100% Family Nurse Practitioner (FNP)
Barkley Post-Test Fall PRACTICE
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP GRADED
A+*INSTANT DOWNLOAD PDF
1. A 58-year-old patient has repeated office blood pressures of
148/92 mmHg. Which diagnosis is most appropriate if elevated
readings are confirmed on separate occasions?
A. Normal blood pressure
B. Elevated blood pressure only
C. Hypertension
D. Hypotension
Rationale: Persistent blood pressure at or above 140/90 mmHg meets
the traditional office threshold for hypertension diagnosis, although
confirmation with appropriate repeated measurements or out-of-
office monitoring is recommended.
2. Which lifestyle intervention has the greatest expected effect on
blood pressure in a patient with hypertension?
A. Increasing dietary sodium
B. Weight reduction when overweight
C. Increasing saturated fat intake
D. Avoiding aerobic exercise
,Rationale: Weight reduction can substantially lower blood pressure
and is an important component of comprehensive hypertension
management.
3. A patient with hypertension and diabetes has albuminuria. Which
medication class is particularly beneficial?
A. Alpha blocker
B. Loop diuretic
C. ACE inhibitor or ARB
D. Nitrate
Rationale: ACE inhibitors and ARBs reduce intraglomerular pressure
and albuminuria and provide renal protection in appropriate patients
with diabetes and albuminuria.
4. Which adverse effect is characteristic of ACE inhibitors?
A. Constipation
B. Bradycardia
C. Persistent dry cough
D. Hypoglycemia
Rationale: Increased bradykinin levels can cause a persistent dry
cough. Angioedema is another important adverse effect.
5. A patient taking an ACE inhibitor develops swelling of the lips and
tongue. What is the priority?
A. Reassure the patient
B. Give the next ACE inhibitor dose
C. Treat as potentially life-threatening angioedema and discontinue
the ACE inhibitor
D. Recommend increased fluids
Rationale: ACE-inhibitor-associated angioedema can rapidly
compromise the airway and requires urgent assessment and
treatment.
,6. Which finding is most suggestive of left-sided heart failure?
A. Ascites only
B. Peripheral edema only
C. Pulmonary crackles and orthopnea
D. Enlarged liver only
Rationale: Left ventricular failure causes pulmonary venous
congestion, producing dyspnea, orthopnea, paroxysmal nocturnal
dyspnea, and crackles.
7. A patient reports sudden crushing substernal chest pain radiating
to the left arm with diaphoresis. What should the FNP do first?
A. Schedule an appointment next week
B. Recommend an antacid
C. Activate emergency evaluation for possible acute coronary
syndrome
D. Recommend routine exercise
Rationale: Crushing chest pain with autonomic symptoms is
concerning for acute coronary syndrome and requires immediate
emergency assessment.
8. Which ECG finding is most concerning for acute myocardial
infarction?
A. Normal sinus rhythm
B. ST-segment elevation in contiguous leads
C. Sinus arrhythmia
D. First-degree AV block
Rationale: New ST-segment elevation in anatomically contiguous
leads can indicate acute coronary occlusion requiring immediate
reperfusion evaluation.
9. Which medication is commonly used for rapid relief of stable
angina?
, A. Warfarin
B. Sublingual nitroglycerin
C. Amoxicillin
D. Metformin
Rationale: Sublingual nitroglycerin rapidly decreases myocardial
oxygen demand and dilates coronary vessels, relieving anginal
symptoms.
10. Which medication should generally not be combined with
nitrates?
A. Acetaminophen
B. Metformin
C. Sildenafil
D. Amoxicillin
Rationale: PDE-5 inhibitors such as sildenafil can markedly potentiate
nitrate-induced hypotension.
11. A patient with atrial fibrillation has an irregularly irregular pulse.
Which complication is particularly important to prevent?
A. Pneumonia
B. Thromboembolic stroke
C. Appendicitis
D. Nephrolithiasis
Rationale: Atrial fibrillation promotes atrial thrombus formation,
increasing the risk of systemic embolization and ischemic stroke.
12. Which physical finding is classic for aortic stenosis?
A. Diastolic rumble
B. Harsh crescendo-decrescendo systolic murmur radiating to the
carotids
C. Continuous machinery murmur
D. Fixed split S2
Barkley Post-Test Fall PRACTICE
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP GRADED
A+*INSTANT DOWNLOAD PDF
1. A 58-year-old patient has repeated office blood pressures of
148/92 mmHg. Which diagnosis is most appropriate if elevated
readings are confirmed on separate occasions?
A. Normal blood pressure
B. Elevated blood pressure only
C. Hypertension
D. Hypotension
Rationale: Persistent blood pressure at or above 140/90 mmHg meets
the traditional office threshold for hypertension diagnosis, although
confirmation with appropriate repeated measurements or out-of-
office monitoring is recommended.
2. Which lifestyle intervention has the greatest expected effect on
blood pressure in a patient with hypertension?
A. Increasing dietary sodium
B. Weight reduction when overweight
C. Increasing saturated fat intake
D. Avoiding aerobic exercise
,Rationale: Weight reduction can substantially lower blood pressure
and is an important component of comprehensive hypertension
management.
3. A patient with hypertension and diabetes has albuminuria. Which
medication class is particularly beneficial?
A. Alpha blocker
B. Loop diuretic
C. ACE inhibitor or ARB
D. Nitrate
Rationale: ACE inhibitors and ARBs reduce intraglomerular pressure
and albuminuria and provide renal protection in appropriate patients
with diabetes and albuminuria.
4. Which adverse effect is characteristic of ACE inhibitors?
A. Constipation
B. Bradycardia
C. Persistent dry cough
D. Hypoglycemia
Rationale: Increased bradykinin levels can cause a persistent dry
cough. Angioedema is another important adverse effect.
5. A patient taking an ACE inhibitor develops swelling of the lips and
tongue. What is the priority?
A. Reassure the patient
B. Give the next ACE inhibitor dose
C. Treat as potentially life-threatening angioedema and discontinue
the ACE inhibitor
D. Recommend increased fluids
Rationale: ACE-inhibitor-associated angioedema can rapidly
compromise the airway and requires urgent assessment and
treatment.
,6. Which finding is most suggestive of left-sided heart failure?
A. Ascites only
B. Peripheral edema only
C. Pulmonary crackles and orthopnea
D. Enlarged liver only
Rationale: Left ventricular failure causes pulmonary venous
congestion, producing dyspnea, orthopnea, paroxysmal nocturnal
dyspnea, and crackles.
7. A patient reports sudden crushing substernal chest pain radiating
to the left arm with diaphoresis. What should the FNP do first?
A. Schedule an appointment next week
B. Recommend an antacid
C. Activate emergency evaluation for possible acute coronary
syndrome
D. Recommend routine exercise
Rationale: Crushing chest pain with autonomic symptoms is
concerning for acute coronary syndrome and requires immediate
emergency assessment.
8. Which ECG finding is most concerning for acute myocardial
infarction?
A. Normal sinus rhythm
B. ST-segment elevation in contiguous leads
C. Sinus arrhythmia
D. First-degree AV block
Rationale: New ST-segment elevation in anatomically contiguous
leads can indicate acute coronary occlusion requiring immediate
reperfusion evaluation.
9. Which medication is commonly used for rapid relief of stable
angina?
, A. Warfarin
B. Sublingual nitroglycerin
C. Amoxicillin
D. Metformin
Rationale: Sublingual nitroglycerin rapidly decreases myocardial
oxygen demand and dilates coronary vessels, relieving anginal
symptoms.
10. Which medication should generally not be combined with
nitrates?
A. Acetaminophen
B. Metformin
C. Sildenafil
D. Amoxicillin
Rationale: PDE-5 inhibitors such as sildenafil can markedly potentiate
nitrate-induced hypotension.
11. A patient with atrial fibrillation has an irregularly irregular pulse.
Which complication is particularly important to prevent?
A. Pneumonia
B. Thromboembolic stroke
C. Appendicitis
D. Nephrolithiasis
Rationale: Atrial fibrillation promotes atrial thrombus formation,
increasing the risk of systemic embolization and ischemic stroke.
12. Which physical finding is classic for aortic stenosis?
A. Diastolic rumble
B. Harsh crescendo-decrescendo systolic murmur radiating to the
carotids
C. Continuous machinery murmur
D. Fixed split S2
