Barkley Review Exam 2023/2024
1. Your patient’s history indicates that his heart has deficient cardiac output after a myocardial infarction. The
... [Show More] patient complains of a wheezing, frothy cough, and appears generally healthy now after the infarction. The patient, however, also has difficulty breathing while at rest. Upon auscultation, you hear a S3 gallop. The patient also tells you that he is unable to carry out any physical activity without incurring symptoms. How should you classify the patient’s condition?
A. Chronic heart failure
B. Class I heart failure
C. Class IV heart failure
D. Class II heart failure
2. You are treating a patient who is receiving hospice care following inpatient treatment for cancer. Which ofthe following types of Medicare does not include home coverage?
A. Medicare A
B. Medicare B
C. Medicare D
D. Medicare C
3. You are treating a Guatemalan patient who speaks only Spanish. According to the standards of Culturallyand Linguistically Appropriate Services, it is necessary to provide all of the following for the patient except:
A. Interpreters
B. Verbal and written notices in the patient’s preferred language
C. Family members and friends who are present to assist with interpretation
D. Bilingual staff
4. You are treating a schizophrenic patient whom you suspect is a danger of hurting himself and/or others asa result of his condition. Under which of the following procedures are you required to administer proper treatmentto the patient?
A. Involuntary commitment
B. Report the patient to the health department
C. Crisis intervention
D. Use of restraints
5. You are treating a patient who requires surgery and are ensuring that measures are taken to prevent harmbeing done to the patient. Which of the following key ethical principles is associated with this duty?
A. Beneficience
B. Utilitarianism
C. Nonmaleficence
D. Justice
6. You are treating a patient who dies unexpectedly following a surgical following a surgical procedure. As anurse practitioner, in which of the following components of the investigation are you most likely to take part to assess the incidence?
A. Risk management
B. Experimental research
C. Root cause analysis
D. Quality assurance
7. A 59-year-old is having a follow-up evaluation two years after the successful conclusion of radiation therapy for leukemia. He tells you that he has been feeling run-down and reports unexplained weight loss and night sweats. Upon examination, you determine that he also has a fever and pain below his ribs and the left side. You know that he is at risk for chronic lymphotic leukemia. Which of the following results is considered the hallmark of this disease?
A. Philadelphia chromosome in leukemic cells
B. Lymphocytosis
C. Non-circulating blast cells in bone marrow
D. Pancytopenia with circulating blasts.
8. A 28-year-old single mother arrives at your office inquiring about alternative options for contraception. The woman mentions that she has been having an oral contraception for the last 10 years but is curious about the hormonal intrauterine device (IUD) option she read about in an article. Which of the following is one of the advantages of using a hormonal IUD?
A. Prevention of depression
B. Prevention of Asherman’s syndrome
C. Increased menstrual loss
D. Spotting
9. You are monitoring a toddler who has serous otitis media. The patients want to understand the treatment their child will receive. Which of the following would be the appropriate way to manage this condition?\
A. Oral antibiotics
B. Antihistamines
C. Decongestants
D. Monitor and re-evaluate in 3 months
10. Which of the following seizure patients would most likely benefit from lumbar puncture?
A. Any child with a tonic-clonic seizure
B. An 11 year old with a fever of 101.5 F
C. A four-month-old without fever
D. A two-year-old with a known seizure disorder
11. You take a serological test on a patient with hepatitis. Checking over the results, you discover the patient’s serology is positive for the following: surface antigen of the Hepatitis-B (HbsAg), antibody to the antigen of the hepatitis B virus (Anti-Hbe), immunoglobulin M (IgM0, immunoglobulin G (IgG0. What is the proper diagnosis?
A. Chronic hepatitis B
B. Recovered hepatitis B
C. Acute hepatitis A
D. Acute hepatitis B
12. Robert, a good friend of your, has called you to advice on obtaining a medical certification. He wants to know his various options. Which statement is true regarding the difference between licensure and certification?
A. Certification signifies that a person is qualified to perform a particular role and is granted by a government agency.
B. Licensure signifies mastery of specialized knowledge and is granted by a government agency.
C. Certification signifies mastery of specialized knowledge and is granted by a non-governmental agency.
D. Licensure signifies that a person is qualified to perform a particular role and is granted by a non-
governmental agency.
13. A mother brings her 3-month-old baby to your clinic to screen for failure to thrive (FTT). Which of the following is not a sign or symptom that would cause you to associate the infant with FTT?
A. Absolute length/width are below the 5th percentile
B. Weight falling greater than 2nd percentiles below the standard
C. Avoids eye contact
D. Commonly cries for more food or milk
14. Which of the following is not true of progestin-only birth control?
A. It has excellent reversibility
B. It most likely changes tubal transport of female and male gametes
C. Its mechanism of action affects the cervical mucus and the endometrium
D. It is typically more effective than combination pulls but has more side effects
15. The parents of a 1-year-old patient presents to you with concerns regarding their daughter’s health. At birth, they were told that their daughter had abnormal features and decreased muscle tone. They hope that their daughter would “grow out” of some these defects but, to their disappointment, she has not. They report that their daughter is having trouble walking and sitting up by herself. Furthermore, they state that no matter how much they feed their baby, she is always crying out for more food and, as a result, has been rapidly gaining weight. You suspect a chromosomal condition. Which of the following would be most likely?
A. Prader-Willi Syndrome
B. Hurler syndrome
C. Down syndrome
D. DiGeorge syndrome
16. The mother of a toddler complains that her 2-year-old child is picky eater, and despite evidence of a healthy growth pattern, she is concerned about her child’s appropriate food intake. Which of the following is the most accurate regarding toddler nutrition?
A. Your toddler’s diet is appropriate if he consumes 70 to 100 kcal/kg/day
B. Toddlers should consume more protein and a total of 120 kcal/kg/day
C. Toddlers must consume a least 45 kcal/kg/day
D. Parent of toddlers should insist that their children clean their plate and consume 100 to 110 kcal/kg/day
17. During a check-up with a 6-year-old, you wish to conduct an interview the child and his parents. He is a new patient, and you want to establish the proper doctor-patient relationship. Which of the following is a necessary component of your interview?
A. Assess child’s cholesterol
B. Informing the parents ahead of time if you are recording data
C. Assess liver function
D. Measure the child’s hematocrit
18. According to Jean Piaget, between the age of seven and 11, a child’s psychological development will be marked by:
A. Development of intuitive thought
B. Capability of logical thought
C. Trial and error learning
D. Capable of complex problem solving
19. After years of not conceiving, Kelly and Ed finally have a child, a girl named Beverly. They often check with you about what to expect as Beverly ages. In a month she will be 2 ½ years old. Which of the following is typically present in a 2 ½ -year-old child?
A. All primary teeth have erupted
B. Birth weight has doubled
C. Anterior fontanel is open
D. The child will be in the industry versus inferiority stage of psychosocial development
20. You are doing a well-child check on an infant. Currently, the baby can lifts his head when on his stomach, laughs aloud, and can crawl to you. When asked to say “mama,” however, the baby just smiles. Based on this description, what is his approximate age?
A. 6 months
B. 10 months
C. 4 months
D. 2 months
21. A mother visits you with her 13-month-old daughter, Vicky. The mother tells you that Vicky had Hib conjugate vaccine (Hib) and that she needs her booster. The mother wants to know if Vicky can still get her Hib booster. Which of the following should you tell the mother?
A. Hib booster is typically given at 12 months of age.
B. Hib booster is typically not recommended until two years of age
C. Hib booster must be given in a series of three before 5 months of age
D. The child does not need a booster until 5 years of age
22. Maggie, 2-month-old, is planning to receive the polio vaccine. Which of the following statements is true regarding polio vaccine administration to the patient?
A. The inactivated polio vaccine would be given at 3, 6, and 9 months of age, with the last dose received by 4 years of age.
B. The oral polio vaccine should be started at 6 years old.
C. The final dose of the inactivated polio vaccine would typically be given when the patient is 6 years old.
D. The inactivated polio vaccine should be given in a single dose at 2 months of age.
23. A parent brings her young infant into the clini, asking questions, about the administration of the rotavirus vaccine to her child. Which of the following is true regarding the rotavirus vaccine? A. The series of doses should begin before 14 weeks of age
B. The rotavirus vaccine may be administered before 14 weeks of age
C. Feedings should be limited after the child received the vaccine
D. The first dose should be administered at 1 year of age.
24. A new mother who is HBsAg-positive has just delivered her first child. Knowing that the baby will need to be protected from hepatitis, what would be your best plan of action for his new born?
A. Administer the hepatitis B vaccine and 1.0 mL hepatitis B immune globulin within six hours of birth.
B. Administer the hepatitis B vaccine and 0.75 mL hepatitis B immune globulin within 8 hrs of birth.
C. Test for HBsAg and antibody to HBsAg immediately after birth
D. Administer the hepatitis B vaccine and 0.5mL hepatitis B immune globulin within 12 hrs of birth.
25. Which of the following is not an event that must be reported to the Vaccine Adverse Events Reposting System?
A. Anaphylaxis
B. Death
C. Pneumonia
D. Encephalitis
26. You have a patient with a genetic disorder. The physical finding on this patient are an abnormal head, flattened nose, and upward slating eyes. Based on the physical findings, which would be the most likely genetic disorder?
A. DiGeorge syndrome
B. Down syndrome
C. Marfan syndrome
D. Turner’s syndrome
27. A 3-month-old infant, who was born healthy and weighed 7 lbs 5 oz at birth, presents with hypotonia, decreased vocalization and suspected seizures, which are all characteristics of Tay-Sachs disease. Which of the following would most predispose the infant to this condition?
A. Family history of hyperlipidemia
B. Ashkenazic Jewish ethnicity
C. African ethnicity
D. Family history of drug addiction
28. A 2-year-old female patient has a webbed neck, lymphedema, and low hair line. Additionally, you note the child’s blood pressure to be above the 95th percentile for children her age. The mother also mentions the child has difficulty grasping concepts at home, especially with learning to use a toilet. With which of the following genetic syndromes does the child most likely present?
A. Marfan
B. Turner’s
C. DiGeorge
D. Klinefeller’s
29. DiGeorge syndrome causes congenital defects in all of the following except:
A. Basal ganglia
B. Conotruncal region of the heart
C. Parathyroid gland
D. Thymus
30. When interviewing an expectant mother regarding family history for the purpose of genetic evaluation, which is not necessary to ask about?
A. Neurologic conditions
B. Birth defects
C. Growth retardation
D. Drug addiction
31. You are assessing a newborn who presents with a reddish-purple vascular malformation of the skin consisting of dilated capillaries. You recognize this as which of the following skin variations?
A. Café au lait spots
B. Port-wine stain
C. Strawberry mark
D. Mongolian spots
32. A Caucasian newborn delivered via Caesarean section at 38 weeks gestation, without complication, is in the nursery for an initial assessment. As the nurse practitioner, which of the following measurements should you most expect?
A. Weight of 1.8 kg, head circumference of 33 cm, and length 52 cm
B. Weight of 4 kg, head circumference of 36 cm, and length 51 cm
C. Weight of 3 kg, head circumference of 30 cm, and length 50 cm
D. Weight of 3 kg, head circumference of 33 cm, and length 51 cm
33. Of the following, which is the appropriate ratio of occurrence of galactoemia? A. 1:3,600 to 5,000
B. 1:400
C. 1:10,000 to 25,000
D. 1:60,000 to 80,000
34. When examining a newborn, which of the following is the best used to diagnose hip dislocation?
A. Uneven skin folds
B. Allis’ sign
C. Ortolani-Barlow maneuver
D. Turned in toes
35. A child is born in the 97th percentile for birth weight. It is surprising since the parents are of normal weight and the mother does not have diabetes. This seems to be the infant’s only abnormality, until it is discovered that the child also has an enlarged tongue. Which of the following is the most likely diagnosis?
A. Perlman syndrome
B. Beckwith-Wiedemann syndrome
C. Costello syndrome
D. Simpson-Golabi-Behmel syndrome.
36. After giving birth to Tabitha, her first child, 28-year-old Samantha and her husband, Darrin, leave the hospital after a day. The conception was without complication. When should Tabitha come back for a follow-up well-child check?
A. Four to six days
B. Two to three days
C. Three to five days
D. One to two days
37. Which of the following is not a supplement typically provided for infants?
A. Fluoride
B. Vitamin K
C. Vitamin D
D. Iron
38. A 3-month-old boy with a fever is brought to your clinic by his parents. You take the infant’s temperature and find that it is slightly higher than 101.8 F, which suggests serious bacterial infection, however, you are unable to find the local site of infection. Which of the following should be your next step?
A. Prescribe ibuprofen to manage the infant’s condition
B. Prescribe alternating doses of ibuprofen and acetaminophen
C. Admit the infant to a hospital
D. Consider the diagnosis of a urinary tract infection
39. By what age should a child have his first dental visit?
A. 2 years
B. 10 months
C. 8 months
D. 1 year
40. Which of the following is a developmental warning sign in infants?
A. An APGAR score of nine
B. Does not try to pick up a toy by two months of age
C. Does not raise head when lying on stomach by 3 months of age
D. Does not try to pick up a toy by three months of age
41. Of the choices, which is typically a result of allergic rhinitis?
A. Orbital edema
B. Mouth breathing
C. Fissures at lip corners
D. Nasal quality voice
42. A four-year-old boy comes to your office accompanied by his mother, who states that she has been concerned about frequent pauses and repetitions in her son’s speech. After conducting differential diagnosis for hearing and
visual impairment, you diagnose the child with stuttering. You assure his mother that no immediate treatment is needed and that stuttering frequently resolves on its own, however, her son may require a future referral. Which of the following conditions would not require a referral?
A. The child speaks but has a vocabulary of less than 1000 words
B. Avoidance of speaking
C. Patient age of six years or older
D. Stuttering lasting more than six months
43. The Bayley-Ill test is the standard for the diagnosis of developmental delays in children until what age/
A. 30 months
B. 42 months
C. 24 months
D. 36 months
44. A father brings in his 6-month-old girl, Hannah, because he is concerned that her development has slowed down considerably in the past month. For example, Hannah no longer makes babbling sounds like she used to, and she now drools excessively. She also used to flex her legs and reach for her mother’s hair with her hands, but now her legs and arms are floppy. You eventually diagnose Hannah with a pervasive development disorder that is diagnosed only in females. Which is it?
A. Autistic disorder
B. Asperger’s syndrome
C. Childhood disintegrative disorder
D. Rett’s disorder
45. Mary and David bring their child, Sarah, to your office, and they tell you that they want to begin potty training her. The child is showing signs that she is ready to begin her training. Which of the following signs is the nest indicator that she is ready?
A. The child’s bowel movement are irregular
B. The child’s seems comfortable with wet diapers
C. The child can walk and transfer objects between her hands
D. The child stays dry after naps
46. A mother brings her 5-year-old son in for a check-up. He is about to enter school for the first time and must go through some screenings before the school will permit him to participate. After reviewing the family history, you learn that his grandfather has a myocardial infarction at the age of 50. Which of the following is specifically indicated by this aspect of the patient’s history?
A. Measles, mumps, and rubella immunization
B. Purified protein derivative screening
C. Cholesterol screening
D. Hematocrit screening
47. The parents of 6-year-old Morris are worried about his adjustment to school. He has not exhibited dysfunctional behavior yet, but his older brother, now 20 years old, did. Which of the following is a likely warning sign in younger, school age children?
A. Disinterested in any extra academic activity
B. Cannot make or keep friends
C. Not working to ability
D. Destructive behavior to express self
48. When considering a school-age child’s nutritional development, which of the following is not typical average, annual height gain for the child?
A. 2 inches
B. 1 ½ inches
C. 3 inches
D. 2 ½ inches
49. A report of suspected child abuse must be made if certain signs or symptoms are observed. Your suspicion of child abuse would be further supported if the child exhibits bruising and the following except?
A. Soft tissue markings with the outline of a hand
B. Child is beneath 30th percentile for weight
C. Partial thromboplastin time of 90 seconds
D. Prothrombin time of 11 seconds
50. There are three general strategies when interviewing an adolescent. Which of the following is not one of the strategies used when interviewing adolescents?
A. PACES format
B. SAFETEENS format
C. HEADSS format
D. CAGE format
51. A 17-year-old patient, Maria, comes to your office with her mother. You notice, comparing her to last year, she has lost weight and looks very unhealthy. She reports that she has an eating disorder and wants help. You conduct a brief test and find that her teeth look transparent and that she has cotton-like hairs on her arms. It is determined that she has an eating disorder. Which of the following would not be a good management option for Maria’s condition?
A. Institutionalization
B. Interdisciplinary management
C. Behavior modification
D. Psychotherapy
52. You are examining a boy whose penis has begun to elongate. The physical development is indicative of what Tanner stage?
A. II
B. IV
C. I
D. III [Show Less]