Barkley Infectious Disease Practice
Exam 200 Original Practice Questions
with Detailed Rationales
Note: This exam contains 200 original questions covering the
core infectious disease content areas tested on the Barkley 3P
Assessment and advanced practice nursing certification exams.
Each question includes the correct answer in italics and a
detailed rationale in bold. These questions reflect the style,
content, and difficulty level of the Barkley review materials and
Diagnostic Readiness Tests (DRTs). The Barkley 3P Assessment
evaluates competency in Advanced Pathophysiology, Advanced
Pharmacology, and Advanced Physical Assessment, with
infectious disease being a critical domain across all certification
exams.
Table of Contents
1. Bacterial Infections (Questions 1–40)
2. Viral Infections (Questions 41–80)
3. Fungal Infections (Questions 81–100)
4. Sexually Transmitted Infections (Questions 101–125)
5. Antimicrobial Pharmacology (Questions 126–160)
6. Immunizations and Prevention (Questions 161–180)
7. Infection Control and Emerging Infections (Questions 181–
200)
8. Answer Key Summary
,9. Exam Preparation Tips
Section 1: Bacterial Infections (Questions 1–40)
1. A nurse accidentally sticks herself with a needle used on
a patient with non-A, non-B hepatitis. She received her
hepatitis B vaccine 2 years ago. Her next step would be to:
A. Begin post-exposure prophylaxis
B. Draw baseline labs for herself and the patient
C. Administer hepatitis B immune globulin
D. No action is needed
Correct Answer: B. Draw baseline labs for herself and the
patient
**Rationale: Following a needlestick injury, the first step is
to draw baseline labs from both the healthcare worker and
the source patient to establish baseline serology. Post-
exposure prophylaxis decisions are based on these results.
Since the source patient has non-A, non-B hepatitis (likely
hepatitis C), the healthcare worker's hepatitis B vaccination
status does not provide protection against hepatitis C.
2. Which of the following populations is most strongly
considered at risk for hepatitis A?
A. Intravenous drug users
B. Men who have sex with men
C. Healthcare workers
D. Dialysis patients
Correct Answer: B. Men who have sex with men
**Rationale: Hepatitis A is transmitted via the fecal-oral
route. Men who have sex with men are at increased risk due
to sexual practices that may involve oral-anal contact.
,Other risk groups include travelers to endemic areas,
individuals experiencing homelessness, and people who use
illicit drugs.
3. What is the most common means of transmission for
hepatitis C?
A. Sexual contact
B. IV drug use
C. Blood transfusion
D. Perinatal transmission
Correct Answer: B. IV drug use
**Rationale: Hepatitis C is most commonly transmitted
through percutaneous exposure, particularly sharing
needles among intravenous drug users. Since the
introduction of blood screening in 1992, transfusion-
related transmission has become rare.
4. A patient presents with fever, cough, and green sputum.
Chest X-ray shows right lower lobe consolidation. What is
the most likely pathogen?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Chlamydia pneumoniae
D. Legionella pneumophila
Correct Answer: B. Streptococcus pneumoniae
**Rationale: Streptococcus pneumoniae is the most common
cause of community-acquired pneumonia, typically
presenting with fever, productive cough, and lobar
consolidation.
, 5. Which of the following is the most common cause of
bacterial meningitis in adults?
A. Neisseria meningitidis
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Listeria monocytogenes
Correct Answer: B. Streptococcus pneumoniae
**Rationale: Streptococcus pneumoniae is the most common
cause of bacterial meningitis in adults. Neisseria
meningitidis is more common in adolescents and young
adults, while Listeria is more common in neonates and
older adults.
6. A patient presents with a painful bump with a small, red-
looking halo on the penis. The affected area is about 5 mm
in diameter, soft, and tender. He states the halo has been
there for about a week. What is the most likely diagnosis?
A. Syphilis
B. Chancroid
C. Herpes simplex virus
D. Gonorrhea
Correct Answer: B. Chancroid
**Rationale: Chancroid is caused by Haemophilus ducreyi
and presents with a painful, soft chancre with a red halo.
This is in contrast to syphilis, which typically presents with a
painless, indurated chancre.
7. A 45-year-old with HIV has fever, dry cough, and
hypoxemia. Chest X-ray shows diffuse bilateral interstitial
infiltrates. CD4 count is 50. What is the most likely
pathogen?
Exam 200 Original Practice Questions
with Detailed Rationales
Note: This exam contains 200 original questions covering the
core infectious disease content areas tested on the Barkley 3P
Assessment and advanced practice nursing certification exams.
Each question includes the correct answer in italics and a
detailed rationale in bold. These questions reflect the style,
content, and difficulty level of the Barkley review materials and
Diagnostic Readiness Tests (DRTs). The Barkley 3P Assessment
evaluates competency in Advanced Pathophysiology, Advanced
Pharmacology, and Advanced Physical Assessment, with
infectious disease being a critical domain across all certification
exams.
Table of Contents
1. Bacterial Infections (Questions 1–40)
2. Viral Infections (Questions 41–80)
3. Fungal Infections (Questions 81–100)
4. Sexually Transmitted Infections (Questions 101–125)
5. Antimicrobial Pharmacology (Questions 126–160)
6. Immunizations and Prevention (Questions 161–180)
7. Infection Control and Emerging Infections (Questions 181–
200)
8. Answer Key Summary
,9. Exam Preparation Tips
Section 1: Bacterial Infections (Questions 1–40)
1. A nurse accidentally sticks herself with a needle used on
a patient with non-A, non-B hepatitis. She received her
hepatitis B vaccine 2 years ago. Her next step would be to:
A. Begin post-exposure prophylaxis
B. Draw baseline labs for herself and the patient
C. Administer hepatitis B immune globulin
D. No action is needed
Correct Answer: B. Draw baseline labs for herself and the
patient
**Rationale: Following a needlestick injury, the first step is
to draw baseline labs from both the healthcare worker and
the source patient to establish baseline serology. Post-
exposure prophylaxis decisions are based on these results.
Since the source patient has non-A, non-B hepatitis (likely
hepatitis C), the healthcare worker's hepatitis B vaccination
status does not provide protection against hepatitis C.
2. Which of the following populations is most strongly
considered at risk for hepatitis A?
A. Intravenous drug users
B. Men who have sex with men
C. Healthcare workers
D. Dialysis patients
Correct Answer: B. Men who have sex with men
**Rationale: Hepatitis A is transmitted via the fecal-oral
route. Men who have sex with men are at increased risk due
to sexual practices that may involve oral-anal contact.
,Other risk groups include travelers to endemic areas,
individuals experiencing homelessness, and people who use
illicit drugs.
3. What is the most common means of transmission for
hepatitis C?
A. Sexual contact
B. IV drug use
C. Blood transfusion
D. Perinatal transmission
Correct Answer: B. IV drug use
**Rationale: Hepatitis C is most commonly transmitted
through percutaneous exposure, particularly sharing
needles among intravenous drug users. Since the
introduction of blood screening in 1992, transfusion-
related transmission has become rare.
4. A patient presents with fever, cough, and green sputum.
Chest X-ray shows right lower lobe consolidation. What is
the most likely pathogen?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Chlamydia pneumoniae
D. Legionella pneumophila
Correct Answer: B. Streptococcus pneumoniae
**Rationale: Streptococcus pneumoniae is the most common
cause of community-acquired pneumonia, typically
presenting with fever, productive cough, and lobar
consolidation.
, 5. Which of the following is the most common cause of
bacterial meningitis in adults?
A. Neisseria meningitidis
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Listeria monocytogenes
Correct Answer: B. Streptococcus pneumoniae
**Rationale: Streptococcus pneumoniae is the most common
cause of bacterial meningitis in adults. Neisseria
meningitidis is more common in adolescents and young
adults, while Listeria is more common in neonates and
older adults.
6. A patient presents with a painful bump with a small, red-
looking halo on the penis. The affected area is about 5 mm
in diameter, soft, and tender. He states the halo has been
there for about a week. What is the most likely diagnosis?
A. Syphilis
B. Chancroid
C. Herpes simplex virus
D. Gonorrhea
Correct Answer: B. Chancroid
**Rationale: Chancroid is caused by Haemophilus ducreyi
and presents with a painful, soft chancre with a red halo.
This is in contrast to syphilis, which typically presents with a
painless, indurated chancre.
7. A 45-year-old with HIV has fever, dry cough, and
hypoxemia. Chest X-ray shows diffuse bilateral interstitial
infiltrates. CD4 count is 50. What is the most likely
pathogen?
