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Let us say we have an Barbarian that has the Vital Strike feat, as well as the Furious Finish feat.
You make a single attack that deals significantly more damage than normal.
Prerequisites: Base attack bonus +6.
Benefit: When you use the attack action, you can make one attack at your highest base attack bonus that deals additional damage. Roll the weapon's damage dice for the attack twice and add the results together before adding bonuses from Strength, weapon abilities (such as flaming), precision based damage, and other damage bonuses. These extra weapon damage dice are not multiplied on a critical hit, but are added to the total.
While raging, when you use the Vital Strike feat, you can choose not to roll your damage dice and instead deal damage equal to the maximum roll possible on those damage dice. If you do, your rage immediately ends, and you are fatigued (even if you would not normally be).
Now, let us say your party found a Double-Barrel Musket on a poor chap that met its end. The Barbarian decides it is an awesome weapon and begins training as a Gunslinger.
With this, the Barbarian chooses to Rage, Shoot both Barrels of the musket, and then decides to Furious Finish.
Would the Fatigue effect trigger once, twice, or convert to Exhaustion?
Since a double-barreled musket shot is considered one attack with two attack rolls, the fatigue effect would trigger only once.