2023-2024 BARKLEY 3P Nursing Diagnosis Actual Exam With Answers (101 Solved Questions)

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BARKLEY 3PEXAM 2023-2024 ACTUAL EXAM100QUESTIONS AND CORRECT DETAILED ANSWERSWITH RATIONALES (VERIFIED ANSWERS) |ALREADYGRADED A+. A patient with sepsis is at risk of developing shock via which mechanism?a. Loss of systemic vascular resistanceb. Slowly evolving pump failure of the heartc. Loss of blood volumed. Loss of centrally-mediated neurogenic tone-ANSWER-a. Loss of systemic vascular resistance. Which of the following descriptors is best associated with Reynaud's Phenomenon?a. Arterialb. Venousc. Unilaterald. Painless-ANSWER-a. Arterial. You are teaching your nursing class about the point of maximal impulse. How do you describe to theclass where it is located?a. 4 th intercostal space (ICS), sternal borderb. 2 nd intercostal space (ICS), midclavicular line (MCL)c. 5 th ICS, MCLd. 3 rd ICS, sternal border-ANSWER-c. 5 th ICS, MCL19. Which of the followingis a true statement regarding migraines?a. These headaches typically present with an aura in most patientsb. Migraines are typically bilateral, and if caught early, respond well to ice and mild analgesics.c. Premenopausal females are the largest group of migraine sufferersd. Migraines occur when macrophages attack myelin sheaths in the CNS-ANSWER-c. Premenopausalfemales are the largest group of migraine sufferers.-menstruation is one of leading causes migraine

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triggers. Estrogen withdrawal with menses can be a trigger. Aura in only 20-25%, Unilateral, notbilateral, macrophages do not cause, are from triggers of stress, diet, sleeping patterns.40. What factor is responsible for the hypertrophy of the myocardium associated with hypertension andcardiac remodeling seen in heart failure?a. Increased epinephrineb. Natriuretic peptidesc. Angiotensin IId. Insulin resistance-ANSWER-c. Angiotensin II59. Kussmaul respirations are best defined by which of the following?a. It is typically seen in patients with anxiety, a cause of respiratory acidosisb. It is a compensatory mechanism to help rid the body of excessive carbon dioxidec. It indicates that the acidosis is causing damage to the respiratory compensatory muscles.d. It indicates that more oxygen is necessary because the patient is going into respiratory distress.-ANSWER-b. It is a compensatory mechanism to help rid the body of excessive carbon dioxide-compensates for acidosis. Is an ABNL breathing patternof series of long deep breaths in Pts w/metabolic acidosis, diabetic ketoacidosis, NOT respiratory acidosis which = hyperventilation.60. Which of the following is of true intention tremors?a. Resembles a snake-like movementb. Becomes worse with voluntary movementc. Disappears with sleepd. Disappears with voluntary movement-ANSWER-b. Becomes worse with voluntary movement61. Which of the following is most likely to be effective in the treatment of acute cluster headaches?a. 6 mg subcutaneous injection of sumatriptanb. 300 mg acetaminophenc. 40 mg riboflavind. 240 mg verapamil.-ANSWER-a. 6 mg subcutaneous injection of sumatriptan-

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correct drug and dose for cluster HA; verapamil & APAP not indicated for cluster, but verapamil can beused as prophylaxis for migraines. Riboflavin is for migraines, but dose is 400 not 40.A 68-year-old male patient desires testosterone replacement to enhance his libido. His testosteronelevel is found to be 250 ng/dL. The nurse practitioner knows thata. AndroGel once daily would restore sex drive and fertility in this clientb. Testosterone replacement is associated with cardiovascular risks, including myocardial infarction, andis not indicated for this patient.c. Testosterone cypionate injections would be a good treatment option for this patient.d. Testosterone replacement is known to suppress the development of prostate cancer, which would bea benefit.-ANSWER-b. Testosterone replacement is associated with cardiovascular risks, includingmyocardial infarction, and is not indicated for this patient.A child born with Tetralogy of Fallot often squats. The practitioner knows that squatting helps to:a. Shunt more blood to the pulmonary circulationb. Reduce the heart ratec. Increase the blood pressure in the legsd. Relieve lower back pain-ANSWER-a. Shunt more blood to the pulmonary circulationA child presents with a community acquired viral pneumonia. Presenting signs and symptoms willinclude:a. Mild to high fever, cough, rhinorrhea, crackles, rhonchi, and wheezesb. High fever, productive cough, and pleuritic chest painc. Decreased breath sounds in areas of consolidation and dyspnead. Increased respiratory rate and respiratory alkalosis-ANSWER-a. Mild to high fever, cough, rhinorrhea,crackles, rhonchi, and wheezes-wheezing esp more common in children w/ viral CAP. Productive cough may be present, by pleuriticchest pain more w/ bacterial CAP, decreased breath sounds, dyspnea also more with bacterial CAP.Incresp rathe and resp alkalosis not usually hallmark sx of CAP.A child presents with congenital phenylketonuria. Which statement is true regarding this disease?

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a. The nucleus if red blood cells is defective in this disorderb. This disease is dueto a deficiency of phenylalanine hydroxylasec. This disease is an X-linked disorder seen in male offspringd. This disease is passed from fathers to sons on sex chromosomes-ANSWER-b. This disease is due to adeficiency of phenylalanine hydroxylaseAmale patient requests a phosphodiesterase inhibitor to treat erectile dysfunction. Which of thefollowing is appropriate?a. Tadalafil (Cialis) may be used at a dose of 2.5 mg daily if sexual activity will take place two or moretimes per week.b. Vardenafil (Levitra), 5 mg, may be taken with a high-fat meal four hours before sexual activityc. Sildenafil (Viagra), 50 mg, may be taken one hour before sexual activity as long as the patient has aresting blood pressure below 170/110 mm Hgd. Avanafil (Stendra) is recommended at 50 mg for all patients, and may be taken 30 minutes beforesexual activity.-ANSWER-a. Tadalafil (Cialis) may be used at a dose of 2.5 mg daily if sexual activity willtake place two or more times per week.A neonate is born with fetal alcohol syndrome. Which of the following abnormalities may be observed?a. Alveolar collapse and flail chestb. Cognitive impairment and facial anomaliesc. Incompetent semilunar valves (ex aortic and pulmonic).d. Esophageal stricture and short gut syndrome-ANSWER-b. Cognitive impairment and facial anomaliesA patient is diagnosed with a methicillin-resistant Staphylococcus aureus infection. A medication thatmay be used for treatment is:a. Metronidazole (Flagyl)b.Amoxicillin (Moxatag)c. Fidaxomicin (Dificid)d. Daptomycin (Cubicin)-ANSWER-d. Daptomycin (Cubicin)-6mg/kg once per day is recommended tx.Metronidazole for anaerobic infection, Amox has 0 effect on MRSA, does well w/ Anthrax & H pylori,Fidamoxicinfor C-diff only.

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a patient is diagnosed with acute inflammatory demyelinating polyneuropathy and resulting Gillian-Barre syndrome. The patient needs to be assessed for which of the following?a. Cerebrospinal fluid high in protein (500 mg/dl) without cellular abnormalityb. Decreased levels if acetylcholinec. Asymmetric paralysisd. Demyelination of the central nervous system nerves-ANSWER-a. Cerebrospinal fluid high in protein(500 mg/dl) without cellular abnormality-Most will have when it is viral or bacterial. Acetylcholine is notaffected by GBS, effect on DTR's or numbness/ paralysis will be symmetric, demyelination of peripheralnerve system NOT CNSA patient is diagnosed with general anxiety disorder. This diagnosis is based on a history which indicateda span of at least how many months spent worrying excessively?a. 3b. 6c. 9d. 12-ANSWER-b. 6-3 months not long enough, could still indicate panic, anxiety or depression. 9-12months = too long and could indicate other psychiatric disorders as well, including psychosis.A patient is diagnosed with primary Raynaud's disease. In simple terms, this disorder may be explainedto the patient as:a. An inflammatory disorder of small-and medium-sized arteries in the feet and sometimes in the handsb. A neoplastic disorder of the lining of the arteries and veins of the upper extremitiesc. A vasospastic disorder of the small arteries and arterioles of the fingers, and less commonly the toesd. An autoimmune disorder of the large arteries and veins of the upper and lower extremities-ANSWER-c. A vasospastic disorder of the small arteries and arterioles of the fingers, and less commonlythe toes.-vasospasm of smaller arteries & limits circulation/ inhibits blood supply to skin. Not caused bytumors. Secondary Reynaud's can be concomitantly with autoimmune, no autoimmune in PrimaryA patient is started on levodopa for the treatment of Parkinson's disease. The practitioner will advise thepatient with which of the following?a. "If you experience symptoms of psychosis while on this drug, then we will add haloperidol to yourregimen."b. "If you eat protein in your diet, space it out evenly throughout the day."

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c. "This drug may turn your sweat, tears, and urine orange-red. This is a normal side effect."d. "Your blood pressure will likely increase while on this medication. We will have to monitor it."-ANSWER-b. "If you eat protein in your diet,space it out evenly throughout the day."A patient is taking furosemide (Lasix) for stage three heart failure. Along with Lisinopril, an aspirin a day,warfarin, atorvastatin, and metoprolol, which other medication should this patient be prescribed?a.Tenecteplaseb. Amitriptylinec. Phytonadioned. Potassium Chloride-ANSWER-d. Potassium ChlorideA patient presents with chronic neuropathic pain in his feet secondary to type 2 diabetes. Of thefollowing, the best therapeutic choice would be:a. Phenobarbital (Luminal)b. Carbidopa (Lodosyn)c. Tiaganine (Gabitril)d. Gabapentin (Neurontin)-ANSWER-d. Gabapentin (Neurontin)A patient presents with pustular lesions on her perineum and groin. She has some oral mucousmembranes lesions, a warty rash on her hands and feet, lymphadenopathy, and pruritis. A presumptivediagnosis would be:a. Herpes simplexb. Syphilisc. Chlamydiad. Trichomonas-ANSWER-b. SyphilisA patient who has suffered a cerebrovascular accident has speech dysphasia involving word finding anddifficulty writing. Which area of the brain has most likely been affected?

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a. Parietal lobeb. Left frontal lobec. Temporal lobed. Limbic system.-ANSWER-b. Left frontal lobe-Broca's area is in left frontal lobe is one of language centers= non fluency w/ sparse output,agrammatism, impaired repetition, affects writing r/t to speech. Parietal lobe= agnosia, Temporal lobe =word deafness, limbic = emotional instabilityA patient with hepatic encephalopathy is most at risk of death due to:a. Synthesis of ammonia by brain cellsb. Toxicity of ammonia to the central nervous systemc. Renal toxicity of ammonia accumulating in the kidneysd. Bleeding of esophageal varices made weak by ammonia-ANSWER-b. Toxicity of ammonia to thecentral nervous systemA patient with kidney stones also presents with hypercalcemia and mental confusion. The practitionershould evaluate the patient for which of the following?a. Cushing Syndromeb. Conn's Syndromec. Hyperparathyroidismd. Addison's disease-ANSWER-c. HyperparathyroidismAdenosine triphosphate levels decrease in ischemia. What effect does this have on cells?a. Cells shrink because of an influx of calciumb. Cells shrink because of the influx of potassiumc. Cells swell because of the influx of sodium

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d. Cells swell because of the influx of nitric oxide.-ANSWER-c. Cells swell because of the influx ofsodiumAll of the following facial movements are still possible after a cerebrovascular accident except:a. Raising the eyebrowsb. Wrinkling the foreheadc. Raising both sides of the mouthd. Closing both eyes-ANSWER-c. Raising both sides of the mouthAssuming these do not present with symptoms other than those stated, antibiotic use is most likely tobe appropriate for which of the following patients?a. The 2-year-old with onset of mucopurulent rhinitis two days agob. The 10-year-old with dry cough lasting 7 daysc. The 60-year-old with clear rhinorrhea for 3 weeks.d. The 5-year-old with cough and mucopurulent rhinitis for 3 weeks-ANSWER-d. The 5-year-old withcough and mucopurulent rhinitis for 3 weeksAzole antifungals are most likely to cause torsades de pointes in which patient population?a. Patients taking isoproterenolb. African-Americansc. Femalesd. Adults over the age of 65-ANSWER-c. Females-Azole can cause in Men and women, but 2-3x morecommon in Women. Prolonged QT interval is 10 microseconds longer in women= more recordeddysrhythmias. Isoproterenol is beta agonist used in tx of torsades & no significant interaction w/ azoles.African Americans less susceptible to torsades than Caucasians, & most common ages 35-50.Benjamin, age 22, comes into your practice complaining of extreme pain in his lower abdomen. You usea stethoscope to listen to his bowel sounds and hear nothing. Which of the following is not a cause ofhypoactive bowel sounds?

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a. Peritonitisb. Constipationc. Paralytic ileusd. Norovirus-ANSWER-d. NorovirusBeta blockers are not used for which of the following conditions?a. Performance anxietyb. Migraine prophylaxisc. Reduction of perioperative mortalityd. Insulin induced hypoglycemia-ANSWER-d. Insulin induced hypoglycemia.-will not aid, more likely to retard recovery. Low dose can be used for performance enhancement, treatmigraines, and decrease perioperative mortality of cardiac Pts.Cecilia, age56, comes into the clinic with severe abdominal cramping. During the physical exam, you askher to lie on her back, and you press into her abdomen about 2-3 inches to determine the skin surfaceand musculature. Which test are you performing?a. Deep Palpationb. Blumberg's signc. Light palpationd. Voluntary guarding-ANSWER-a. Deep Palpation-checks for abdominal muscles, Blumberg's slowly push in and rapid pull back, light palpation is 1 cm,guarding judges rigidity of muscles d/t involuntarily movement.Early detection of acute leukemia would include which of the following symptoms?a. Dizziness, dehydration, palpitations, hypotensionb. Dyspnea, paresthesia, malaise

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