Barkley FNP PRACTICE QUESTIONS
|ORIGINAL QUESTIONS & ANSWERS
|DETAILED RATIONALES |HINTED
COMPLETE EXAM PREP GRADED
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1. A 58-year-old patient has a blood pressure of 168/102 mmHg on
two separate visits. Which classification best describes this blood
pressure?
A. Elevated
B. Stage 1 hypertension
C. Stage 2 hypertension
D. Hypertensive emergency
Answer: C. Stage 2 hypertension
Stage 2 hypertension is defined by systolic BP ≥140 mmHg or diastolic
BP ≥90 mmHg. A hypertensive emergency requires severe BP
elevation with acute target-organ damage.
2. A 64-year-old man presents with crushing substernal chest pain
radiating to his left arm and diaphoresis. What is the priority
diagnostic test?
A. Echocardiogram
B. Chest CT
C. Exercise stress test
D. 12-lead ECG
Answer: D. 12-lead ECG
,An ECG should be obtained rapidly in suspected acute coronary
syndrome to identify ischemic changes or STEMI.
3. Which symptom is most characteristic of left-sided heart failure?
A. Ascites
B. Peripheral edema
C. Paroxysmal nocturnal dyspnea
D. Hepatomegaly
Answer: C. Paroxysmal nocturnal dyspnea
Left-sided heart failure causes pulmonary congestion, producing
dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.
4. A patient with stable angina reports predictable chest discomfort
when walking uphill that resolves after resting. What is the
underlying mechanism?
A. Acute coronary thrombosis
B. Pericardial inflammation
C. Transient myocardial ischemia from increased oxygen demand
D. Pulmonary embolism
Answer: C. Transient myocardial ischemia from increased oxygen
demand
Stable angina occurs when myocardial oxygen demand exceeds
supply, usually because of fixed coronary atherosclerotic obstruction.
5. Which finding is most concerning for aortic dissection?
A. Bilateral ankle edema
B. Gradual exertional dyspnea
,C. Sudden severe tearing chest pain radiating to the back
D. Pleuritic chest pain after exercise
Answer: C. Sudden severe tearing chest pain radiating to the back
Acute tearing chest or back pain is classic for aortic dissection and
requires emergency evaluation.
6. A patient with atrial fibrillation is at increased risk for which
complication?
A. Pneumothorax
B. Ischemic stroke
C. Pericarditis
D. Aortic aneurysm
Answer: B. Ischemic stroke
Atrial fibrillation promotes atrial blood stasis and thrombus
formation, which can embolize to the cerebral circulation.
7. Which physical examination finding is most associated with
peripheral arterial disease?
A. Warm feet with bounding pulses
B. Bilateral pitting edema
C. Diminished peripheral pulses
D. Brown ankle pigmentation
Answer: C. Diminished peripheral pulses
Peripheral arterial disease reduces arterial perfusion and may
produce diminished pulses, cool skin, and exertional claudication.
8. Which finding is most consistent with deep vein thrombosis?
, A. Bilateral leg swelling
B. Unilateral leg swelling and tenderness
C. Bilateral diminished pulses
D. Dependent rubor only
Answer: B. Unilateral leg swelling and tenderness
DVT commonly causes unilateral swelling, warmth, tenderness, and
sometimes erythema.
9. A patient develops sudden dyspnea, pleuritic chest pain,
tachycardia, and hypoxemia after a long flight. Which diagnosis
should be suspected?
A. Asthma
B. Pneumonia
C. Pulmonary embolism
D. Stable angina
Answer: C. Pulmonary embolism
Sudden dyspnea and pleuritic chest pain following prolonged
immobilization are classic warning signs of pulmonary embolism.
10. Which medication is commonly used as a rescue treatment for
acute bronchospasm?
A. Fluticasone
B. Montelukast
C. Albuterol
D. Tiotropium
Answer: C. Albuterol
Albuterol is a short-acting β2-agonist that rapidly relaxes bronchial
smooth muscle.
|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 168/102 mmHg on
two separate visits. Which classification best describes this blood
pressure?
A. Elevated
B. Stage 1 hypertension
C. Stage 2 hypertension
D. Hypertensive emergency
Answer: C. Stage 2 hypertension
Stage 2 hypertension is defined by systolic BP ≥140 mmHg or diastolic
BP ≥90 mmHg. A hypertensive emergency requires severe BP
elevation with acute target-organ damage.
2. A 64-year-old man presents with crushing substernal chest pain
radiating to his left arm and diaphoresis. What is the priority
diagnostic test?
A. Echocardiogram
B. Chest CT
C. Exercise stress test
D. 12-lead ECG
Answer: D. 12-lead ECG
,An ECG should be obtained rapidly in suspected acute coronary
syndrome to identify ischemic changes or STEMI.
3. Which symptom is most characteristic of left-sided heart failure?
A. Ascites
B. Peripheral edema
C. Paroxysmal nocturnal dyspnea
D. Hepatomegaly
Answer: C. Paroxysmal nocturnal dyspnea
Left-sided heart failure causes pulmonary congestion, producing
dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.
4. A patient with stable angina reports predictable chest discomfort
when walking uphill that resolves after resting. What is the
underlying mechanism?
A. Acute coronary thrombosis
B. Pericardial inflammation
C. Transient myocardial ischemia from increased oxygen demand
D. Pulmonary embolism
Answer: C. Transient myocardial ischemia from increased oxygen
demand
Stable angina occurs when myocardial oxygen demand exceeds
supply, usually because of fixed coronary atherosclerotic obstruction.
5. Which finding is most concerning for aortic dissection?
A. Bilateral ankle edema
B. Gradual exertional dyspnea
,C. Sudden severe tearing chest pain radiating to the back
D. Pleuritic chest pain after exercise
Answer: C. Sudden severe tearing chest pain radiating to the back
Acute tearing chest or back pain is classic for aortic dissection and
requires emergency evaluation.
6. A patient with atrial fibrillation is at increased risk for which
complication?
A. Pneumothorax
B. Ischemic stroke
C. Pericarditis
D. Aortic aneurysm
Answer: B. Ischemic stroke
Atrial fibrillation promotes atrial blood stasis and thrombus
formation, which can embolize to the cerebral circulation.
7. Which physical examination finding is most associated with
peripheral arterial disease?
A. Warm feet with bounding pulses
B. Bilateral pitting edema
C. Diminished peripheral pulses
D. Brown ankle pigmentation
Answer: C. Diminished peripheral pulses
Peripheral arterial disease reduces arterial perfusion and may
produce diminished pulses, cool skin, and exertional claudication.
8. Which finding is most consistent with deep vein thrombosis?
, A. Bilateral leg swelling
B. Unilateral leg swelling and tenderness
C. Bilateral diminished pulses
D. Dependent rubor only
Answer: B. Unilateral leg swelling and tenderness
DVT commonly causes unilateral swelling, warmth, tenderness, and
sometimes erythema.
9. A patient develops sudden dyspnea, pleuritic chest pain,
tachycardia, and hypoxemia after a long flight. Which diagnosis
should be suspected?
A. Asthma
B. Pneumonia
C. Pulmonary embolism
D. Stable angina
Answer: C. Pulmonary embolism
Sudden dyspnea and pleuritic chest pain following prolonged
immobilization are classic warning signs of pulmonary embolism.
10. Which medication is commonly used as a rescue treatment for
acute bronchospasm?
A. Fluticasone
B. Montelukast
C. Albuterol
D. Tiotropium
Answer: C. Albuterol
Albuterol is a short-acting β2-agonist that rapidly relaxes bronchial
smooth muscle.
