BARKLEY POST TEST 2026/ BARKLEY POST TEST
PRACTICE EXAM NEWEST VERSION 2026
ACTUAL EXAM A+
1. A patient with chronic kidney disease is prescribed an ACE inhibitor.
Which lab value is most important to monitor?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Correct Answer: B
Big Rationale:
ACE inhibitors decrease aldosterone, causing potassium retention. In
CKD, the kidneys already struggle to excrete potassium, increasing the
risk of life-threatening hyperkalemia.
2. Which finding best differentiates SIADH from diabetes insipidus?
A. Altered mental status
B. Polyuria
C. Serum sodium level
D. Blood pressure changes
Correct Answer: C
,Big Rationale:
SIADH causes hyponatremia due to excess water retention, while
diabetes insipidus causes hypernatremia from excessive water loss.
Sodium level is the key distinguishing lab.
3. A patient receiving total parenteral nutrition (TPN) suddenly
develops dyspnea and crackles. Priority action?
A. Increase infusion rate
B. Stop TPN
C. Place patient supine
D. Check blood glucose
Correct Answer: B
Big Rationale:
TPN is hyperosmolar and can cause fluid overload, especially in
compromised patients. Sudden respiratory symptoms indicate overload—
stop the infusion first, then assess.
4. Which condition places a patient at highest risk for metabolic
acidosis?
A. Prolonged vomiting
B. Diuretic use
C. Renal failure
D. Hyperventilation
Correct Answer: C
, Big Rationale:
Kidneys regulate acid–base balance. Renal failure prevents acid
excretion, leading to metabolic acidosis. Vomiting causes alkalosis.
5. A patient with atrial fibrillation is prescribed apixaban. Teaching
priority?
A. Avoid leafy greens
B. Monitor INR weekly
C. Report signs of bleeding
D. Take with food
Correct Answer: C
Big Rationale:
DOACs (like apixaban) do not require INR monitoring and are not
affected by vitamin K. Bleeding is the primary safety concern.
6. Which ABG indicates respiratory acidosis?
A. pH 7.48, CO₂ 30
B. pH 7.32, CO₂ 55
C. pH 7.50, HCO₃⁻ 30
D. pH 7.36, CO₂ 40
Correct Answer: B
Big Rationale:
Low pH + high CO₂ = respiratory acidosis, commonly seen in COPD or
hypoventilation.
PRACTICE EXAM NEWEST VERSION 2026
ACTUAL EXAM A+
1. A patient with chronic kidney disease is prescribed an ACE inhibitor.
Which lab value is most important to monitor?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Correct Answer: B
Big Rationale:
ACE inhibitors decrease aldosterone, causing potassium retention. In
CKD, the kidneys already struggle to excrete potassium, increasing the
risk of life-threatening hyperkalemia.
2. Which finding best differentiates SIADH from diabetes insipidus?
A. Altered mental status
B. Polyuria
C. Serum sodium level
D. Blood pressure changes
Correct Answer: C
,Big Rationale:
SIADH causes hyponatremia due to excess water retention, while
diabetes insipidus causes hypernatremia from excessive water loss.
Sodium level is the key distinguishing lab.
3. A patient receiving total parenteral nutrition (TPN) suddenly
develops dyspnea and crackles. Priority action?
A. Increase infusion rate
B. Stop TPN
C. Place patient supine
D. Check blood glucose
Correct Answer: B
Big Rationale:
TPN is hyperosmolar and can cause fluid overload, especially in
compromised patients. Sudden respiratory symptoms indicate overload—
stop the infusion first, then assess.
4. Which condition places a patient at highest risk for metabolic
acidosis?
A. Prolonged vomiting
B. Diuretic use
C. Renal failure
D. Hyperventilation
Correct Answer: C
, Big Rationale:
Kidneys regulate acid–base balance. Renal failure prevents acid
excretion, leading to metabolic acidosis. Vomiting causes alkalosis.
5. A patient with atrial fibrillation is prescribed apixaban. Teaching
priority?
A. Avoid leafy greens
B. Monitor INR weekly
C. Report signs of bleeding
D. Take with food
Correct Answer: C
Big Rationale:
DOACs (like apixaban) do not require INR monitoring and are not
affected by vitamin K. Bleeding is the primary safety concern.
6. Which ABG indicates respiratory acidosis?
A. pH 7.48, CO₂ 30
B. pH 7.32, CO₂ 55
C. pH 7.50, HCO₃⁻ 30
D. pH 7.36, CO₂ 40
Correct Answer: B
Big Rationale:
Low pH + high CO₂ = respiratory acidosis, commonly seen in COPD or
hypoventilation.
