Barkley 3P Exam Questions
and Answers 350+
(Updated for 2026) Exam
Prep Pack A+ Questions &
Verified Answers
SECTION 1: CARDIOVASCULAR ASSESSMENT (Questions 1-
30)
1. Your colleague's patient experiences a sudden onset of pain in her
lower leg. The area is erythematous and warm to the touch but not
swollen. Your colleague suggests elevating the leg, applying warm
compresses, prescribing an NSAID, and ordering bed rest for at
least a week. Based on these findings, which measure is NOT a
correct form of treatment?
A) Elevating the leg
B) Applying warm compresses
,C) Prescribing non-steroidal anti-inflammatory drugs
D) Ordering bed rest
Correct ,,,,answer,,,: D) Ordering bed rest
Rationale: Based on the sudden presentation of pain, heat, and erythema
in the affected leg with lack of swelling, the patient is most likely
experiencing superficial thrombosis. Superficial thrombosis is generally
NOT treated with bed rest—rather, mobility is encouraged. Bed rest is a
standard treatment for deep thrombosis, not superficial thrombosis.
Elevating the leg, applying warm compresses, and NSAIDs are all
effective for managing superficial thrombosis .
2. Which of the following is NOT a common finding of acute left-
sided heart failure?
A) Coarse rales in all lung fields
B) Hepatomegaly
C) Wheezing, frothy cough
D) An S3 gallop sound
Correct ,,,,answer,,,: B) Hepatomegaly
Rationale: Hepatomegaly is common in chronic right-sided heart failure
but is much less common in acute heart failure. Coarse rales over all
lung fields, a wheezing frothy cough, and an S3 gallop are all common
findings in acute left-sided heart failure due to pulmonary congestion
and increased ventricular filling pressures .
,3. A patient has a blood pressure of 162/94 in the right arm and
148/88 in the left arm. What is the most appropriate next step?
A) Record the higher reading
B) Repeat BP in both arms after 5 minutes
C) Assume equipment error
D) Use the lower reading for treatment
Correct ,,,,answer,,,: B) Repeat BP in both arms after 5 minutes
Rationale: A difference >10-15 mmHg between arms suggests possible
subclavian stenosis or aortic dissection. This is a red flag finding
requiring careful repeat measurement before proceeding. In an acute
presentation, assume dissection until ruled out. Repeating the
measurement confirms whether the difference is consistent.
4. A patient reports chest pain that worsens when lying flat and
improves when leaning forward. This is most characteristic of:
A) Pericarditis
B) Myocardial ischemia
C) Aortic dissection
D) Pulmonary embolism
Correct ,,,,answer,,,: A) Pericarditis
Rationale: Pericarditis pain is characteristically positional—worse when
supine (as inflamed pericardial layers approximate) and relieved by
sitting up or leaning forward. This finding helps distinguish pericarditis
from other causes of chest pain. Myocardial ischemia, aortic dissection,
, and pulmonary embolism do not typically present with this positional
feature.
5. Which murmur is best heard with the patient leaning forward in
expiration?
A) Mitral stenosis
B) Aortic regurgitation
C) Tricuspid regurgitation
D) Pulmonic stenosis
Correct ,,,,answer,,,: B) Aortic regurgitation
Rationale: Leaning forward and exhaling brings the aortic valve closer
to the chest wall, enhancing the murmur of aortic regurgitation. This
position is optimal for detecting the early diastolic murmur of AR,
which is often faint. Mitral stenosis is best heard in the left lateral
decubitus position.
6. You auscultate a high-pitched, blowing, decrescendo murmur
immediately after S2 at the left sternal border. What is this?
A) Aortic stenosis
B) Aortic regurgitation
C) Mitral regurgitation
D) Tricuspid stenosis
Correct ,,,,answer,,,: B) Aortic regurgitation
and Answers 350+
(Updated for 2026) Exam
Prep Pack A+ Questions &
Verified Answers
SECTION 1: CARDIOVASCULAR ASSESSMENT (Questions 1-
30)
1. Your colleague's patient experiences a sudden onset of pain in her
lower leg. The area is erythematous and warm to the touch but not
swollen. Your colleague suggests elevating the leg, applying warm
compresses, prescribing an NSAID, and ordering bed rest for at
least a week. Based on these findings, which measure is NOT a
correct form of treatment?
A) Elevating the leg
B) Applying warm compresses
,C) Prescribing non-steroidal anti-inflammatory drugs
D) Ordering bed rest
Correct ,,,,answer,,,: D) Ordering bed rest
Rationale: Based on the sudden presentation of pain, heat, and erythema
in the affected leg with lack of swelling, the patient is most likely
experiencing superficial thrombosis. Superficial thrombosis is generally
NOT treated with bed rest—rather, mobility is encouraged. Bed rest is a
standard treatment for deep thrombosis, not superficial thrombosis.
Elevating the leg, applying warm compresses, and NSAIDs are all
effective for managing superficial thrombosis .
2. Which of the following is NOT a common finding of acute left-
sided heart failure?
A) Coarse rales in all lung fields
B) Hepatomegaly
C) Wheezing, frothy cough
D) An S3 gallop sound
Correct ,,,,answer,,,: B) Hepatomegaly
Rationale: Hepatomegaly is common in chronic right-sided heart failure
but is much less common in acute heart failure. Coarse rales over all
lung fields, a wheezing frothy cough, and an S3 gallop are all common
findings in acute left-sided heart failure due to pulmonary congestion
and increased ventricular filling pressures .
,3. A patient has a blood pressure of 162/94 in the right arm and
148/88 in the left arm. What is the most appropriate next step?
A) Record the higher reading
B) Repeat BP in both arms after 5 minutes
C) Assume equipment error
D) Use the lower reading for treatment
Correct ,,,,answer,,,: B) Repeat BP in both arms after 5 minutes
Rationale: A difference >10-15 mmHg between arms suggests possible
subclavian stenosis or aortic dissection. This is a red flag finding
requiring careful repeat measurement before proceeding. In an acute
presentation, assume dissection until ruled out. Repeating the
measurement confirms whether the difference is consistent.
4. A patient reports chest pain that worsens when lying flat and
improves when leaning forward. This is most characteristic of:
A) Pericarditis
B) Myocardial ischemia
C) Aortic dissection
D) Pulmonary embolism
Correct ,,,,answer,,,: A) Pericarditis
Rationale: Pericarditis pain is characteristically positional—worse when
supine (as inflamed pericardial layers approximate) and relieved by
sitting up or leaning forward. This finding helps distinguish pericarditis
from other causes of chest pain. Myocardial ischemia, aortic dissection,
, and pulmonary embolism do not typically present with this positional
feature.
5. Which murmur is best heard with the patient leaning forward in
expiration?
A) Mitral stenosis
B) Aortic regurgitation
C) Tricuspid regurgitation
D) Pulmonic stenosis
Correct ,,,,answer,,,: B) Aortic regurgitation
Rationale: Leaning forward and exhaling brings the aortic valve closer
to the chest wall, enhancing the murmur of aortic regurgitation. This
position is optimal for detecting the early diastolic murmur of AR,
which is often faint. Mitral stenosis is best heard in the left lateral
decubitus position.
6. You auscultate a high-pitched, blowing, decrescendo murmur
immediately after S2 at the left sternal border. What is this?
A) Aortic stenosis
B) Aortic regurgitation
C) Mitral regurgitation
D) Tricuspid stenosis
Correct ,,,,answer,,,: B) Aortic regurgitation
