BARKLEY ACTUAL EXAM LATEST 2024/2025 QUESTIONS
AND VERIFIED CORRECT ANSWERS/ ALREADY GRADED
A++
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 - ANSWER 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 - ANSWER a. 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. - ANSWER 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.
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 - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER b.
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 - ANSWER 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 - ANSWER c. 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.
he main reason for discontinuance of implanted etonogestrel (Nexplanon)
is:
a. Weight gain
b. Pregnancy
c. Breast tenderness
d. Irregular bleeding - ANSWER d. Irregular bleeding
For the treatment of relapsing-remitting multiple sclerosis, the nurse
practitioner knows that:
a. First-line therapy typically involves an immunomodulator
b. Natalizumab is one of the safest drugs to use as initial therapy
c. A patient using interferon-beta products would have to have renal
function monitored.
d. Fingolimod is given intravenously for patients with resistant remitting-
relapsing multiple sclerosis. - ANSWER a. First-line therapy typically
involves an immune modulator
therapy begins with interferon-beta products (fingolimod, glatiramer,
natalizumab) which are immune modulator. Natalizumab limited (assoc w/
infections in brain) are used if others don't work. Meds are hepatotoxic and
