Barkley Comprehensive Nurse Practitioner
Certification Review Exam PRACTICE
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP GRADED
A+*INSTANT DOWNLOAD PDF
1. A 58-year-old patient has a blood pressure of 168/96 mmHg on
two separate office visits. Which diagnosis is most appropriate?
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 hypertension
D. Stage 2 hypertension
Answer: D. Stage 2 hypertension
Stage 2 hypertension is defined by systolic blood pressure ≥140
mmHg or diastolic blood pressure ≥90 mmHg. Persistent readings
should prompt confirmation and treatment planning.
2. Which cardiovascular risk factor is considered modifiable?
A. Age
B. Family history
C. Cigarette smoking
D. Genetic predisposition
Answer: C. Cigarette smoking
Smoking is a major modifiable cardiovascular risk factor. Age,
genetics, and family history cannot be changed.
,3. A patient reports crushing substernal chest pain radiating to the
left arm with diaphoresis and nausea. What is the priority action?
A. Schedule an outpatient stress test
B. Obtain a routine lipid panel
C. Activate emergency evaluation for acute coronary syndrome
D. Recommend an antacid trial
Answer: C. Activate emergency evaluation for acute coronary
syndrome
The symptom pattern is highly concerning for acute myocardial
ischemia. Immediate emergency assessment and ECG-based
evaluation are required.
4. Which finding is most characteristic of left-sided heart failure?
A. Peripheral edema only
B. Pulmonary crackles
C. Ascites
D. Hepatomegaly
Answer: B. Pulmonary crackles
Left-sided heart failure commonly causes pulmonary congestion,
producing dyspnea, orthopnea, and crackles. Right-sided failure more
prominently causes systemic venous congestion.
5. Which symptom is most characteristic of peripheral arterial
disease?
A. Bilateral dependent edema
B. Calf pain with walking relieved by rest
,C. Orthopnea
D. Pleuritic chest pain
Answer: B. Calf pain with walking relieved by rest
Intermittent claudication occurs when arterial blood flow cannot
meet muscular oxygen demands during exertion.
6. A patient with atrial fibrillation is at increased risk for which major
complication?
A. Pneumothorax
B. Ischemic stroke
C. Peptic ulcer disease
D. Nephrolithiasis
Answer: B. Ischemic stroke
Atrial fibrillation promotes blood stasis, particularly in the left atrial
appendage, increasing the risk of systemic thromboembolism and
ischemic stroke.
7. Which physical finding is most consistent with mitral stenosis?
A. Diastolic murmur at the apex
B. Continuous machinery murmur
C. Systolic murmur radiating to the carotids
D. Pericardial friction rub
Answer: A. Diastolic murmur at the apex
Mitral stenosis classically produces a low-pitched diastolic rumble
best heard at the cardiac apex.
, 8. A patient with suspected infective endocarditis should have which
diagnostic test obtained before antibiotics when clinically feasible?
A. Lipid panel
B. Blood cultures
C. Pulmonary function tests
D. D-dimer only
Answer: B. Blood cultures
Multiple blood cultures should generally be obtained before
antimicrobial therapy when this can be done without delaying
treatment in an unstable patient.
9. Which finding is most concerning for an abdominal aortic
aneurysm?
A. Small, soft, reducible umbilical hernia
B. Pulsatile abdominal mass
C. Hyperactive bowel sounds
D. Mild epigastric tenderness after meals
Answer: B. Pulsatile abdominal mass
A pulsatile abdominal mass, particularly in a patient with vascular
risk factors, raises concern for abdominal aortic aneurysm.
10. Which patient has the greatest risk for osteoporosis?
A. 25-year-old healthy man
B. 35-year-old woman who exercises regularly
C. 72-year-old postmenopausal woman
D. 40-year-old man with normal BMI
Answer: C. 72-year-old postmenopausal woman
Certification Review Exam PRACTICE
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP GRADED
A+*INSTANT DOWNLOAD PDF
1. A 58-year-old patient has a blood pressure of 168/96 mmHg on
two separate office visits. Which diagnosis is most appropriate?
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 hypertension
D. Stage 2 hypertension
Answer: D. Stage 2 hypertension
Stage 2 hypertension is defined by systolic blood pressure ≥140
mmHg or diastolic blood pressure ≥90 mmHg. Persistent readings
should prompt confirmation and treatment planning.
2. Which cardiovascular risk factor is considered modifiable?
A. Age
B. Family history
C. Cigarette smoking
D. Genetic predisposition
Answer: C. Cigarette smoking
Smoking is a major modifiable cardiovascular risk factor. Age,
genetics, and family history cannot be changed.
,3. A patient reports crushing substernal chest pain radiating to the
left arm with diaphoresis and nausea. What is the priority action?
A. Schedule an outpatient stress test
B. Obtain a routine lipid panel
C. Activate emergency evaluation for acute coronary syndrome
D. Recommend an antacid trial
Answer: C. Activate emergency evaluation for acute coronary
syndrome
The symptom pattern is highly concerning for acute myocardial
ischemia. Immediate emergency assessment and ECG-based
evaluation are required.
4. Which finding is most characteristic of left-sided heart failure?
A. Peripheral edema only
B. Pulmonary crackles
C. Ascites
D. Hepatomegaly
Answer: B. Pulmonary crackles
Left-sided heart failure commonly causes pulmonary congestion,
producing dyspnea, orthopnea, and crackles. Right-sided failure more
prominently causes systemic venous congestion.
5. Which symptom is most characteristic of peripheral arterial
disease?
A. Bilateral dependent edema
B. Calf pain with walking relieved by rest
,C. Orthopnea
D. Pleuritic chest pain
Answer: B. Calf pain with walking relieved by rest
Intermittent claudication occurs when arterial blood flow cannot
meet muscular oxygen demands during exertion.
6. A patient with atrial fibrillation is at increased risk for which major
complication?
A. Pneumothorax
B. Ischemic stroke
C. Peptic ulcer disease
D. Nephrolithiasis
Answer: B. Ischemic stroke
Atrial fibrillation promotes blood stasis, particularly in the left atrial
appendage, increasing the risk of systemic thromboembolism and
ischemic stroke.
7. Which physical finding is most consistent with mitral stenosis?
A. Diastolic murmur at the apex
B. Continuous machinery murmur
C. Systolic murmur radiating to the carotids
D. Pericardial friction rub
Answer: A. Diastolic murmur at the apex
Mitral stenosis classically produces a low-pitched diastolic rumble
best heard at the cardiac apex.
, 8. A patient with suspected infective endocarditis should have which
diagnostic test obtained before antibiotics when clinically feasible?
A. Lipid panel
B. Blood cultures
C. Pulmonary function tests
D. D-dimer only
Answer: B. Blood cultures
Multiple blood cultures should generally be obtained before
antimicrobial therapy when this can be done without delaying
treatment in an unstable patient.
9. Which finding is most concerning for an abdominal aortic
aneurysm?
A. Small, soft, reducible umbilical hernia
B. Pulsatile abdominal mass
C. Hyperactive bowel sounds
D. Mild epigastric tenderness after meals
Answer: B. Pulsatile abdominal mass
A pulsatile abdominal mass, particularly in a patient with vascular
risk factors, raises concern for abdominal aortic aneurysm.
10. Which patient has the greatest risk for osteoporosis?
A. 25-year-old healthy man
B. 35-year-old woman who exercises regularly
C. 72-year-old postmenopausal woman
D. 40-year-old man with normal BMI
Answer: C. 72-year-old postmenopausal woman
