Advanced Barkley FNP Board Review:
High-Yield Practice Questions With
Board-Style Rationales (GRADED A+)
Q1. A 52-year-old male with type 2 diabetes has an A1C of 8.9%
despite metformin therapy. According to current guidelines, the
most appropriate next step is to add:
A. Sulfonylurea
B. GLP-1 receptor agonist
C. Basal insulin only
D. Thiazolidinedione
Correct Answer: B
Rationale: GLP-1 receptor agonists improve glycemic control, promote
weight loss, and reduce cardiovascular risk. They are preferred over
sulfonylureas and insulin when A1C is uncontrolled on metformin alone.
Q2. A patient presents with sudden onset unilateral facial droop
involving the forehead. The most likely diagnosis is:
A. Stroke
B. Trigeminal neuralgia
,C. Bell’s palsy
D. Temporal arteritis
Correct Answer: C
Rationale: Bell’s palsy causes complete unilateral facial paralysis
including the forehead, unlike stroke which typically spares the forehead.
Q3. The first-line treatment for acute bacterial sinusitis in adults is:
A. Azithromycin
B. Amoxicillin-clavulanate
C. Doxycycline
D. Ciprofloxacin
Correct Answer: B
Rationale: Amoxicillin-clavulanate is the first-line therapy due to
resistance patterns. Macrolides are no longer recommended.
Q4. A patient with asthma reports nighttime symptoms twice weekly.
This asthma is classified as:
A. Intermittent
B. Mild persistent
C. Moderate persistent
D. Severe persistent
Correct Answer: B
,Rationale: Nighttime symptoms more than twice per month but less than
weekly indicate mild persistent asthma, requiring daily low-dose inhaled
corticosteroids.
Q5. Which medication is contraindicated in pregnancy?
A. Methyldopa
B. Labetalol
C. ACE inhibitors
D. Nifedipine
Correct Answer: C
Rationale: ACE inhibitors are teratogenic and associated with fetal renal
failure and death.
Q6. A patient presents with polyuria, polydipsia, and weight loss. The
most diagnostic initial test is:
A. Fasting glucose
B. A1C
C. Random plasma glucose
D. Oral glucose tolerance test
Correct Answer: C
Rationale: A random glucose ≥200 mg/dL with symptoms is diagnostic of
diabetes.
, Q7. Which vaccine is recommended annually for all adults?
A. Pneumococcal
B. Influenza
C. Hepatitis B
D. Shingles
Correct Answer: B
Rationale: Annual influenza vaccination is recommended for all adults
unless contraindicated.
Q8. A 67-year-old smoker presents with hemoptysis and weight
loss.
The most concerning diagnosis is:
A. Bronchitis
B. Tuberculosis
C. Lung cancer
D. Pulmonary embolism
Correct Answer: C
Rationale: Hemoptysis and weight loss in an older smoker strongly
suggest lung malignancy.
High-Yield Practice Questions With
Board-Style Rationales (GRADED A+)
Q1. A 52-year-old male with type 2 diabetes has an A1C of 8.9%
despite metformin therapy. According to current guidelines, the
most appropriate next step is to add:
A. Sulfonylurea
B. GLP-1 receptor agonist
C. Basal insulin only
D. Thiazolidinedione
Correct Answer: B
Rationale: GLP-1 receptor agonists improve glycemic control, promote
weight loss, and reduce cardiovascular risk. They are preferred over
sulfonylureas and insulin when A1C is uncontrolled on metformin alone.
Q2. A patient presents with sudden onset unilateral facial droop
involving the forehead. The most likely diagnosis is:
A. Stroke
B. Trigeminal neuralgia
,C. Bell’s palsy
D. Temporal arteritis
Correct Answer: C
Rationale: Bell’s palsy causes complete unilateral facial paralysis
including the forehead, unlike stroke which typically spares the forehead.
Q3. The first-line treatment for acute bacterial sinusitis in adults is:
A. Azithromycin
B. Amoxicillin-clavulanate
C. Doxycycline
D. Ciprofloxacin
Correct Answer: B
Rationale: Amoxicillin-clavulanate is the first-line therapy due to
resistance patterns. Macrolides are no longer recommended.
Q4. A patient with asthma reports nighttime symptoms twice weekly.
This asthma is classified as:
A. Intermittent
B. Mild persistent
C. Moderate persistent
D. Severe persistent
Correct Answer: B
,Rationale: Nighttime symptoms more than twice per month but less than
weekly indicate mild persistent asthma, requiring daily low-dose inhaled
corticosteroids.
Q5. Which medication is contraindicated in pregnancy?
A. Methyldopa
B. Labetalol
C. ACE inhibitors
D. Nifedipine
Correct Answer: C
Rationale: ACE inhibitors are teratogenic and associated with fetal renal
failure and death.
Q6. A patient presents with polyuria, polydipsia, and weight loss. The
most diagnostic initial test is:
A. Fasting glucose
B. A1C
C. Random plasma glucose
D. Oral glucose tolerance test
Correct Answer: C
Rationale: A random glucose ≥200 mg/dL with symptoms is diagnostic of
diabetes.
, Q7. Which vaccine is recommended annually for all adults?
A. Pneumococcal
B. Influenza
C. Hepatitis B
D. Shingles
Correct Answer: B
Rationale: Annual influenza vaccination is recommended for all adults
unless contraindicated.
Q8. A 67-year-old smoker presents with hemoptysis and weight
loss.
The most concerning diagnosis is:
A. Bronchitis
B. Tuberculosis
C. Lung cancer
D. Pulmonary embolism
Correct Answer: C
Rationale: Hemoptysis and weight loss in an older smoker strongly
suggest lung malignancy.
