin. Which deficiency is most
likely?
A. Vitamin B12
B. Folate
C. Iron
D. Vitamin D
**Answer: C. Iron
Iron deficiency classically produces a microcytic, hypochromic
anemia.
5. Which symptom is most characteristic of hyperthyroidism?
A. Weight gain
B. Cold intolerance
C. Bradycardia
D. Heat intolerance
**Answer: D. Heat intolerance
Excess thyroid hormone increases metabolic activity and commonly
causes heat intolerance, sweating, weight loss, and tachycardia.
6. A patient has a blood pressure of 182/116 mmHg and reports
chest pain and neurologic symptoms. What is the priority?
A. Repeat the blood pressure in one month
B. Begin lifestyle modification
,C. Emergency evaluation
D. Recommend home blood-pressure monitoring
**Answer: C. Emergency evaluation
Severe hypertension accompanied by symptoms suggesting acute
target-organ injury requires immediate evaluation.
7. Which finding is most suggestive of dehydration?
A. Bounding pulse
B. Orthostatic hypotension
C. Peripheral edema
D. Jugular venous distention
**Answer: B. Orthostatic hypotension
Volume depletion may produce tachycardia, orthostatic hypotension,
dry mucous membranes, and decreased urine output.
8. Which screening test is most appropriate for osteoporosis risk in
an older woman?
A. CT scan
B. DEXA scan
C. MRI
D. Bone biopsy
**Answer: B. DEXA scan
Dual-energy X-ray absorptiometry is the standard test for assessing
bone mineral density.
9. Which physical finding is most consistent with peripheral arterial
disease?
A. Warm feet with bounding pulses
B. Dependent rubor and diminished pulses
C. Bilateral pitting edema only
D. Increased hair growth on the lower legs
**Answer: B. Dependent rubor and diminished pulses
, Peripheral arterial disease may cause diminished pulses, cool skin,
hair loss, pallor with elevation, and dependent rubor.
10. Which symptom is a classic manifestation of hypoglycemia?
A. Polyuria
B. Tremor and diaphoresis
C. Kussmaul respirations
D. Fruity breath
**Answer: B. Tremor and diaphoresis
Adrenergic symptoms of hypoglycemia include sweating, tremor,
palpitations, anxiety, and hunger.
11. A patient reports several months of progressive fatigue,
constipation, and weight gain. Which condition should be
considered?
A. Hyperthyroidism
B. Hypothyroidism
C. Pheochromocytoma
D. Diabetes insipidus
**Answer: B. Hypothyroidism
Fatigue, constipation, weight gain, cold intolerance, and dry skin are
typical hypothyroid manifestations.
12. Which electrolyte abnormality is most associated with prolonged
vomiting?
A. Hyperkalemia
B. Hyperchloremia
C. Hypochloremia
D. Hypermagnesemia
**Answer: C. Hypochloremia
Loss of gastric hydrochloric acid through vomiting can result in
hypochloremia and metabolic alkalosis.
Practitioner Certification PRACTICE
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP
GRADED A+*INSTANT DOWNLOAD PDF
1. A 52-year-old patient presents for a routine examination. Which
finding is most concerning for secondary hypertension?
A. BMI of 31 kg/m²
B. Family history of hypertension
C. Hypertension beginning at age 25
D. Abrupt onset of severe hypertension at age 52
Answer: D. Abrupt onset of severe hypertension at age 52
Abrupt or severe hypertension developing later in life raises concern
for a secondary cause such as renal artery stenosis, endocrine
disease, or medication effects.
2. Which physical finding is most consistent with hypothyroidism?
A. Warm, moist skin
B. Fine tremor
C. Delayed relaxation of deep tendon reflexes
D. Hyperreflexia
**Answer: C. Delayed relaxation of deep tendon reflexes
Hypothyroidism commonly causes fatigue, cold intolerance, dry skin,
bradycardia, and delayed relaxation of deep tendon reflexes.
3. Which laboratory test is generally the initial screening test for
thyroid dysfunction?
,A. Total T3
B. TSH
C. Thyroglobulin
D. Reverse T3
**Answer: B. TSH
TSH is typically the initial test used to evaluate suspected primary
thyroid dysfunction.
4. A patient reports fatigue, pallor, and exertional dyspnea. CBC
shows microcytosis and low hemoglobin. Which deficiency is most
likely?
A. Vitamin B12
B. Folate
C. Iron
D. Vitamin D
**Answer: C. Iron
Iron deficiency classically produces a microcytic, hypochromic
anemia.
5. Which symptom is most characteristic of hyperthyroidism?
A. Weight gain
B. Cold intolerance
C. Bradycardia
D. Heat intolerance
**Answer: D. Heat intolerance
Excess thyroid hormone increases metabolic activity and commonly
causes heat intolerance, sweating, weight loss, and tachycardia.
6. A patient has a blood pressure of 182/116 mmHg and reports
chest pain and neurologic symptoms. What is the priority?
A. Repeat the blood pressure in one month
B. Begin lifestyle modification
,C. Emergency evaluation
D. Recommend home blood-pressure monitoring
**Answer: C. Emergency evaluation
Severe hypertension accompanied by symptoms suggesting acute
target-organ injury requires immediate evaluation.
7. Which finding is most suggestive of dehydration?
A. Bounding pulse
B. Orthostatic hypotension
C. Peripheral edema
D. Jugular venous distention
**Answer: B. Orthostatic hypotension
Volume depletion may produce tachycardia, orthostatic hypotension,
dry mucous membranes, and decreased urine output.
8. Which screening test is most appropriate for osteoporosis risk in
an older woman?
A. CT scan
B. DEXA scan
C. MRI
D. Bone biopsy
**Answer: B. DEXA scan
Dual-energy X-ray absorptiometry is the standard test for assessing
bone mineral density.
9. Which physical finding is most consistent with peripheral arterial
disease?
A. Warm feet with bounding pulses
B. Dependent rubor and diminished pulses
C. Bilateral pitting edema only
D. Increased hair growth on the lower legs
**Answer: B. Dependent rubor and diminished pulses
, Peripheral arterial disease may cause diminished pulses, cool skin,
hair loss, pallor with elevation, and dependent rubor.
10. Which symptom is a classic manifestation of hypoglycemia?
A. Polyuria
B. Tremor and diaphoresis
C. Kussmaul respirations
D. Fruity breath
**Answer: B. Tremor and diaphoresis
Adrenergic symptoms of hypoglycemia include sweating, tremor,
palpitations, anxiety, and hunger.
11. A patient reports several months of progressive fatigue,
constipation, and weight gain. Which condition should be
considered?
A. Hyperthyroidism
B. Hypothyroidism
C. Pheochromocytoma
D. Diabetes insipidus
**Answer: B. Hypothyroidism
Fatigue, constipation, weight gain, cold intolerance, and dry skin are
typical hypothyroid manifestations.
12. Which electrolyte abnormality is most associated with prolonged
vomiting?
A. Hyperkalemia
B. Hyperchloremia
C. Hypochloremia
D. Hypermagnesemia
**Answer: C. Hypochloremia
Loss of gastric hydrochloric acid through vomiting can result in
hypochloremia and metabolic alkalosis.
