LEIK FNP LATEST 2026 EXAM EVALUATION QUESTIONS
AND SOLUTIONS RATED A+
✔✔A 21-year-old woman complains of left-sided pelvic pain accompanied by
dyspareunia. During the gynecological exam, the nurse practitioner notices green
cervical discharge. The patient mentions a new onset of a painful and swollen left knee
and denies a history of trauma. This best describes: - ✔✔Symptoms of pelvic
inflammatory disease (PID) with painful, swollen joints of extremities indicate
disseminated gonorrheal infection. Untreated disseminated gonorrhea can lead to septic
arthritis. Symptoms may be mild, ranging from slight joint pain and no fever to severe
joint pain with high fever. PID symptoms do not occur with septic arthritis, Reiter's
syndrome, or chondromalacia of the patella.
✔✔Threated abortion - ✔✔vaginal bleeding and cramping without the presence of
cervical dilation.
✔✔Positive Coomb's Test - ✔✔Mother has autoantibodies against Rh-positive RBCs
The mother's autoantibodies can attack the fetus's Rh-positive RBCs and cause
destruction of these cells, which can cause severe anemia and complications in the
fetus. Today this is preventable with the administration of anti-RhD immunoglobulin
(Rho[D] immune globulin) to an Rh-negative mother at 28 weeks gestation and after
birth if the newborn is Rh positive.
✔✔A 38-year-old multigravida who is at 32 weeks gestation calls the family nurse
practitioner complaining of vaginal bleeding, abdominal pain, and uterine contractions.
There is no watery discharge. She states that her uterus feels hard and is very painful.
Which of the following conditions is most likely? - ✔✔Symptoms of placental abruption
are bright-red vaginal bleeding, board-like uterus on palpation, and pain. However, there
can be concealed hemorrhage, and the patient may not have vaginal bleeding. Placenta
previa is painless bleeding. Ectopic and molar pregnancy would not progress to 32
weeks gestation.
✔✔All of the following viruses can infect the fetus and/or the mother during pregnancy.
Which of the following viruses is not associated with serious sequelae?
1. Human parvovirus B19
2. Varicella
3. Rubella
4. Rhinovirus - ✔✔Infection with rhinovirus causes the common cold and is not
associated with serious sequelae in pregnant women or their fetuses. Infection during
pregnancy with human parvovirus B19 can cause severe fetal anemia (hemolysis), fetal
hydrops (hydrops fetalis), fetal death, and spontaneous abortions. Most women with
B19 infection in pregnancy do not suffer serious sequelae. Congenital rubella infection
in early pregnancy causes severe birth defects, fetal demise, miscarriages, and
,stillbirths. Congenital varicella infection is extremely rare but affects the skin,
extremities, and brain, and also causes low birth weight.
✔✔A college freshman who is using oral contraceptives calls the nurse practitioner's
office asking for advice. She forgot to take her pills 2 days in a row during the second
week of the pill cycle and wants to know what to do. What is the best advice? -
✔✔When forgetting to take the birth control pill on 2 consecutive days, it is
recommended to take two pills immediately and two pills the next day, then continue the
rest of the pack. Stress the importance of the use of condoms for protection against
pregnancy and STIs.
✔✔A second triple screen on a 35-year-old primigravida reveals abnormally low levels
of alpha fetoprotein and estriol and high levels of human chorionic gonadotropin. Which
of the following interventions is the best choice for this patient? - ✔✔Order U/s
Abnormally low levels of alpha fetoprotein and estriol and high levels of human
chorionic gonadotropin are abnormal during pregnancy. An ultrasound should be
ordered to further evaluate the fetus for characteristics of Down syndrome and/or fetal
demise.
✔✔Major risk factor for Down Syndrome - ✔✔Maternal age older than 35 yo
✔✔Koplik's spots - ✔✔Measles
✔✔Leading cause of death in US: - ✔✔1. Heart disease
2. Cancer
3. Chronic lower respiratory disease (COPD)
✔✔Leading cause of death - birth to 12 months: - ✔✔congenital malformations
✔✔Leading cause of death - 1 to 44 yo - ✔✔unintentional injuries
✔✔Leading cause of death 45 to 64 yo - ✔✔Cancer
✔✔Leading cause of death- 65 and older: - ✔✔Heart disease
✔✔Leading cause of death in adolescents: - ✔✔1. Accidents - most common: MVA (16-
19 yo)
2. Suicide
3. Homicide
✔✔Leading cause of cancer death: - ✔✔Lung cancer
✔✔Leading cause of cancer deaths in men: - ✔✔1. Lung cancer
,2. Prostate cancer
3. Colorectal cancer
✔✔Leading cause of cancer deaths in women: - ✔✔1. Lung cancer
2. Breast cancer
3. Colorectal cancer
✔✔Most common cancer: - ✔✔Skin cancer
most common type:
1. Basal cell carcinoma
2. Melanoma - cause majority of skin cancer deaths
✔✔Most common cancer in men: - ✔✔Prostate cancer
✔✔Most common cancer in women: - ✔✔Breast cancer
✔✔Most common cancer in children: - ✔✔acute lymphoblastic leukemia
✔✔CDC recommendation for Hep B vaccine - ✔✔- 3 doses - do not restart if not
completed; give second dose at least 4 weeks from 1st dose. Catch up until 3 doses
completed
- 0, 1, 6 months
✔✔MMR - ✔✔2 doses needed, at least 28 days apart
- do not give to pregnant, immunosuppressed
✔✔Herpes Keratitis - ✔✔ACUTE onset of severe eye PAIN, photophobia, tearing and
blurred vision in ONE eye. Diagnosed by using FLUORESCEIN dye. A BLACK lamp in
a darkened room is used to search for FERNLIKE lines in the corneal surface.
Infection PERMANENTLY damages corneal EPITHELIUM, which may result in corneal
BLINDNESS.
✔✔acute angle closure glaucoma - ✔✔- Elderly patient with acute onset of severe eye
pain accompanied by headache, nausea/vomiting, halos around lights, and decreased
vision.
- PE: oval shaped mid-dilated pupils, cornea appears cloudy, cupping of optic nerve
- OPTHALMIC EMERGENCY - refer to ED
✔✔Multiple Sclerosis (Optic Neuritis) - ✔✔- Young adult with new or intermittent loss of
vision of one eye (optic neuritis) alone or accompanied by nystagmus or other abnormal
eye movements
, - may be accompanied by: aphasia, paresthesia, abnormal gait, spasticity
-fatigue on awakening that worsens through the day; heat exacerbates symptoms;
recurrent episodes
- Refer to neurology
✔✔Orbital Cellulitis - ✔✔- Acute onset: erythematous swollen eyelid with proptosis
(bulging of the eyeball) and eye pain on affected eye
- Abnormal EOM (limited ROM), pain with movement
- Hx of recent rhino sinusitis or URI; cause by acute bacterial infection
- More common in young children than adults
- REFER to ED
✔✔Retinal Detachment - ✔✔Sudden onset of shower of floaters; "looking through a
curtain" with sudden flashes of light (photopsia)
REFER to ED
✔✔Peritonsillar abscess - ✔✔- severe sore throat, difficulty swallowing, odynophagia,
truisms, "hot potato" voice
- PE: unilateral swelling of peritonsillar area and soft palate; bulging red mass, uvula
displaced away from mass; accompanied by malaise, fever, chills
- Refer to ED
✔✔Diphteria - ✔✔- sore throat, fever, "bull neck"; dysphagia
- PE: posterior pharynx, tonsils, uvula and soft palate coated with gray to yellow colored
pseudomembrane that is hard to displace
- VERY contagious; contact prophylaxis. Refer to ED
✔✔Cholesteatoma - ✔✔"cauliflowerlike" groth accompanied by foul smelling ear
discharge. Hearing loss on affected ear. refer to ENT MD, can cause face and damage
to fcaial nerve VII
✔✔Battle Sign - ✔✔"raccoon eyes" and bruising behind ear that appears 2-3 days after
trauma
AND SOLUTIONS RATED A+
✔✔A 21-year-old woman complains of left-sided pelvic pain accompanied by
dyspareunia. During the gynecological exam, the nurse practitioner notices green
cervical discharge. The patient mentions a new onset of a painful and swollen left knee
and denies a history of trauma. This best describes: - ✔✔Symptoms of pelvic
inflammatory disease (PID) with painful, swollen joints of extremities indicate
disseminated gonorrheal infection. Untreated disseminated gonorrhea can lead to septic
arthritis. Symptoms may be mild, ranging from slight joint pain and no fever to severe
joint pain with high fever. PID symptoms do not occur with septic arthritis, Reiter's
syndrome, or chondromalacia of the patella.
✔✔Threated abortion - ✔✔vaginal bleeding and cramping without the presence of
cervical dilation.
✔✔Positive Coomb's Test - ✔✔Mother has autoantibodies against Rh-positive RBCs
The mother's autoantibodies can attack the fetus's Rh-positive RBCs and cause
destruction of these cells, which can cause severe anemia and complications in the
fetus. Today this is preventable with the administration of anti-RhD immunoglobulin
(Rho[D] immune globulin) to an Rh-negative mother at 28 weeks gestation and after
birth if the newborn is Rh positive.
✔✔A 38-year-old multigravida who is at 32 weeks gestation calls the family nurse
practitioner complaining of vaginal bleeding, abdominal pain, and uterine contractions.
There is no watery discharge. She states that her uterus feels hard and is very painful.
Which of the following conditions is most likely? - ✔✔Symptoms of placental abruption
are bright-red vaginal bleeding, board-like uterus on palpation, and pain. However, there
can be concealed hemorrhage, and the patient may not have vaginal bleeding. Placenta
previa is painless bleeding. Ectopic and molar pregnancy would not progress to 32
weeks gestation.
✔✔All of the following viruses can infect the fetus and/or the mother during pregnancy.
Which of the following viruses is not associated with serious sequelae?
1. Human parvovirus B19
2. Varicella
3. Rubella
4. Rhinovirus - ✔✔Infection with rhinovirus causes the common cold and is not
associated with serious sequelae in pregnant women or their fetuses. Infection during
pregnancy with human parvovirus B19 can cause severe fetal anemia (hemolysis), fetal
hydrops (hydrops fetalis), fetal death, and spontaneous abortions. Most women with
B19 infection in pregnancy do not suffer serious sequelae. Congenital rubella infection
in early pregnancy causes severe birth defects, fetal demise, miscarriages, and
,stillbirths. Congenital varicella infection is extremely rare but affects the skin,
extremities, and brain, and also causes low birth weight.
✔✔A college freshman who is using oral contraceptives calls the nurse practitioner's
office asking for advice. She forgot to take her pills 2 days in a row during the second
week of the pill cycle and wants to know what to do. What is the best advice? -
✔✔When forgetting to take the birth control pill on 2 consecutive days, it is
recommended to take two pills immediately and two pills the next day, then continue the
rest of the pack. Stress the importance of the use of condoms for protection against
pregnancy and STIs.
✔✔A second triple screen on a 35-year-old primigravida reveals abnormally low levels
of alpha fetoprotein and estriol and high levels of human chorionic gonadotropin. Which
of the following interventions is the best choice for this patient? - ✔✔Order U/s
Abnormally low levels of alpha fetoprotein and estriol and high levels of human
chorionic gonadotropin are abnormal during pregnancy. An ultrasound should be
ordered to further evaluate the fetus for characteristics of Down syndrome and/or fetal
demise.
✔✔Major risk factor for Down Syndrome - ✔✔Maternal age older than 35 yo
✔✔Koplik's spots - ✔✔Measles
✔✔Leading cause of death in US: - ✔✔1. Heart disease
2. Cancer
3. Chronic lower respiratory disease (COPD)
✔✔Leading cause of death - birth to 12 months: - ✔✔congenital malformations
✔✔Leading cause of death - 1 to 44 yo - ✔✔unintentional injuries
✔✔Leading cause of death 45 to 64 yo - ✔✔Cancer
✔✔Leading cause of death- 65 and older: - ✔✔Heart disease
✔✔Leading cause of death in adolescents: - ✔✔1. Accidents - most common: MVA (16-
19 yo)
2. Suicide
3. Homicide
✔✔Leading cause of cancer death: - ✔✔Lung cancer
✔✔Leading cause of cancer deaths in men: - ✔✔1. Lung cancer
,2. Prostate cancer
3. Colorectal cancer
✔✔Leading cause of cancer deaths in women: - ✔✔1. Lung cancer
2. Breast cancer
3. Colorectal cancer
✔✔Most common cancer: - ✔✔Skin cancer
most common type:
1. Basal cell carcinoma
2. Melanoma - cause majority of skin cancer deaths
✔✔Most common cancer in men: - ✔✔Prostate cancer
✔✔Most common cancer in women: - ✔✔Breast cancer
✔✔Most common cancer in children: - ✔✔acute lymphoblastic leukemia
✔✔CDC recommendation for Hep B vaccine - ✔✔- 3 doses - do not restart if not
completed; give second dose at least 4 weeks from 1st dose. Catch up until 3 doses
completed
- 0, 1, 6 months
✔✔MMR - ✔✔2 doses needed, at least 28 days apart
- do not give to pregnant, immunosuppressed
✔✔Herpes Keratitis - ✔✔ACUTE onset of severe eye PAIN, photophobia, tearing and
blurred vision in ONE eye. Diagnosed by using FLUORESCEIN dye. A BLACK lamp in
a darkened room is used to search for FERNLIKE lines in the corneal surface.
Infection PERMANENTLY damages corneal EPITHELIUM, which may result in corneal
BLINDNESS.
✔✔acute angle closure glaucoma - ✔✔- Elderly patient with acute onset of severe eye
pain accompanied by headache, nausea/vomiting, halos around lights, and decreased
vision.
- PE: oval shaped mid-dilated pupils, cornea appears cloudy, cupping of optic nerve
- OPTHALMIC EMERGENCY - refer to ED
✔✔Multiple Sclerosis (Optic Neuritis) - ✔✔- Young adult with new or intermittent loss of
vision of one eye (optic neuritis) alone or accompanied by nystagmus or other abnormal
eye movements
, - may be accompanied by: aphasia, paresthesia, abnormal gait, spasticity
-fatigue on awakening that worsens through the day; heat exacerbates symptoms;
recurrent episodes
- Refer to neurology
✔✔Orbital Cellulitis - ✔✔- Acute onset: erythematous swollen eyelid with proptosis
(bulging of the eyeball) and eye pain on affected eye
- Abnormal EOM (limited ROM), pain with movement
- Hx of recent rhino sinusitis or URI; cause by acute bacterial infection
- More common in young children than adults
- REFER to ED
✔✔Retinal Detachment - ✔✔Sudden onset of shower of floaters; "looking through a
curtain" with sudden flashes of light (photopsia)
REFER to ED
✔✔Peritonsillar abscess - ✔✔- severe sore throat, difficulty swallowing, odynophagia,
truisms, "hot potato" voice
- PE: unilateral swelling of peritonsillar area and soft palate; bulging red mass, uvula
displaced away from mass; accompanied by malaise, fever, chills
- Refer to ED
✔✔Diphteria - ✔✔- sore throat, fever, "bull neck"; dysphagia
- PE: posterior pharynx, tonsils, uvula and soft palate coated with gray to yellow colored
pseudomembrane that is hard to displace
- VERY contagious; contact prophylaxis. Refer to ED
✔✔Cholesteatoma - ✔✔"cauliflowerlike" groth accompanied by foul smelling ear
discharge. Hearing loss on affected ear. refer to ENT MD, can cause face and damage
to fcaial nerve VII
✔✔Battle Sign - ✔✔"raccoon eyes" and bruising behind ear that appears 2-3 days after
trauma
