BARKLEY 3P EXAM (Answered 100% Correctly) (Complete) Updated 2024
You are auscultating Jon's chest. When he sits up and leans forward, you can hear a
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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
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.
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
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? [Show Less]