LEIK (AANP) FNP PRACTICE ACTUAL EXAM TEST BANK
QUESTIONS AND DETAILED ANSWERS 640+ Q&A (A+ GUIDE
SOLUTION)
A 72-year-old woman has been on hydrochlorothiazide 12.5 mg for many years to control
her Stage II hypertension. Her blood pressure (BP) at this visit is 168/96. She is currently
complaining of pain on her right hip and on both knees. She has increased her dose of
ibuprofen (Motrin) from 400 mg 3 times day (TID) to 800 mg TID. She is still in pain and
would like something stronger. Which of the following statements is the best explanation of
the effects of ibuprofen (Motrin) on her disease?
A) It increases the chances of adverse effects to her health
B) It inhibits the effect of renal prostaglandins and blunts the effectiveness of the diuretic
C) It prolongs the therapeutic effects of hydrochlorothiazide and other diuretics
D) None of the statements are true -ANSWER-B) It inhibits the effect of renal prostaglandins
and blunts the effectiveness of the diuretic.
NSAIDs and ASA inhibit the vasodilatory effects of prostaglandins, which predisposes the
kidney to ischemia. NSAIDs and diuretics can cause acute prerenal failure by decreasing
renal blood flow.
2. All of the following are infections that affect mostly the labia and vagina except:
A) Bacterialvaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis -ANSWER-D) Chlamydia trachomatis
Infections that commonly affect the labia and vagina include bacterial vaginosis, candidiasis,
and trichomoniasis. Chlamydia trachomatis commonly affects the cervix, endometrial lining ,
fallopian tubes, and pelvic cavity.
,The nurse practitioner would test the obturator and iliopsoas muscle to evaluate for:
A) Cholecystitis
B) Acute appendicitis
C) Inguinal hernia
D) Gastriculcer -ANSWER-B) Acute appendicitis.
Signs and symptoms of an acute abdomen include invol- untary guarding, rebound
tenderness, boardlike abdomen, and a positive obtu- rator and psoas sign. A positive
obturator sign occurs when pain is elicted by internal rotation of the right hip from 90
degrees hip/knee flexion. The psoas sign is positive when pain occurs with passive extension
of the thigh while the patient is lying on his/her side with knees extended, or when pain
occurs with active flexion of his/her thigh at the hip.
Treatment for mild preeclampsia includes all of the following except:
A) Bed rest except for bathroom privileges
B) Close monitoring of weight and blood pressure
C) Close follow-up of urinary protein, serum creatinine, and platelet count
D) A prescription of methyldopa (Aldomet) to control blood pressure -ANSWER-D) A
prescription of methyldopa (Aldomet) to control blood pressure
Recommended care for women diagnosed with preeclampsia includes bed rest with bath-
room privileges, weight and BP monitoring, and closely following urine protein and serum
protein, creatinine, and platelet counts. Oral medications are not used as first-line
treatment.
All of the following services are covered under Medicare Part A except:
A) Inpatienthospitalizations
,B) Medicines administered to a patient while hospitalized
C) Nursing home care
D) Surgeons -ANSWER-C) Nursing home care
Medicare A coverage includes inpatient hospitalization and skilled care given in a certified
skilled nursing facility. Most nursing home care is custodial care (help with bathing, dressing,
using a bathroom, and eating). This care is not covered by Medicare A.
A 28-year-old student is seen in the school health clinic with complaints of a hacking cough
that is productive of small amounts of sputum and a runny nose. He does not take any
medications, denies any allergies, and has no significant medical history. Physical
examination reveals a low-grade temperature of 99.9 degrees Fahrenheit, respirations of
16/min, a pulse of 90 beats per minute, and diffuse fine crackles in the base of the lungs. A
chest radiograph (x-ray) shows diffuse infiltrates on the lower lobe of the right lung. The
total white blood cell count is 10,500/uL. What is the most likely diagnosis?
A) Streptococcal pneumonia
B) Mycoplasma pneumonia
C) Acute bronchitis
D) Legionnaires disease -ANSWER-B) Mycoplasma pneumonia
Mycoplasma pneumonia is the organism most com- monly seen in children and young
adults. It is easily spread from droplets, from sneezing and coughing, in close proximity.
Diagnosis is based on symptoms and x-ray results of infiltrates in lower lobes.
A 39-year-old migrant worker presents to the clinic 2.5 days after a purified protein
derivative (PPD) test. What minimum size of induration would be considered posi- tive for
this patient?
A) 3 mm B) 5 mm C) 10 mm D) 15 mm -ANSWER-C) 10 mm
, The PPD is administered on the volar aspect of the lower arm and read 48 hours after the
test is given. The PPD result must have induration and measure 10 mm or greater to be
positive in a low-risk patient. Induration (firmness with palpation) must be present. If the
site has erythema but no induration, result would be negative. Color is not important.
All of the following are correct statements regarding the role of the person named in a
durable power of attorney except:
A) The agent's decisions are legally binding
B) The agent can make decisions in other areas of the patient's life such as financial
issues
C) The agent can decide for the patient who is on life support when that life support
can be terminated
D) The patient's spouse has a right to override the agent's decisions -ANSWER-D) The
patient's spouse has a right to override the agent's decisions
The person named in a durable power of attorney (the agent) is designated by the patient to
make all medical decisions, as well as any decisions regarding the patient's private affairs in
the event that the patient becomes incompetent and unable to make his/her own decisions.
No one has the ability to override the agent's decision.
All of the following are true statements regarding Munchausen syndrome except:
A) It is considered a mental illness
B) The patient has a medical illness that causes an anxiety reaction and denial
C) The patient fakes an illness in order to gain attention from health care providers
D) The patient has an inconsistent medical history along with a past history of
frequent hospitalizations -ANSWER-B) The patient has a medical illness that causes an
anxiety reaction and denial
QUESTIONS AND DETAILED ANSWERS 640+ Q&A (A+ GUIDE
SOLUTION)
A 72-year-old woman has been on hydrochlorothiazide 12.5 mg for many years to control
her Stage II hypertension. Her blood pressure (BP) at this visit is 168/96. She is currently
complaining of pain on her right hip and on both knees. She has increased her dose of
ibuprofen (Motrin) from 400 mg 3 times day (TID) to 800 mg TID. She is still in pain and
would like something stronger. Which of the following statements is the best explanation of
the effects of ibuprofen (Motrin) on her disease?
A) It increases the chances of adverse effects to her health
B) It inhibits the effect of renal prostaglandins and blunts the effectiveness of the diuretic
C) It prolongs the therapeutic effects of hydrochlorothiazide and other diuretics
D) None of the statements are true -ANSWER-B) It inhibits the effect of renal prostaglandins
and blunts the effectiveness of the diuretic.
NSAIDs and ASA inhibit the vasodilatory effects of prostaglandins, which predisposes the
kidney to ischemia. NSAIDs and diuretics can cause acute prerenal failure by decreasing
renal blood flow.
2. All of the following are infections that affect mostly the labia and vagina except:
A) Bacterialvaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis -ANSWER-D) Chlamydia trachomatis
Infections that commonly affect the labia and vagina include bacterial vaginosis, candidiasis,
and trichomoniasis. Chlamydia trachomatis commonly affects the cervix, endometrial lining ,
fallopian tubes, and pelvic cavity.
,The nurse practitioner would test the obturator and iliopsoas muscle to evaluate for:
A) Cholecystitis
B) Acute appendicitis
C) Inguinal hernia
D) Gastriculcer -ANSWER-B) Acute appendicitis.
Signs and symptoms of an acute abdomen include invol- untary guarding, rebound
tenderness, boardlike abdomen, and a positive obtu- rator and psoas sign. A positive
obturator sign occurs when pain is elicted by internal rotation of the right hip from 90
degrees hip/knee flexion. The psoas sign is positive when pain occurs with passive extension
of the thigh while the patient is lying on his/her side with knees extended, or when pain
occurs with active flexion of his/her thigh at the hip.
Treatment for mild preeclampsia includes all of the following except:
A) Bed rest except for bathroom privileges
B) Close monitoring of weight and blood pressure
C) Close follow-up of urinary protein, serum creatinine, and platelet count
D) A prescription of methyldopa (Aldomet) to control blood pressure -ANSWER-D) A
prescription of methyldopa (Aldomet) to control blood pressure
Recommended care for women diagnosed with preeclampsia includes bed rest with bath-
room privileges, weight and BP monitoring, and closely following urine protein and serum
protein, creatinine, and platelet counts. Oral medications are not used as first-line
treatment.
All of the following services are covered under Medicare Part A except:
A) Inpatienthospitalizations
,B) Medicines administered to a patient while hospitalized
C) Nursing home care
D) Surgeons -ANSWER-C) Nursing home care
Medicare A coverage includes inpatient hospitalization and skilled care given in a certified
skilled nursing facility. Most nursing home care is custodial care (help with bathing, dressing,
using a bathroom, and eating). This care is not covered by Medicare A.
A 28-year-old student is seen in the school health clinic with complaints of a hacking cough
that is productive of small amounts of sputum and a runny nose. He does not take any
medications, denies any allergies, and has no significant medical history. Physical
examination reveals a low-grade temperature of 99.9 degrees Fahrenheit, respirations of
16/min, a pulse of 90 beats per minute, and diffuse fine crackles in the base of the lungs. A
chest radiograph (x-ray) shows diffuse infiltrates on the lower lobe of the right lung. The
total white blood cell count is 10,500/uL. What is the most likely diagnosis?
A) Streptococcal pneumonia
B) Mycoplasma pneumonia
C) Acute bronchitis
D) Legionnaires disease -ANSWER-B) Mycoplasma pneumonia
Mycoplasma pneumonia is the organism most com- monly seen in children and young
adults. It is easily spread from droplets, from sneezing and coughing, in close proximity.
Diagnosis is based on symptoms and x-ray results of infiltrates in lower lobes.
A 39-year-old migrant worker presents to the clinic 2.5 days after a purified protein
derivative (PPD) test. What minimum size of induration would be considered posi- tive for
this patient?
A) 3 mm B) 5 mm C) 10 mm D) 15 mm -ANSWER-C) 10 mm
, The PPD is administered on the volar aspect of the lower arm and read 48 hours after the
test is given. The PPD result must have induration and measure 10 mm or greater to be
positive in a low-risk patient. Induration (firmness with palpation) must be present. If the
site has erythema but no induration, result would be negative. Color is not important.
All of the following are correct statements regarding the role of the person named in a
durable power of attorney except:
A) The agent's decisions are legally binding
B) The agent can make decisions in other areas of the patient's life such as financial
issues
C) The agent can decide for the patient who is on life support when that life support
can be terminated
D) The patient's spouse has a right to override the agent's decisions -ANSWER-D) The
patient's spouse has a right to override the agent's decisions
The person named in a durable power of attorney (the agent) is designated by the patient to
make all medical decisions, as well as any decisions regarding the patient's private affairs in
the event that the patient becomes incompetent and unable to make his/her own decisions.
No one has the ability to override the agent's decision.
All of the following are true statements regarding Munchausen syndrome except:
A) It is considered a mental illness
B) The patient has a medical illness that causes an anxiety reaction and denial
C) The patient fakes an illness in order to gain attention from health care providers
D) The patient has an inconsistent medical history along with a past history of
frequent hospitalizations -ANSWER-B) The patient has a medical illness that causes an
anxiety reaction and denial
