Barkley 3Ps Exam

Barkley 3P exam- (Graded A)

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1.            A 59-year-old is having a follow-up evaluation two years after the successful conclusion of radiation therapy for leukemia. He tells you that he has been feeling run-down and reports unexplained weight loss and night sweats. Upon examination, you determine that he also has a fever and pain below his ribs and the left side. You know that he is at risk for chronic lymphotic leukemia. Which of the following results is considered the hallmark of this disease?


A.            Philadelphia chromosome in leukemic cells


B.            Lymphocytosis


C.            Non-circulating blast cells in bone marrow


D.            Pancytopenia with circulating blasts.


2.            A 28-year-old single mother arrives at your office inquiring about alternative options for contraception. The woman mentions that she has been having an oral contraception for the last 10 years but is curious about the hormonal intrauterine device (IUD) option she read about in an article. Which of the following is one of the advantages of using a hormonal IUD?


A.            Prevention of depression


B.            Prevention of Asherman’s syndrome


C.            Increased menstrual loss


D.            Spotting


3.            You are monitoring a toddler who has serous otitis media. The patients want to understand the treatment their child will receive. Which of the following would be the appropriate way to manage this condition?

A.            Oral antibiotics


B.            Antihistamines


C.            Decongestants


D.            Monitor and re-evaluate in 3 months


4.            Which of the following seizure patients would most likely benefit from lumbar puncture?


A.            Any child with a tonic-clonic seizure


B.            An 11 year old with a fever of 101.5 F


C.            A four-month-old without fever


D.            A two-year-old with a known seizure disorder


5.            You take a serological test on a patient with hepatitis. Checking over the results, you discover the patient’s serology is positive for the following: surface antigen of the Hepatitis-B (HbsAg), antibody to the antigen of the hepatitis B virus (Anti-Hbe), immunoglobulin M (IgM0, immunoglobulin G (IgG0. What is the proper diagnosis?


A.            Chronic hepatitis B


B.            Recovered hepatitis B


C.            Acute hepatitis A


D.            Acute hepatitis B


6.            Robert, a good friend of your, has called you to advice on obtaining a medical certification. He wants to know his various options. Which statement is true regarding the difference between licensure and certification?


A.            Certification signifies that a person is qualified to perform a particular role and is granted by a government agency.


B.            Licensure signifies mastery of specialized knowledge and is granted by a government agency.


C.            Certification signifies mastery of specialized knowledge and is granted by a non-governmental agency.




D.            Licensure signifies that a person is qualified to perform a particular role and is granted by a non-governmental agency.




7.            A mother brings her 3-month-old baby to your clinic to screen for failure to thrive (FTT). Which of the following is not a sign or symptom that would cause you to associate the infant with FTT?

A.            Absolute length/width are below the 5th percentile


B.            Weight falling greater than 2nd percentiles below the standard

C.            Avoids eye contact


D.            Commonly cries for more food or milk


8.            Which of the following is not true of progestin-only birth control?


A.            It has excellent reversibility


B.            It most likely changes tubal transport of female and male gametes


C.            Its mechanism of action affects the cervical mucus and the endometrium


D.            It is typically more effective than combination pulls but has more side effects


9.            The parents of a 1-year-old patient presents to you with concerns regarding their daughter’s health. At birth, they were told that their daughter had abnormal features and decreased muscle tone. They hope that their daughter would “grow out” of some these defects but, to their disappointment, she has not.


They report that their daughter is having trouble walking and sitting up by herself. Furthermore, they state that no matter how much they feed their baby, she is always crying out for more food and, as a result, has been rapidly gaining weight. You suspect a chromosomal condition. Which of the following would be most likely?


A.            Prader-Willi Syndrome


B.            Hurler syndrome


C.            Down syndrome


D.            DiGeorge syndrome


10.          The mother of a toddler complains that her 2-year-old child is picky eater, and despite evidence of a healthy growth pattern, she is concerned about her child’s appropriate food intake. Which of the following is the most accurate regarding toddler nutrition?


A.            Your toddler’s diet is appropriate if he consumes 70 to 100 kcal/kg/day


B.            Toddlers should consume more protein and a total of 120 kcal/kg/day


C.            Toddlers must consume a least 45 kcal/kg/day


D.            Parent of toddlers should insist that their children clean their plate and consume 100 to 110 kcal/kg/day


11.          During a check-up with a 6-year-old, you wish to conduct an interview the child and his parents. He is a new patient, and you want to establish the proper doctor-patient relationship. Which of the following is a necessary component of your interview?


A.            Assess child’s cholesterol


B.            Informing the parents ahead of time if you are recording data


C.            Assess liver function


D.            Measure the child’s hematocrit


12.          According to Jean Piaget, between the age of seven and 11, a child’s psychological development will be marked by:


A.            Development of intuitive thought


B.            Capability of logical thought


C.            Trial and error learning


D.            Capable of complex problem solving


13.          After years of not conceiving, Kelly and Ed finally have a child, a girl named Beverly. They often check with you about what to expect as Beverly ages. In a month she will be 2 ½ years old. Which of the following is typically present in a 2 ½ -year-old child?




A.            All primary teeth have erupted


B.            Birth weight has doubled


C.            Anterior fontanel is open


D.            The child will be in the industry versus inferiority stage of psychosocial development




14.          You are doing a well-child check on an infant. Currently, the baby can lifts his head when on his stomach, laughs aloud, and can crawl to you. When asked to say “mama,” however, the baby just smiles. Based on this description, what is his approximate age?


A.            6 months


B.            10 months


C.            4 months


D.            2 months


15.          A mother visits you with her 13-month-old daughter, Vicky. The mother tells you that Vicky had Hib conjugate vaccine (Hib) and that she needs her booster. The mother wants to know if Vicky can still get her Hib booster. Which of the following should you tell the mother?


A.            Hib booster is typically given at 12 months of age.


B.            Hib booster is typically not recommended until two years of age


C.            Hib booster must be given in a series of three before 5 months of age


D.            The child does not need a booster until 5 years of age


16.          Maggie, 2-month-old, is planning to receive the polio vaccine. Which of the following statements is true regarding polio vaccine administration to the patient?


A.            The inactivated polio vaccine would be given at 3, 6, and 9 months of age, with the last dose received by 4 years of age.


B.            The oral polio vaccine should be started at 6 years old.


C.            The final dose of the inactivated polio vaccine would typically be given when the patient is 6 years old.


D.            The inactivated polio vaccine should be given in a single dose at 2 months of age.


65.          Jimmy comes to your office for a checkup. During the physical exam, his nose begins to bleed. You begin to apply pressure to which part of the nasal septum?


A.            Anterosuperior


B.            Anteroinferior


C.            Posterosuperior


D.            Posteroinferior


66.          Melissa brings her 10-year-old son Alex for a checkup. His medical history includes corticosteroid treatment for juvenile rheumatoid arthritis (JRA) with which he was diagnosed last month. Melissa was told by the immunologist that Alex would need periodic checkups with an ophthalmologist, however, she notes her son has yet to mention any problems with his eyes. Which of the following should you tell her?


A.            The inflammation due to JRA often inflames the conjunctiva, causing gradual strabismus.


B.            The resulting weakened immune system usually leads to recurrent conjunctivitis


C.            Juvenile rheumatoid arthritis leads to glaucoma


D.            Prolonged use of corticosteroids may lead to cataracts


67.          What are the 2 most common presentations of mononucleosis on the 16 to 20-yeail-old group?


A.            Fatigue, sore throat


B.            Swollen lymph nodes, nausea


C.            Swollen lymph nodes, joint aches


D.            Fatigue, nausea.


68.          An adolescent presents with copious mucopurulent discharge from his right eye. Given the most likely diagnosis, which of the following is the most appropriate first-line treatment?


A.            Penicillin


B.            Zithromax


C.            Ceftriaxone


D.            Erythromycin


69.          You are treating a 9-year-old patient with asthma. Her symptoms, which include coughing and chest tightness, occur three times a week during the day and three times a month during the night. Additionally, she also has a forced expiratory volume in the one second of 80%. Which of the following is the most likely severity level of the asthma condition?


A.            Mild persistent


B.            Moderate persistent


C.            Severe persistent


D.            Mild intermittent


70.          A 1-month-old patient presents with symptoms of chronic cough, nasal passages filled with mucus, and a respiratory infection. You find an obstructive pattern in the pulmonary function test and try to look for more signs to confirm your suspected diagnosis. Which of the following findings, if encountered at sometime, would not help you confirm the most likely diagnosis?


A.            Fever


B.            Delayed puberty


C.            Large, liquid, bulky, foul stool


D.            Salt-tasting skin


71.          You are seeing a 2-year-old who has an upper respiratory infection. Findings include a fever of 102 F, grunting, and prolonged expiration. Based on these signs, which of the following would be the most likely laboratory finding for this patient?


A.            Slight WBC elevation with eosinophilia


B.            Abnormalities typical of obstructive dysfunction




C.            Productive cough


D.            Chest x-ray with hyperinflated lungs




72.          The nurse practitioner conducts a physical exam on a 15-year-old patient presenting with symptoms of respiratory infection. During ausculatation, she hears decreased breath sounds in the right lower lobe. To confirm this finding, she asks the patient to say “EEE” and you hear “AAA”. What respiratory assessment is the nurse practitioner conducting on the patient?


A.            Type and location of breath sounds


B.            Egophony


C.            Testing for heart murmur


D.            Pulmonary function test


73.          Which of the following is not a bacterial pneumonia?


A.            Klebsiella


B.            Haemophilus influenza


C.            Pseudomonas


D.            Rickettsia


74.          Seven-year-old Will is brought to your office after developing a limp. His parents state Will has begun to experience pain in his groin, hip, and left knee since the limp began. Moreover, they express concern about their son’s growth as Will is shorter in stature than most of his peers. Physical examination finding include abduction of the hip joint and passive internal rotation of the hip. Given the patient’s age and presentation, which of the following is the most appropriate form of treatment?


A.            Limitation of physical activity


B.            Referral to orthopedics


C.            Observation


D.            Analgesics


75.          The parents on a 13 year old girl come to your office concerned about the risk of scoliosis in their daughter given a family history of the condition. The daughter is developing asymmetry in her posture and is slightly shorter in stature than most her peers. Which of the following aspects of the patient’s presentation is not a risk factor for scoliosis?


A.            Age


B.            Gender


C.            Stature


D.            Family history


76.          Twelve year old Adam comes to your office after having experienced a recent, sudden growth spurt. He complains of pain in the area just below his right knee and reports tenderness when you apply pressure to the area. These findings indicate which of the following as the most likely diagnosis?


A.            Osgood-Schlatter disease


B.            Slipped capital femoral epiphysis


C.            Toxic synovitis


D.            Legg-Calve-Perthes disease


77.          Which of the following is not a component of the physical examination for developmental dysplasia of the hip?


A.            Galeazzi’s sign


B.            Barlow’s maneuver


C.            Ortalani test


D.            Adam’s forward bend test


78.          A concerned mother brings her four-year-old son, Kevin, to the office. The mother is worried about Kevin’s weakness and clumsiness compared to other children his age as well as his abnormal posture. Further, she notes unusual movements from her son such as moving his hands up his legs when rising to stand. As you begin laboratory testing to confirm your suspected diagnosis, which of the following would you not expect to see?

A.            Decreased creatine kinase


B.            Necrotic degenerating fibers




C.            Abnormal electrocardiogram


D.            Myopathy




79.          Bell’s palsy is associated with the malfunction of which cranial nerve?


A.            VII


B.            IV


C.            VIII


D.            XII


80.          A mother brings her 6-year-old son, Glenn, to the clinic for a check-up. She is concerned that her son constantly says that he smells “peppermint.” Upon physical examination, you notice the child’s mouth starts twitching to the right. After a minute, the twitching stops and Glenn asks why everybody is looking at him. The child is exhibiting signs of which of the following conditions?


A.            Complex partial seizures


B.            Clonic seizures


C.            Simple partial seizures


D.            Tic disorders


81.          A 5-month-old infant is brought to your office by her mother, who states that the infant has lately seemed lethargic and has been vomiting and feeding poorly. Upon examination, you note a bulging fontanel and fever. Which of the following laboratory tests would help confirm your suspected diagnosis?


A.            Complete blood count


B.            Computed axial tomography scan


C.            Erythrocyte sedimentation rate


D.            Cerebrospinal fluid analysis


82.          Sixteen-year-old Jeffrey complains of having debilitating pain once a week. H states that during or after the episodes of abdominal pain, he gets so nauseous that he has to vomit. The results of a stool sample are guiac negative and do not reveal occult blood. Which of the following is the most likely diagnosis?

A.            Basilar migraine


B.            Gastroesophageal reflux disease


C.            Gastroenteritis


D.            Abdominal migraine


83.          You are examining Cody, 8 years old, who has recently begun to experience morning headaches followed by vomiting. Cary states that these headaches have become more frequent since they began. You note numerous findings including head tilt, failure to thrive, and loss of fine motor control. Moreover, Cody tests positive when you administer the Babinski reflex test. Which of the following laboratory tests would not confirm the most likely diagnosis?


A.            Lumbar puncture


B.            Magnetic resonance imaging


C.            Electroencephalogram


D.            Computerized axial tomography.


84.          You are examining a 2-year-old who present with a low grade fever. During physical examination, you note the child is responding as though he has excruciating pain in his back, chest, and abdomen. A lab test reveals his white blood cell count is elevated to 14,000. Which of the following would you also expect to be revealed?


A.            Poikilocylosis and basophilic stippling


B.            Howell-Jolly bodies


C.            Heinz bodies


D.            Blast cells


85.          You have been seeing Larry and Shawna during Shawna’s pregnancy. You did a genotype test for


Shawna, but Larry was adopted and, therefore, has no knowledge his biological parents. Now they report that their child has a strange growth on his forehead as well as a pale coloring to his skin. Which of the following is the most likely diagnosis?


A.            Iron deficiency anemia




B.            Hemophilia A


C.            Thalassemia


D.            Sickle cell anemia




86.          You are examining 2-year-old Donald after his parents tell you he has been vomiting and experiencing diarrhea the past week, leading to him losing an alarming amount of weight. Moreover, his gums are blue. During the examination, Donald rapidly jerks his right arm back. When you ask why he did this, he replies that his “arm moved on its own.” Which of the following is the most likely diagnosis?


A.            Pyloric stenosis


B.            Lead poisoning


C.            Appendicitis


D.            Gastroenteritis


87.          While she is pregnant, you discover that Sharon is a carrier for hemophilia A. She asks you what the chance is that she could pass the disorder on to her daughter. Which of the following should you tell her?


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