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BARKLY 3P EXAM - WITH 100% VERIFIED SOLUTIONS - 2024/2025

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BARKLY 3P EXAM - WITH 100% VERIFIED SOLUTIONS - 2024/2025 You are auscultating Jon's chest. When he sits up and leans forward, you can hear a high pitched, blowing murmur at S2. What does this type of murmur most likely indicate? a. Mitral stenosis b. Aortic Stenosis c. Mitral regurgitation ...

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  • October 2, 2024
  • 35
  • 2024/2025
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BARKLY 3P EXAM - WITH 100%
VERIFIED SOLUTIONS - 2024/2025

You are auscultating Jon's chest. When he sits up and leans forward, you can hear a high pitched,
blowing murmur at S2. What does this type of murmur most likely indicate?

a. Mitral stenosis

b. Aortic Stenosis

c. Mitral regurgitation

d. Aortic regurgitation

d. Aortic regurgitation



Aortic regurg is soft, high pitched, blowing diastolic decrescendo that best heard at the 3rd left
interspace at base. Murmur initiated w/ S2 and heard when Pt sits up and leans forward. Mitral
Stenosis= low pitched diastolic rumble & doesn't radiate. Best heard in apex when in left lateral
position. Aortic stenosis= loud, harsh murmur midsystole, radiated down the side of neck and down
apex. Mitral regurg= loud blowing murmur heard at apex and is pansystolic.




Which of the following is the most common clinical manifestation of osteoporosis?

a. Bone deformity

b. Bone pain

c. Pathologic fracture

d. Fat embolism

• Bone deformity

most common metabolic bone disease, is chronic, progressive, & systemic; Low bone mass and
deterioration of bone tissue, = leads to increased skeletal fragility & deformity. Osteoporosis usually not
apparent until AFTER a fracture; 2/3 of vertebral fractures are painless. Fat embolism from fat
obstruction d/t injury or trauma & not common in osteoporosis.

, A male patient requests a phosphodiesterase inhibitor to treat erectile dysfunction. Which of the
following is appropriate?

a. Tadalafil (Cialis) may be used at a dose of 2.5 mg daily if sexual activity will take place two or more
times per week.

b. Vardenafil (Levitra), 5 mg, may be taken with a high-fat meal four hours before sexual activity

c. Sildenafil (Viagra), 50 mg, may be taken one hour before sexual activity as long as the patient has a
resting blood pressure below 170/110 mm Hg

d. Avanafil (Stendra) is recommended at 50 mg for all patients, and may be taken 30 minutes before
sexual activity.

• Tadalafil (Cialis) may be used at a dose of 2.5 mg daily if sexual activity will take place two or more
times per week.



Which of the following is NOT part of Virchow's Triad?

a. Hypercoagulability

b. Damage to endothelial cells

c. Sympathetic tone

d. Turbulent blood flow

c. Sympathetic tone

Virchow's triad is a method of describing the three main factors that lead to a thrombosis --
sympathetic tone is not one of those and doesn't affect blood clotting.

Hypercoagulability does lead to clotting, including malignancy, trauma, sepsis, and thrombophilia.
Endothelial cell damage is part of Virchow's triad bc it causes blood to clot by promoting platelet
adherence to the wall of the vessels; vascular wall injury is the second aspect of Virchow's triad.
Lastly, turbulent blood flow is a constituent of circulatory stasis the third component of the triad,
which can be caused by atrial fibrillation, venous obstruction, and ventricular dysfunction



A patient with kidney stones also presents with hypercalcemia and mental confusion. The
practitioner should evaluate the patient for which of the following?

a. Cushing Syndrome

b. Conn's Syndrome

c. Hyperparathyroidism

,d. Addison's disease

c. Hyperparathyroidism



Which of the following statements is true regarding contraceptives?

a. Because oral contraceptives may cause harm to the fetus, they are pregnancy category X drugs in
pregnancy.

b. Oral contraceptives are linked to the promotion of ovarian, endometrial, and breast cancer.

c. By increasing angiotensin and aldosterone, oral contraceptives may increase blood pressure.

d. Oral contraceptives may reduce the effects of theophylline, benzodiazepines, and tricyclic
antidepressants

c. By increasing angiotensin and aldosterone, oral contraceptives may increase blood pressure.



estrogen promotes aldosterone production= sodium retention & HTN. Also believed stimulates
hepatic production of angiotensinogen, affecting renal system via elevated angiotensin & BP. OCP are
category X, but because serve no use, decrease incidence of ovarian and endometrial ca and don't
increase risk of breast ca. OCP containing progestin may enhance effects of theophylline, benzos, and
tricyclic antidepressants by decreasing clearance.



Upon percussion of the chest, you notice hyperresonance. Of the following choices which would
most likely be the cause?

a. Atelectasis

b. Normal Lung

c. Pneumothorax

d. Pulmonary embolism

c. Pneumothorax



What is the proper order of steps to accurately perform the Ortolani maneuver?

a. Extend the legs, adduct the legs, and abduct the knees

b. Flex the knees, abduct the knees, and adduct the legs

c. Flex the knees, adduct the legs, and abduct the legs

d. Extend the knees, abduct the legs, and adduct the knees

, • Flex the knees, abduct the knees, and adduct the legs



done on supine infant, flex knees while holding thighs. Adduct legs until thumbs touch, follow with
abduct knees until lateral part of knee touch table.



You have four patients who all have a family history of developing coronary heart disease at an early
age. According to their blood test results, which patient would most likely develop coronary heart
disease first?

a. Cholesterol: 170; LDL: 120; Triglycerides: 120; HDL: 45

b. Cholesterol: 195; LDL: 110; Triglycerides: 135; HDL: 30

c. Cholesterol: 170; LDL: 100; Triglycerides: 140; HDL: 20

d. Cholesterol: 190; LDL: 140; Triglycerides: 151; HDL: 50

d. Cholesterol: 190; LDL: 140; Triglycerides: 151; HDL: 50



3 of the 4 measurements are above what should be; HDL <40 in men & 50 in women increase risk, LDL
aim is <130, Chol > 200 & trig >150 attributed to increase risk heart disease.



This low-molecular-weight heparin is indicated for use with warfarin for the treatment of acute
symptomatic deep vein thrombosis, either with or without pulmonary embolism:

a. Nadroparin

b. Dalteparin

c. Tinzaparin

d. Fondaparinux

• Tinzaparin-



can be combined with warfarin for DVT, aids warfarin in inhibiting clotting of blood. Nadroparin &
Dalteparin don't use w/ warfarin, use independently. Fondaparinux is a Xa inhibitor NOT LMWH.



The main reason for discontinuance of implanted etonogestrel (Nexplanon) is:

a. Weight gain

b. Pregnancy

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