LEIK FNP PRACTICE FULL SOLUTION STUDY
GUIDE
◉ Jenny, a 21-year-old, complains to you of a 1-week episode of
dysuria, frequency, and a strong odor to her urine. This is her second
episode of the year. What is the most appropriate follow-up for this
patient?
A) Order a urinalysis and urine for culture and sensitivity (C&S) and
treat the patient with antibiotics
B) Order a urine C&S and hold treatment until you get the results
from the lab
C) Treat the patient with a 7-day course of antibiotics and order a
urine for culture
and sensitivity (urine C&S) now and after she completes her
antibiotics
D) Treat the patient with a stronger drug such as ofloxacin (Floxin)
for 10 days.
Answer: A) Order a urinalysis and urine for culture and sensitivity
(C&S) and treat the patient with antibiotics
,The best treatment for this patient is to order the urinalysis and
urine C&S to identify the organism causing the infection. Treatment
may begin while waiting for the culture results. However,
occasionally treatment may have to be changed after the
culture/sensitivity results return, due to resistance to the antibiotic
used.
◉ You are checking a 75-year-old woman's breast during an annual
gynecologi- cal exam. The left nipple and areola are scaly and
reddened. The patient denies pain and pruritis. She has noticed this
scaliness on her left nipple for the past 8 months. Her dermatologist
gave her a potent topical steroid, which she used twice a day for 1
month. The patient never went back for the follow-up. She still has
the rash and wants an evaluation. Which of the following is the best
intervention for this patient?
A) Prescribe another potent topical steroid and tell the patient to
use it twice a day for 4 weeks
B) Order a mammogram and refer the patient to a breast surgeon
C) Advise her to stop using soap on both breasts when she bathes to
avoid drying
up the skin on her areolae and nipples
D) Order a sonogram and fine-needle biopsy of the breast.
Answer: B) Order a mammogram and refer the patient to a breast
surgeon
,A scaly, reddened rash on the breast that does not resolve after a few
weeks of medical treatment may indicate breast cancer. She should
have a mammogram performed and see a breast surgeon for
evaluation and treatment.
◉ During a sports physical exam of a 14-year-old high school
athlete, the nurse practitioner notices a split of the S2 component of
the heart sound during deep inspiration. She notes that it disappears
upon expiration. The heart rate is regular and no murmurs are
auscultated. Which of the following is correct?
A) This is an abnormal finding and should be evaluated further by a
cardiologist
B) A stress test should be ordered
C) This is a normal finding in some young athletes
D) An echocardiogram should be ordered.
Answer: C) This is a normal finding in some young athletes
It is common to hear a split of the S2 over the pulmonic area of the
heart with inspiration as long as it disappears with expiration, with
no other abnormal symptoms. This is caused by split- ting of the
aortic and pulmonic components.
◉ What does a KOH (potassium hydroxide) prep help the nurse
practitioner diagnose?
, A) Herpes zoster infections
B) Yeast infections
C) Herpes simplex infections
D) Viral infections.
Answer: B) Yeast infections
The KOH prep test is performed by placing a sample of dis- charge
on a glass slide, with one drop of potassium hydroxide and a
coverslip on top to evaluate for yeast infections. Budding spores and
pseudohyphae will be seen with Candida, with a pH of 3.5-4.5.
◉ A woman is being evaluated by the nurse practitioner for
complaints of dyspareunia. A microscopy slide reveals a large
number of atrophic squamous epithelial cells. The vaginal pH is 4.0.
There are very few leukocytes and no RBCs are seen on the wet
smear. Which of the following is most likely?
A) Atrophic vaginitis
B) Bacterial vaginosis
C) Trichomoniasis
D) This is a normal finding.
Answer: A) Atrophic vaginitis
GUIDE
◉ Jenny, a 21-year-old, complains to you of a 1-week episode of
dysuria, frequency, and a strong odor to her urine. This is her second
episode of the year. What is the most appropriate follow-up for this
patient?
A) Order a urinalysis and urine for culture and sensitivity (C&S) and
treat the patient with antibiotics
B) Order a urine C&S and hold treatment until you get the results
from the lab
C) Treat the patient with a 7-day course of antibiotics and order a
urine for culture
and sensitivity (urine C&S) now and after she completes her
antibiotics
D) Treat the patient with a stronger drug such as ofloxacin (Floxin)
for 10 days.
Answer: A) Order a urinalysis and urine for culture and sensitivity
(C&S) and treat the patient with antibiotics
,The best treatment for this patient is to order the urinalysis and
urine C&S to identify the organism causing the infection. Treatment
may begin while waiting for the culture results. However,
occasionally treatment may have to be changed after the
culture/sensitivity results return, due to resistance to the antibiotic
used.
◉ You are checking a 75-year-old woman's breast during an annual
gynecologi- cal exam. The left nipple and areola are scaly and
reddened. The patient denies pain and pruritis. She has noticed this
scaliness on her left nipple for the past 8 months. Her dermatologist
gave her a potent topical steroid, which she used twice a day for 1
month. The patient never went back for the follow-up. She still has
the rash and wants an evaluation. Which of the following is the best
intervention for this patient?
A) Prescribe another potent topical steroid and tell the patient to
use it twice a day for 4 weeks
B) Order a mammogram and refer the patient to a breast surgeon
C) Advise her to stop using soap on both breasts when she bathes to
avoid drying
up the skin on her areolae and nipples
D) Order a sonogram and fine-needle biopsy of the breast.
Answer: B) Order a mammogram and refer the patient to a breast
surgeon
,A scaly, reddened rash on the breast that does not resolve after a few
weeks of medical treatment may indicate breast cancer. She should
have a mammogram performed and see a breast surgeon for
evaluation and treatment.
◉ During a sports physical exam of a 14-year-old high school
athlete, the nurse practitioner notices a split of the S2 component of
the heart sound during deep inspiration. She notes that it disappears
upon expiration. The heart rate is regular and no murmurs are
auscultated. Which of the following is correct?
A) This is an abnormal finding and should be evaluated further by a
cardiologist
B) A stress test should be ordered
C) This is a normal finding in some young athletes
D) An echocardiogram should be ordered.
Answer: C) This is a normal finding in some young athletes
It is common to hear a split of the S2 over the pulmonic area of the
heart with inspiration as long as it disappears with expiration, with
no other abnormal symptoms. This is caused by split- ting of the
aortic and pulmonic components.
◉ What does a KOH (potassium hydroxide) prep help the nurse
practitioner diagnose?
, A) Herpes zoster infections
B) Yeast infections
C) Herpes simplex infections
D) Viral infections.
Answer: B) Yeast infections
The KOH prep test is performed by placing a sample of dis- charge
on a glass slide, with one drop of potassium hydroxide and a
coverslip on top to evaluate for yeast infections. Budding spores and
pseudohyphae will be seen with Candida, with a pH of 3.5-4.5.
◉ A woman is being evaluated by the nurse practitioner for
complaints of dyspareunia. A microscopy slide reveals a large
number of atrophic squamous epithelial cells. The vaginal pH is 4.0.
There are very few leukocytes and no RBCs are seen on the wet
smear. Which of the following is most likely?
A) Atrophic vaginitis
B) Bacterial vaginosis
C) Trichomoniasis
D) This is a normal finding.
Answer: A) Atrophic vaginitis
