BARKELY 3P EXAM WITH VERIFIED ANSWERS WITH EXPLANATIONS

BARKELY 3P EXAM WITH VERIFIED ANSWERS WITH EXPLANATIONS
You have four patients who all have a family history of developing coronary heart disease
at an early age. According to their blood test results, which patient would most likely
develop coronary heart diseasefirst?
a. Cholesterol: 170; LDL: 120; Triglycerides: 120; HDL: 45
b. Cholesterol: 195; LDL: 110; Triglycerides: 135; HDL:30
c. Cholesterol: 170; LDL: 100; Triglycerides: 140; HDL: 20
d. Cholesterol: 190; LDL: 140; Triglycerides: 151; HDL: 50 - answer-d. Cholesterol:
190; LDL: 140; Triglycerides: 151; HDL: 50
3of the 4 measurements are above what should be; HDL <40 in men & 50 inwomen
increaserisk, LDL aim is<130, Chol > 200 & trig >150 attributed to increaserisk heart
disease.
This low-molecular-weight heparin is indicated for use with warfarin for the treatment of
acute symptomatic deep vein thrombosis, either with or withoutpulmonary embolism:
a. Nadroparinb.
Dalteparin c.
Tinzaparin
d. Fondaparinux - answer-c. Tinzaparincan be combined with warfarin for DVT, aids warfarin in inhibiting clotting of blood.Nadroparin
& Dalteparin don't use w/ warfarin, use independently. Fondaparinux is a Xa inhibitor NOT
LMWH.
he main reason for discontinuanceof implanted etonogestrel (Nexplanon) is:a. Weight
gain
b. Pregnancy
c. Breast tenderness
d. Irregular bleeding - answer-d. Irregular bleeding
Which of the following statements is true regarding contraceptives?
a. Because oral contraceptives may cause harm to the fetus, they are pregnancy
categoryX drugs in pregnancy.
b. Oral contraceptives are linked to the promotion of ovarian, endometrial, andbreast
cancer.
c. By increasing angiotensin and aldosterone, oral contraceptives may increaseblood
pressure.
d. Oral contraceptives may reduce the effects of theophylline, benzodiazepines,and
tricyclic antidepressants - answer-c. By increasing angiotensin and aldosterone, oral
contraceptives may increase blood pressure.
estrogen promotes aldosterone production= sodium retention & HTN. Also believed
stimulates hepatic production of angiotensinogen, affecting renal systemvia elevated
angiotensin & BP. OCP are category X, but because serve no use, decrease incidence of
ovarian and endometrial ca and don't increase risk of breast ca. OCP containing progestin
may enhance effects of theophylline, benzos, and tricyclic antidepressants by decreasing
clearance.
Upon percussion of thechest,you notice hyperresonance. Of thefollowing choiceswhich
would most likely bethecause?
a. Atelectasis b.
Normal Lung
c. Pneumothorax
d. Pulmonary embolism - answer-c. Pneumothorax
What is the proper order of steps to accurately perform the Ortolani maneuver?a. Extend
the legs, adduct the legs, and abduct the knees
b. Flex the knees, abduct the knees, and adduct the legs
c. Flex the knees, adduct the legs, and abduct the legs
d. Extend the knees, abduct the legs, and adduct the knees - answer-b. Flex theknees,
abduct the knees, and adduct the legs
done on supine infant, flex knees while holding thighs. Adduct legs until thumbstouch, follow
with abduct knees until lateral part of knee touch table.
For the treatment of relapsing-remitting multiple sclerosis, the nurse practitionerknows
that:
a. First-linetherapy typicallyinvolves an immunomodulator
b. Natalizumab is oneof thesafest drugs to use as initial therapy
c. A patient using interferon-beta products would haveto haverenal function
monitored.
d. Fingolimod is given intravenously for patients with resistant remitting-relapsing
multiple sclerosis. - answer-a. First-line therapy typically involves an immune
modulator
therapy begins with interferon-beta products (fingolimod, glatiramer, natalizumab) which
are immune modulator. Natalizumab limited (assoc w/ infections in brain) are used if others
don't work. Meds are hepatotoxic and needliverfunction monitoring. Fingolimod is1st ORAL
disease modifying med approved for MS.
You are auscultating Jon's chest. When he sits up and leans forward, you can heara high
pitched, blowing murmur at S2. What does this type of murmur most likely indicate?
a. Mitral stenosisb.
Aortic Stenosis
c. Mitral regurgitation
d. Aortic regurgitation - answer-d. Aortic regurgitation
Aortic regurg is soft, high pitched, blowing diastolic decrescendo that best heardat the
3rd left interspace at base. Murmur initiated w/ S2 and heard when Pt sitsup and leans
forward. Mitral Stenosis= low pitched diastolic rumble & doesn't radiate. Best heard in apex
when in left lateral position. Aortic stenosis= loud, harsh murmur midsystole, radiated down
the side of neck and down apex. Mitral regurg= loud blowing murmur heard at apex and is
pansystolic.
Which of thefollowing is the most common clinical manifestation of osteoporosis?a. Bone
deformity
b. Bone pain
c. Pathologic fracture
d. Fatembolism - answer-a. Bone deformity
most common metabolic bone disease, is chronic, progressive, & systemic; Low bone mass
and deterioration of bone tissue, = leads to increased skeletal fragility& deformity.
Osteoporosis usually not apparent until AFTER a fracture; 2/3 of vertebral fractures are
painless. Fat embolism from fat obstruction d/t injury or trauma & notcommon in
osteoporosis