AG-ACNP DRT #3 (Barkley Diagnostic Readiness
Test #3) Exam Questions and Answers with
rationale Latest Versions Top Rated
1. Patient c/o wrist and hand pain, swollen, redness and pain that
is worse in the morning and resolves as the day goes on. What
findings would support your suspected diagnosis of RA? a.
narrowing of joint space b. osteophytes c. elevated ESR d. juxta-
articular erosions (or similar radiographic changes) Answer: c.
elevated ESR Rationale: Elevated erythrocyte sedimentation rate
(ESR) is a nonspecific marker of inflammation commonly seen in
rheumatoid arthritis (RA), an autoimmune inflammatory
condition. Morning stiffness improving with activity is classic for
RA. Narrowing/erosions are later radiographic findings;
osteophytes are more typical of osteoarthritis.
2. Patient presents with nausea, vomiting, dehydrated and anxious.
Friends reported finding empty bottle of ASA by patient's bed.
What is the primary intervention?Answer: Activated charcoal
(AC) via orogastric tube (OGT) Rationale: This suggests salicylate
(aspirin/ASA) overdose. After airway assessment, decontamination
with activated charcoal is a key early intervention if within an
appropriate time window and the patient can be protected.
Supportive care (fluids, alkalinization, etc.) follows, but
decontamination is primary here.
, 3. You are examining a patient with PMH of seizures. Patient
sustains a seizure lasting around 12 minutes during exam. What
is the most appropriate intervention?Answer: Diazepam (Valium)
5-10 mg IV Rationale: A seizure >5 minutes is status epilepticus.
Benzodiazepines (e.g., diazepam or lorazepam IV) are first-line to
terminate the seizure rapidly. If it persists, proceed to second-line
agents (e.g., fosphenytoin). Immediate ABCs and glucose check
are also critical.
4. Labs: urine Na 28, serum osmolality 250, urine osmolality 115.
Suspected cause?Answer: SIADH (Syndrome of Inappropriate
Antidiuretic Hormone) Rationale: Low serum osmolality with
inappropriately concentrated urine (urine osmolality >100) and
urine sodium often >20-40 mEq/L points to SIADH (euvolemic
hyponatremia). Urine osmolality here is relatively higher than
expected for maximal dilution in other causes.
5. True or False: Barium enema is indicated in the conservative
management of diverticulitis.Answer: False Rationale: In acute
diverticulitis, contrast studies like barium enema are generally
avoided during the acute phase due to risk of perforation. CT with
contrast is preferred for diagnosis; conservative management
involves NPO/IV fluids/antibiotics, with colonoscopy later (after
resolution) for evaluation.
6. Patient has low diastolic rumble murmur in the left lateral
position with no radiation. What murmur do you
suspect?Answer: Mitral stenosis Rationale: Classic auscultatory
finding for mitral stenosis is a low-pitched mid-diastolic rumbling
murmur best heard at the apex (mitral area) in the left lateral
Test #3) Exam Questions and Answers with
rationale Latest Versions Top Rated
1. Patient c/o wrist and hand pain, swollen, redness and pain that
is worse in the morning and resolves as the day goes on. What
findings would support your suspected diagnosis of RA? a.
narrowing of joint space b. osteophytes c. elevated ESR d. juxta-
articular erosions (or similar radiographic changes) Answer: c.
elevated ESR Rationale: Elevated erythrocyte sedimentation rate
(ESR) is a nonspecific marker of inflammation commonly seen in
rheumatoid arthritis (RA), an autoimmune inflammatory
condition. Morning stiffness improving with activity is classic for
RA. Narrowing/erosions are later radiographic findings;
osteophytes are more typical of osteoarthritis.
2. Patient presents with nausea, vomiting, dehydrated and anxious.
Friends reported finding empty bottle of ASA by patient's bed.
What is the primary intervention?Answer: Activated charcoal
(AC) via orogastric tube (OGT) Rationale: This suggests salicylate
(aspirin/ASA) overdose. After airway assessment, decontamination
with activated charcoal is a key early intervention if within an
appropriate time window and the patient can be protected.
Supportive care (fluids, alkalinization, etc.) follows, but
decontamination is primary here.
, 3. You are examining a patient with PMH of seizures. Patient
sustains a seizure lasting around 12 minutes during exam. What
is the most appropriate intervention?Answer: Diazepam (Valium)
5-10 mg IV Rationale: A seizure >5 minutes is status epilepticus.
Benzodiazepines (e.g., diazepam or lorazepam IV) are first-line to
terminate the seizure rapidly. If it persists, proceed to second-line
agents (e.g., fosphenytoin). Immediate ABCs and glucose check
are also critical.
4. Labs: urine Na 28, serum osmolality 250, urine osmolality 115.
Suspected cause?Answer: SIADH (Syndrome of Inappropriate
Antidiuretic Hormone) Rationale: Low serum osmolality with
inappropriately concentrated urine (urine osmolality >100) and
urine sodium often >20-40 mEq/L points to SIADH (euvolemic
hyponatremia). Urine osmolality here is relatively higher than
expected for maximal dilution in other causes.
5. True or False: Barium enema is indicated in the conservative
management of diverticulitis.Answer: False Rationale: In acute
diverticulitis, contrast studies like barium enema are generally
avoided during the acute phase due to risk of perforation. CT with
contrast is preferred for diagnosis; conservative management
involves NPO/IV fluids/antibiotics, with colonoscopy later (after
resolution) for evaluation.
6. Patient has low diastolic rumble murmur in the left lateral
position with no radiation. What murmur do you
suspect?Answer: Mitral stenosis Rationale: Classic auscultatory
finding for mitral stenosis is a low-pitched mid-diastolic rumbling
murmur best heard at the apex (mitral area) in the left lateral
