Page 1 of 31
15 June 2026
BARKLEY 3P EXAM 2026 ACTUAL EXAM 100
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+
. A patient with sepsis is at risk of developing shock via which mechanism?
a. Loss of systemic vascular resistance
b. Slowly evolving pump failure of the heart
c. Loss of blood volume
d. 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.
Arterial
b. Venous
c. Unilateral
d. Painless - ANSWER-a. Arterial
. You are teaching your nursing class about the point of maximal impulse. How do you describe to the
class where it is located?
a. 4 th intercostal space (ICS), sternal border
b. 2 nd intercostal space (ICS), midclavicular line (MCL)
c. 5 th ICS, MCL
d. 3 rd ICS, sternal border - ANSWER-c. 5 th ICS, MCL
19. Which of the following is a true statement regarding migraines?
a. These headaches typically present with an aura in most patients
b. Migraines are typically bilateral, and if caught early, respond well to ice and mild analgesics.
c. Premenopausal females are the largest group of migraine sufferers
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15 June 2026
d. Migraines occur when macrophages attack myelin sheaths in the CNS - ANSWER-c. Premenopausal
females are the largest group of migraine sufferers.- menstruation is one of leading causes migraine
triggers. Estrogen withdrawal with menses can be a trigger. Aura in only 20-25%, Unilateral, not
bilateral, 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 and
cardiac remodeling seen in heart failure?
a. Increased epinephrine
b. Natriuretic peptides
c. Angiotensin II
d. Insulin resistance - ANSWER-c. Angiotensin II
59. Kussmaul respirations are best defined by which of the following?
a. It is typically seen in patients with anxiety, a cause of respiratory acidosis
b. It is a compensatory mechanism to help rid the body of excessive carbon dioxide
c. 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 pattern of 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 movement
b. Becomes worse with voluntary movement
c. Disappears with sleep
d. Disappears with voluntary movement - ANSWER-b. Becomes worse with voluntary movement
61. Which of the following is most likely to be effective in the treatment of acute cluster headaches?
a. 6 mg subcutaneous injection of sumatriptan
, Page 3 of 31
15 June 2026
b. 300 mg acetaminophen
c. 40 mg riboflavin
d. 240 mg verapamil. - ANSWER-a. 6 mg subcutaneous injection of sumatriptan-
correct drug and dose for cluster HA; verapamil & APAP not indicated for cluster, but verapamil can be
used 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 testosterone
level is found to be 250 ng/dL. The nurse practitioner knows that
a. AndroGel once daily would restore sex drive and fertility in this client
b. Testosterone replacement is associated with cardiovascular risks, including myocardial infarction, and
is 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 be
a benefit. - ANSWER-b. Testosterone replacement is associated with cardiovascular risks, including
myocardial 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 circulation
b. Reduce the heart rate
c. Increase the blood pressure in the legs
d. Relieve lower back pain - ANSWER-a. Shunt more blood to the pulmonary circulation
A child presents with a community acquired viral pneumonia. Presenting signs and symptoms will
include:
a. Mild to high fever, cough, rhinorrhea, crackles, rhonchi, and wheezes
b. High fever, productive cough, and pleuritic chest pain
c. Decreased breath sounds in areas of consolidation and dyspnea
d. Increased respiratory rate and respiratory alkalosis - ANSWER-a. Mild to high fever, cough,
rhinorrhea, crackles, rhonchi, and wheezes-
, Page 4 of 31
15 June 2026
wheezing esp more common in children w/ viral CAP. Productive cough may be present, by pleuritic
chest pain more w/ bacterial CAP, decreased breath sounds, dyspnea also more with bacterial CAP. Inc
resp rathe and resp alkalosis not usually hallmark sx of CAP.
A child presents with congenital phenylketonuria. Which statement is true regarding this disease?
a. The nucleus if red blood cells is defective in this disorder
b. This disease is due to a deficiency of phenylalanine hydroxylase
c. This disease is an X-linked disorder seen in male offspring
d. This disease is passed from fathers to sons on sex chromosomes - ANSWER-b. This disease is due to a
deficiency of phenylalanine hydroxylase
A male patient requests a phosphodiesterase inhibitor to treat erectile dysfunction. Which of the
following is appropriate?
a. Tadalafil (Cialis) may be used at a dose of 2.5 mg daily if sexual activity will take place two or more
times per week.
b. Vardenafil (Levitra), 5 mg, may be taken with a high-fat meal four hours before sexual activity
c. Sildenafil (Viagra), 50 mg, may be taken one hour before sexual activity as long as the patient has a
resting blood pressure below 170/110 mm Hg
d. Avanafil (Stendra) is recommended at 50 mg for all patients, and may be taken 30 minutes before
sexual activity. - ANSWER-a. Tadalafil (Cialis) may be used at a dose of 2.5 mg daily if sexual activity
will take 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 chest
b. Cognitive impairment and facial anomalies
c. Incompetent semilunar valves (ex aortic and pulmonic).
d. Esophageal stricture and short gut syndrome - ANSWER-b. Cognitive impairment and facial
anomalies
A patient is diagnosed with a methicillin-resistant Staphylococcus aureus infection. A medication that
may be used for treatment is:
15 June 2026
BARKLEY 3P EXAM 2026 ACTUAL EXAM 100
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+
. A patient with sepsis is at risk of developing shock via which mechanism?
a. Loss of systemic vascular resistance
b. Slowly evolving pump failure of the heart
c. Loss of blood volume
d. 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.
Arterial
b. Venous
c. Unilateral
d. Painless - ANSWER-a. Arterial
. You are teaching your nursing class about the point of maximal impulse. How do you describe to the
class where it is located?
a. 4 th intercostal space (ICS), sternal border
b. 2 nd intercostal space (ICS), midclavicular line (MCL)
c. 5 th ICS, MCL
d. 3 rd ICS, sternal border - ANSWER-c. 5 th ICS, MCL
19. Which of the following is a true statement regarding migraines?
a. These headaches typically present with an aura in most patients
b. Migraines are typically bilateral, and if caught early, respond well to ice and mild analgesics.
c. Premenopausal females are the largest group of migraine sufferers
, Page 2 of 31
15 June 2026
d. Migraines occur when macrophages attack myelin sheaths in the CNS - ANSWER-c. Premenopausal
females are the largest group of migraine sufferers.- menstruation is one of leading causes migraine
triggers. Estrogen withdrawal with menses can be a trigger. Aura in only 20-25%, Unilateral, not
bilateral, 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 and
cardiac remodeling seen in heart failure?
a. Increased epinephrine
b. Natriuretic peptides
c. Angiotensin II
d. Insulin resistance - ANSWER-c. Angiotensin II
59. Kussmaul respirations are best defined by which of the following?
a. It is typically seen in patients with anxiety, a cause of respiratory acidosis
b. It is a compensatory mechanism to help rid the body of excessive carbon dioxide
c. 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 pattern of 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 movement
b. Becomes worse with voluntary movement
c. Disappears with sleep
d. Disappears with voluntary movement - ANSWER-b. Becomes worse with voluntary movement
61. Which of the following is most likely to be effective in the treatment of acute cluster headaches?
a. 6 mg subcutaneous injection of sumatriptan
, Page 3 of 31
15 June 2026
b. 300 mg acetaminophen
c. 40 mg riboflavin
d. 240 mg verapamil. - ANSWER-a. 6 mg subcutaneous injection of sumatriptan-
correct drug and dose for cluster HA; verapamil & APAP not indicated for cluster, but verapamil can be
used 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 testosterone
level is found to be 250 ng/dL. The nurse practitioner knows that
a. AndroGel once daily would restore sex drive and fertility in this client
b. Testosterone replacement is associated with cardiovascular risks, including myocardial infarction, and
is 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 be
a benefit. - ANSWER-b. Testosterone replacement is associated with cardiovascular risks, including
myocardial 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 circulation
b. Reduce the heart rate
c. Increase the blood pressure in the legs
d. Relieve lower back pain - ANSWER-a. Shunt more blood to the pulmonary circulation
A child presents with a community acquired viral pneumonia. Presenting signs and symptoms will
include:
a. Mild to high fever, cough, rhinorrhea, crackles, rhonchi, and wheezes
b. High fever, productive cough, and pleuritic chest pain
c. Decreased breath sounds in areas of consolidation and dyspnea
d. Increased respiratory rate and respiratory alkalosis - ANSWER-a. Mild to high fever, cough,
rhinorrhea, crackles, rhonchi, and wheezes-
, Page 4 of 31
15 June 2026
wheezing esp more common in children w/ viral CAP. Productive cough may be present, by pleuritic
chest pain more w/ bacterial CAP, decreased breath sounds, dyspnea also more with bacterial CAP. Inc
resp rathe and resp alkalosis not usually hallmark sx of CAP.
A child presents with congenital phenylketonuria. Which statement is true regarding this disease?
a. The nucleus if red blood cells is defective in this disorder
b. This disease is due to a deficiency of phenylalanine hydroxylase
c. This disease is an X-linked disorder seen in male offspring
d. This disease is passed from fathers to sons on sex chromosomes - ANSWER-b. This disease is due to a
deficiency of phenylalanine hydroxylase
A male patient requests a phosphodiesterase inhibitor to treat erectile dysfunction. Which of the
following is appropriate?
a. Tadalafil (Cialis) may be used at a dose of 2.5 mg daily if sexual activity will take place two or more
times per week.
b. Vardenafil (Levitra), 5 mg, may be taken with a high-fat meal four hours before sexual activity
c. Sildenafil (Viagra), 50 mg, may be taken one hour before sexual activity as long as the patient has a
resting blood pressure below 170/110 mm Hg
d. Avanafil (Stendra) is recommended at 50 mg for all patients, and may be taken 30 minutes before
sexual activity. - ANSWER-a. Tadalafil (Cialis) may be used at a dose of 2.5 mg daily if sexual activity
will take 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 chest
b. Cognitive impairment and facial anomalies
c. Incompetent semilunar valves (ex aortic and pulmonic).
d. Esophageal stricture and short gut syndrome - ANSWER-b. Cognitive impairment and facial
anomalies
A patient is diagnosed with a methicillin-resistant Staphylococcus aureus infection. A medication that
may be used for treatment is:
