BARKLEY 3PS REVIEW EXAM BANK LATEST
ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS,,,2026 100%
Cardiovascular System (Questions 1-15)
1. A 68-year-old male patient desires testosterone replacement to enhance his
libido. His testosterone level is 250 ng/dL. What should the nurse practitioner
advise?
• A. AndroGel once daily would restore sex drive and fertility
• B. Testosterone replacement is associated with cardiovascular risks and is
not indicated for this patient
• C. Testosterone cypionate injections would be a good treatment option
• D. Testosterone replacement suppresses prostate cancer development
Correct ,,,,ANSWER,,,: B
Rationale: Testosterone levels naturally decline with age; a level of 250 ng/dL may
be normal for a 68-year-old. Testosterone replacement is associated with
increased cardiovascular risks (MI, stroke) and is not indicated solely for age-
related libido changes. It does not restore fertility and may actually stimulate
prostate cancer growth .
2. You are auscultating a patient's chest. When he sits up and leans forward, you
hear a high-pitched, blowing murmur at S2. What does this murmur most likely
indicate?
• A. Mitral stenosis
• B. Aortic stenosis
• C. Mitral regurgitation
• D. Aortic regurgitation
,Correct ,,,,ANSWER,,,: D
Rationale: Aortic regurgitation produces a soft, high-pitched, blowing diastolic
decrescendo murmur best heard at the 3rd left intercostal space (Erb's point). The
murmur is accentuated when the patient sits up and leans forward. Mitral stenosis
is a low-pitched diastolic rumble best heard at the apex in the left lateral position.
Aortic stenosis is a harsh systolic murmur radiating to the neck. Mitral regurgitation
is a pansystolic blowing murmur at the apex radiating to the axilla .
3. 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
Correct ,,,,ANSWER,,,: C
Rationale: Virchow's Triad describes the three primary factors leading to
thrombosis: (1) hypercoagulability, (2) endothelial injury/damage, and (3)
circulatory stasis (turbulent or stagnant blood flow). Sympathetic tone is not a
component of Virchow's Triad and does not directly affect clotting .
4. Regarding the split S2 heart sound, which statement is FALSE?
• A. It is a normal phenomenon
• B. The aortic valve closes significantly earlier than the pulmonic valve
• C. It is noted only in the aortic auscultatory area
• D. It occurs on end inspiration
Correct ,,,,ANSWER,,,: C
Rationale: A split S2 is a normal finding that can be heard throughout the
precordium, not just the aortic area. During inspiration, increased venous return to
the right ventricle delays pulmonic valve closure, causing the split. The aortic valve
closes earlier than the pulmonic valve during inspiration .
5. You hear a low-pitched diastolic rumble at the fifth intercostal space with the
patient in the left lateral position. The murmur does not radiate. What condition
should you "rule out"?
• A. Aortic regurgitation
• B. Mitral stenosis
, • C. Aortic stenosis
• D. Mitral regurgitation
Correct ,,,,ANSWER,,,: B
Rationale: A low-pitched diastolic rumble best heard at the apex (5th intercostal
space, midclavicular line) with the patient in the left lateral position is classic for
mitral stenosis. The murmur does not radiate significantly. This position brings the
apex closer to the chest wall, making the murmur more audible .
6. With regard to S3 and S4 heart sounds, which statement is TRUE?
• A. An S3 sounds like "Kentucky" and is expected during pregnancy but
otherwise is not a normal finding in adults
• B. An S3 is an atrial gallop and sounds like "Tennessee"
• C. An S4 sounds like "Kentucky" and is expected during pregnancy
• D. An S4 is a ventricular gallop and sounds like "Tennessee"
Correct ,,,,ANSWER,,,: A
Rationale: S3 is a ventricular gallop that matches the cadence of "Kentucky" (S1-
S2-S3). It occurs due to rapid ventricular filling and can be normal in children, young
adults, and pregnancy. Outside of these, it suggests volume overload (e.g., heart
failure). S4 is an atrial gallop ("Tennessee" cadence) associated with stiff ventricles
(hypertension, MI) .
7. Which of the following is NOT a common finding of acute left-sided heart failure?
• A. Coarse rales in all lung fields
• B. Hepatomegaly
• C. Wheezing, frothy cough
• D. An S3 gallop sound
Correct ,,,,ANSWER,,,: B
Rationale: Hepatomegaly (enlarged liver) is a sign of chronic right-sided heart
failure due to systemic venous congestion. Acute left-sided heart failure presents
with pulmonary findings: crackles/rales (pulmonary edema), wheezing (cardiac
asthma), frothy sputum, and S3 gallop from increased ventricular filling pressures .
8. According to the Eighth Joint National Committee (JNC 8) hypertension
guidelines, which of the following is NOT used to estimate 10-year and lifetime
atherosclerotic cardiovascular disease (ASCVD) risks?
, • A. High-density lipoprotein (HDL) cholesterol
• B. Race
• C. Diastolic blood pressure
• D. Diabetes status
Correct ,,,,ANSWER,,,: C
Rationale: The ASCVD risk estimator uses systolic blood pressure, not diastolic
blood pressure. Other risk factors include age, sex, race, total cholesterol, HDL
cholesterol, diabetes status, smoking status, and hypertension treatment status .
9. Dependent rubor is a physical finding associated with which condition?
• A. Chronic venous insufficiency
• B. Superficial thrombophlebitis
• C. Deep vein thrombosis
• D. Peripheral vascular disease
Correct ,,,,ANSWER,,,: D
Rationale: Dependent rubor (a dusky, red-purple discoloration of the foot when
placed in a dependent position) is a classic finding in peripheral arterial disease
(PAD). It indicates severe ischemia and occurs due to reactive hyperemia after the
foot is lowered. Chronic venous insufficiency presents with stasis dermatitis and
edema, not dependent rubor .
10. A patient experiences sudden onset of pain in her lower leg. The area is
erythematous and warm to the touch but not swollen. The patient is afebrile. Which
treatment measure is NOT correct for this condition?
• A. Elevating the leg
• B. Applying warm compresses
• C. Prescribing NSAIDs
• D. Ordering bed rest
Correct ,,,,ANSWER,,,: D
Rationale: The presentation (pain, heat, erythema without swelling, afebrile)
suggests superficial thrombophlebitis, not DVT. For superficial thrombophlebitis,
mobility is encouraged rather than bed rest. Elevation, warm compresses, and
NSAIDs are appropriate. Bed rest is indicated for DVT to prevent embolization .
ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS,,,2026 100%
Cardiovascular System (Questions 1-15)
1. A 68-year-old male patient desires testosterone replacement to enhance his
libido. His testosterone level is 250 ng/dL. What should the nurse practitioner
advise?
• A. AndroGel once daily would restore sex drive and fertility
• B. Testosterone replacement is associated with cardiovascular risks and is
not indicated for this patient
• C. Testosterone cypionate injections would be a good treatment option
• D. Testosterone replacement suppresses prostate cancer development
Correct ,,,,ANSWER,,,: B
Rationale: Testosterone levels naturally decline with age; a level of 250 ng/dL may
be normal for a 68-year-old. Testosterone replacement is associated with
increased cardiovascular risks (MI, stroke) and is not indicated solely for age-
related libido changes. It does not restore fertility and may actually stimulate
prostate cancer growth .
2. You are auscultating a patient's chest. When he sits up and leans forward, you
hear a high-pitched, blowing murmur at S2. What does this murmur most likely
indicate?
• A. Mitral stenosis
• B. Aortic stenosis
• C. Mitral regurgitation
• D. Aortic regurgitation
,Correct ,,,,ANSWER,,,: D
Rationale: Aortic regurgitation produces a soft, high-pitched, blowing diastolic
decrescendo murmur best heard at the 3rd left intercostal space (Erb's point). The
murmur is accentuated when the patient sits up and leans forward. Mitral stenosis
is a low-pitched diastolic rumble best heard at the apex in the left lateral position.
Aortic stenosis is a harsh systolic murmur radiating to the neck. Mitral regurgitation
is a pansystolic blowing murmur at the apex radiating to the axilla .
3. 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
Correct ,,,,ANSWER,,,: C
Rationale: Virchow's Triad describes the three primary factors leading to
thrombosis: (1) hypercoagulability, (2) endothelial injury/damage, and (3)
circulatory stasis (turbulent or stagnant blood flow). Sympathetic tone is not a
component of Virchow's Triad and does not directly affect clotting .
4. Regarding the split S2 heart sound, which statement is FALSE?
• A. It is a normal phenomenon
• B. The aortic valve closes significantly earlier than the pulmonic valve
• C. It is noted only in the aortic auscultatory area
• D. It occurs on end inspiration
Correct ,,,,ANSWER,,,: C
Rationale: A split S2 is a normal finding that can be heard throughout the
precordium, not just the aortic area. During inspiration, increased venous return to
the right ventricle delays pulmonic valve closure, causing the split. The aortic valve
closes earlier than the pulmonic valve during inspiration .
5. You hear a low-pitched diastolic rumble at the fifth intercostal space with the
patient in the left lateral position. The murmur does not radiate. What condition
should you "rule out"?
• A. Aortic regurgitation
• B. Mitral stenosis
, • C. Aortic stenosis
• D. Mitral regurgitation
Correct ,,,,ANSWER,,,: B
Rationale: A low-pitched diastolic rumble best heard at the apex (5th intercostal
space, midclavicular line) with the patient in the left lateral position is classic for
mitral stenosis. The murmur does not radiate significantly. This position brings the
apex closer to the chest wall, making the murmur more audible .
6. With regard to S3 and S4 heart sounds, which statement is TRUE?
• A. An S3 sounds like "Kentucky" and is expected during pregnancy but
otherwise is not a normal finding in adults
• B. An S3 is an atrial gallop and sounds like "Tennessee"
• C. An S4 sounds like "Kentucky" and is expected during pregnancy
• D. An S4 is a ventricular gallop and sounds like "Tennessee"
Correct ,,,,ANSWER,,,: A
Rationale: S3 is a ventricular gallop that matches the cadence of "Kentucky" (S1-
S2-S3). It occurs due to rapid ventricular filling and can be normal in children, young
adults, and pregnancy. Outside of these, it suggests volume overload (e.g., heart
failure). S4 is an atrial gallop ("Tennessee" cadence) associated with stiff ventricles
(hypertension, MI) .
7. Which of the following is NOT a common finding of acute left-sided heart failure?
• A. Coarse rales in all lung fields
• B. Hepatomegaly
• C. Wheezing, frothy cough
• D. An S3 gallop sound
Correct ,,,,ANSWER,,,: B
Rationale: Hepatomegaly (enlarged liver) is a sign of chronic right-sided heart
failure due to systemic venous congestion. Acute left-sided heart failure presents
with pulmonary findings: crackles/rales (pulmonary edema), wheezing (cardiac
asthma), frothy sputum, and S3 gallop from increased ventricular filling pressures .
8. According to the Eighth Joint National Committee (JNC 8) hypertension
guidelines, which of the following is NOT used to estimate 10-year and lifetime
atherosclerotic cardiovascular disease (ASCVD) risks?
, • A. High-density lipoprotein (HDL) cholesterol
• B. Race
• C. Diastolic blood pressure
• D. Diabetes status
Correct ,,,,ANSWER,,,: C
Rationale: The ASCVD risk estimator uses systolic blood pressure, not diastolic
blood pressure. Other risk factors include age, sex, race, total cholesterol, HDL
cholesterol, diabetes status, smoking status, and hypertension treatment status .
9. Dependent rubor is a physical finding associated with which condition?
• A. Chronic venous insufficiency
• B. Superficial thrombophlebitis
• C. Deep vein thrombosis
• D. Peripheral vascular disease
Correct ,,,,ANSWER,,,: D
Rationale: Dependent rubor (a dusky, red-purple discoloration of the foot when
placed in a dependent position) is a classic finding in peripheral arterial disease
(PAD). It indicates severe ischemia and occurs due to reactive hyperemia after the
foot is lowered. Chronic venous insufficiency presents with stasis dermatitis and
edema, not dependent rubor .
10. A patient experiences sudden onset of pain in her lower leg. The area is
erythematous and warm to the touch but not swollen. The patient is afebrile. Which
treatment measure is NOT correct for this condition?
• A. Elevating the leg
• B. Applying warm compresses
• C. Prescribing NSAIDs
• D. Ordering bed rest
Correct ,,,,ANSWER,,,: D
Rationale: The presentation (pain, heat, erythema without swelling, afebrile)
suggests superficial thrombophlebitis, not DVT. For superficial thrombophlebitis,
mobility is encouraged rather than bed rest. Elevation, warm compresses, and
NSAIDs are appropriate. Bed rest is indicated for DVT to prevent embolization .
