LEIK FNP
600+ Practice Questions
Answers with detailed Rationales
What You’ll Get:
• 600+ FNP practice questions
• Detailed answer rationales for deeper understanding
• Board-style and exam-focused content
• High-yield topics for efficient studying
Not affiliated with LEIK, AANP, ANCC, or any official testing
organization. For study purposes only.
,1. 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
Correct Answer: B. It inhibits the effect of renal prostaglandins and blunts the
effectiveness of the diuretic.
Expert Rationale: 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
Correct Answer: D. Chlamydia trachomatis
Expert Rationale: 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.
,3. The nurse practitioner would test the obturator and iliopsoas muscle to evaluate for:
A. Cholecystitis
B. Acute appendicitis
C. Inguinal hernia
D. Gastriculcer
Correct Answer: B. Acute appendicitis.
Expert Rationale: 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.
4. 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
Correct Answer: D. A prescription of methyldopa (Aldomet) to control blood pressure
Expert Rationale: 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.
5. 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
Correct Answer: C. Nursing home care
Expert Rationale: 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.
,6. 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
Correct Answer: B. Mycoplasma pneumonia
Expert Rationale: 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.
7. 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
Correct Answer: C. 10 mm
Expert Rationale: 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.
8. 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
Correct Answer: D. The patient's spouse has a right to override the agent's decisions
Expert Rationale: 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.
,9. 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
Correct Answer: B. The patient has a medical illness that causes an anxiety reaction and
denial
Expert Rationale: Munchausen syndrome is a psychiatric disorder in which the patient fakes a
medical illness or disorder to gain attention from health care provid- ers. These patients
commonly use the emergency department frequently to gain attention.
10. Which of the following antihypertensive medications should the nurse practitioner
avoid when treating patients with emphysema?
A. Calcium channel blockers
B. Angiotensin-converting enzyme (ACE) inhibitors
C. Beta-blockers
D. Diuretics
Correct Answer: C. Beta-blockers
Expert Rationale: Beta-blockers should be avoided in patients with a history of emphysema.
Studies have shown evidence of a reduction in forced expiratory volume in 1 second (FEV1),
increased airway hyperresponsiveness, and inhibition of bronchodilator response to beta
agonists in patients receiving non-selective betablockers and high doses of cardioselective
beta-blockers.
11. A 30-year-old chef complains of pruritic hives over her chest and arms but denies
difficulty swallowing or breathing. She reports a family history of allergic rhinitis and
asthma. Which of the following interventions is most appropriate?
A. Perform a complete and thorough history
B. Prescribe an oral antihistamine such as diphenhydramine 25 mg PO QID
C. Give an injection of epinephrine 1:1000 intramuscularly stat
D. Call 911
Correct Answer: A. Perform a complete and thorough history
Expert Rationale: Prior to prescribing medications, a complete and thorough history must be
performed to determine possible causes of hives. The patient denied difficulty with swallowing
and breathing, so there was no medical emergency to require calling 911.
,12. Which of the following findings is most likely in young primigravidas with
pregnancyinduced hypertension?
A. Abdominal cramping and constipation
B. Edema of the face and the upper extremities
C. Shortness of breath
D. Dysuria and frequency
Correct Answer: B. Edema of the face and the upper extremities
Expert Rationale: Common signs and symptoms of pregnancy-induced hypertension include
edema of the face and the upper extremities, weight gain, blurred vision, elevated BP,
proteinuria, and headaches.
13. Which of the following symptoms is associated with B12 deficiency anemia?
A. Spoon-shaped nails and pica
B. An abnormal neurological exam
C. A vegan diet
D. Tingling and numbness of both feet
Correct Answer: D. Tingling and numbness of both feet
Expert Rationale: Vitamin B12 deficiency anemia can cause nerve cell damage if not treated.
Symptoms of B12 deficiency anemia may include tingling or numbness in fingers and toes,
difficulty walking, mood changes or depression, memory loss, disorientation, and dementia.
14. A second triple screen on a 35-year-old primigravida reveals abnormally low lev- els
of the alpha fetoprotein and estriol and high levels of human chorionic gonad- otropin.
Which of the following interventions is the best choice for this patient?
A. Order an ultrasound
B. Order a computed tomography (CT) scan of the abdomen
C. Order a 24-hour urine for protein clearance
D. Assess for a history of illicit drug or alcohol use
Correct Answer: A. Order an ultrasound
Expert Rationale: 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.
,15. All of the following are true statements about diverticula except:
A. Diverticula are located in the colon
B. A low-fiber diet is associated with the condition
C. Most diverticula in the colon are infected with gram-negative bacteria
D. Supplementingwithfibersuchaspsyllium(Meta mucil)isrecommended
Correct Answer: C. Most diverticula in the colon are infected with gram-negative bacteria
Expert Rationale: Diverticuli in the colon can be infected with both gram-negative and gram-
positive bacteria.
16. Patients who are diagnosed with gonorrhea should also be treated for which of the
following infections?
A. Chancroid
B. Chlamydia trachomatis
C. Herpes genitalis
D. PID (pelvic inflammatory disease)
Correct Answer: B. Chlamydia trachomatis
Expert Rationale: When diagnosed with gonorrhea, the patient should also be treated for
Chlamydia trachomatis.
17. Kyphosis is a late sign of:
A. Old age
B. Osteopenia
C. Osteoporosis
D. Osteoarthritis
Correct Answer: C. Osteoporosis
Expert Rationale: Kyphosis is a curvature of the spine that causes a rounding of the back,
which leads to a slouching posture. Severe thinning of the bones (osteoporosis) contributes to
this curvature in the spine. Symptoms that may occur with severe cases of kyphosis include
difficulty breathing, fatigue, and back pain.
,18. A 35-year-old primigravida who is at 28 weeks of gestation is expecting twins. What
would you would expect her alpha fetoprotein (AFP) values to be?
A. Normal
B. Higher than normal
C. Lower than normal
D. None of the above
Correct Answer: B. Higher than normal
Expert Rationale: Alpha fetoprotein is produced in the fetal and maternal liver. Higher levels of
alpha fetoprotein are commonly seen in multiple gestations due to the growing fetuses and
enlargement of the livers.
19. Which of the following antihypertensive medications has beneficial effects for an
elderly White female with osteoporosis?
A. Calcium channel blocker
B. Angiotensin-converting enzyme (ACE) inhibitor
C. Beta-blocker
D. Diuretic
Correct Answer: A. Calcium channel blocker
Expert Rationale: Calcium channel blockers act by blocking the cal- cium channels in the heart
muscle and the blood vessels, thereby keeping more calcium in the bones.
20. The Lachman maneuver is used to detect which of the following?
A. Knee instability
B. Nerve damage of the knee due to past knee injuries
C. The integrity of the patellar tendon
D. Tears on the meniscus of the knee
Correct Answer: A. Knee instability
Expert Rationale: The Lachman maneuver is a test performed to assess for knee instability.
Knee instability indicates a tear of the anterior cruciate ligament.
21. When an adolescent male's penis grows more in length than width, at which of the
following Tanner stages is he classified?
A. Tanner Stage II
B. Tanner Stage III
C. Tanner Stage IV
D. Tanner Stage V
Correct Answer: B. Tanner Stage III
Expert Rationale: Tanner Stage III in males consists of penis lengthening and darker, coarse
pubic hair, which begins to curl
,22. Fetal TORCH infections can cause microcephaly, mental retardation, hepatospleno-
megaly, and intrauterine growth retardation. The acronym TORCH stands for:
A. Toxoplasma gondii, other infections, rubella, cytomegalovirus, and herpes
B. Toxic shock syndrome, ocular infections, rubella, cytomegalovirus, and herpes zoster
C. Tetanus, ophthalmic infections, roseola, cancer, and head abnormalities
D. Toxins, other infections, roseola, candidiasis, and head abnormalities
Correct Answer: A. Toxoplasmagondii, other infections, rubella, cytomegalovirus, and
herpes
Expert Rationale: The acronym TORCH stands for Toxoplasma gondii, other infections,
rubella, cytomegalovirus, and herpes. Although several of the conditions listed in the other
answer options can also cause fetal problems, they are not included in the TORCH acronym.
23. Human papilloma virus (HPV) infection of the larynx has been associated with:
A. Laryngeal neoplasia
B. Esophageal stricture
C. Cervical cancer
D. Metaplasia of esophageal squamous cells
Correct Answer: A. Laryngeal neoplasia
Expert Rationale: HPV infection of the larynx has been associated with laryngeal neoplasia;
HPV infection of the cervix is associated with cervical cancer.
24. Mr. Brown is a 65-year-old carpenter complaining of morning stiffness and pain in
both his hands and right knee upon awakening. He feels some relief after warming up.
On exam, the nurse notices the presence of Heberden's nodes. Which of the fol- lowing
is most likely?
A. Osteoporosis
B. Rheumatoid arthritis
C. Degenerative joint disease
D. Reiter's syndrome
Correct Answer: C. Degenerative joint disease
Expert Rationale: Heberden's nodes are commonly seen in degenerative joint disease.
Heberden's nodes are bony nodules located on the distal interphalangeal joints (DIPs).
, 25. What does a positive posterior drawer sign in a 10-year-old soccer player signify?
A. An abnormal knee
B. Instability of the knee
C. A large amount of swelling on the knee
D. An injury of the meniscus
Correct Answer: B. Instability of the knee
Expert Rationale: The drawer sign is performed on the knee or ankle to assess for knee
instability. The affected knee will have more laxity when compared to the unaffected knee.
26. A multigravida who is at 28 weeks of gestation has a fundal height of 29 cm. Which of
the following is the best recommendation for this patient?
A. Advise the mother that her pregnancy is progressing well
B. Order an ultrasound of the uterus
C. Refer her to an obstetrician for an amniocentesis
D. Recommend bed rest with bathroom privileges
Correct Answer: A. Advise the mother that her pregnancy is progressing well
Expert Rationale: From 20-35 weeks' gestation, fundal height should equal weeks gestation. If
greater than 2 cm within the gestational week of pregnancy, further testing should be performed
to evaluate fetal growth
27. A multigravida who is at 34 weeks of gestation wants to know at what level her
uterine fundus should be. The best answer is to advise the mother that her fun- dus is:
A. Midway between the umbilicus and the lower ribs
B. At the level of the umbilicus
C. From 33 to 35 cm
D. From 32 to 34 cm
Correct Answer: C. From 33 to 35 cm
Expert Rationale: After 20 weeks gestation, fundal height in centimeters should measure
approximately the same as the number of weeks of gestation
600+ Practice Questions
Answers with detailed Rationales
What You’ll Get:
• 600+ FNP practice questions
• Detailed answer rationales for deeper understanding
• Board-style and exam-focused content
• High-yield topics for efficient studying
Not affiliated with LEIK, AANP, ANCC, or any official testing
organization. For study purposes only.
,1. 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
Correct Answer: B. It inhibits the effect of renal prostaglandins and blunts the
effectiveness of the diuretic.
Expert Rationale: 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
Correct Answer: D. Chlamydia trachomatis
Expert Rationale: 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.
,3. The nurse practitioner would test the obturator and iliopsoas muscle to evaluate for:
A. Cholecystitis
B. Acute appendicitis
C. Inguinal hernia
D. Gastriculcer
Correct Answer: B. Acute appendicitis.
Expert Rationale: 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.
4. 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
Correct Answer: D. A prescription of methyldopa (Aldomet) to control blood pressure
Expert Rationale: 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.
5. 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
Correct Answer: C. Nursing home care
Expert Rationale: 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.
,6. 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
Correct Answer: B. Mycoplasma pneumonia
Expert Rationale: 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.
7. 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
Correct Answer: C. 10 mm
Expert Rationale: 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.
8. 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
Correct Answer: D. The patient's spouse has a right to override the agent's decisions
Expert Rationale: 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.
,9. 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
Correct Answer: B. The patient has a medical illness that causes an anxiety reaction and
denial
Expert Rationale: Munchausen syndrome is a psychiatric disorder in which the patient fakes a
medical illness or disorder to gain attention from health care provid- ers. These patients
commonly use the emergency department frequently to gain attention.
10. Which of the following antihypertensive medications should the nurse practitioner
avoid when treating patients with emphysema?
A. Calcium channel blockers
B. Angiotensin-converting enzyme (ACE) inhibitors
C. Beta-blockers
D. Diuretics
Correct Answer: C. Beta-blockers
Expert Rationale: Beta-blockers should be avoided in patients with a history of emphysema.
Studies have shown evidence of a reduction in forced expiratory volume in 1 second (FEV1),
increased airway hyperresponsiveness, and inhibition of bronchodilator response to beta
agonists in patients receiving non-selective betablockers and high doses of cardioselective
beta-blockers.
11. A 30-year-old chef complains of pruritic hives over her chest and arms but denies
difficulty swallowing or breathing. She reports a family history of allergic rhinitis and
asthma. Which of the following interventions is most appropriate?
A. Perform a complete and thorough history
B. Prescribe an oral antihistamine such as diphenhydramine 25 mg PO QID
C. Give an injection of epinephrine 1:1000 intramuscularly stat
D. Call 911
Correct Answer: A. Perform a complete and thorough history
Expert Rationale: Prior to prescribing medications, a complete and thorough history must be
performed to determine possible causes of hives. The patient denied difficulty with swallowing
and breathing, so there was no medical emergency to require calling 911.
,12. Which of the following findings is most likely in young primigravidas with
pregnancyinduced hypertension?
A. Abdominal cramping and constipation
B. Edema of the face and the upper extremities
C. Shortness of breath
D. Dysuria and frequency
Correct Answer: B. Edema of the face and the upper extremities
Expert Rationale: Common signs and symptoms of pregnancy-induced hypertension include
edema of the face and the upper extremities, weight gain, blurred vision, elevated BP,
proteinuria, and headaches.
13. Which of the following symptoms is associated with B12 deficiency anemia?
A. Spoon-shaped nails and pica
B. An abnormal neurological exam
C. A vegan diet
D. Tingling and numbness of both feet
Correct Answer: D. Tingling and numbness of both feet
Expert Rationale: Vitamin B12 deficiency anemia can cause nerve cell damage if not treated.
Symptoms of B12 deficiency anemia may include tingling or numbness in fingers and toes,
difficulty walking, mood changes or depression, memory loss, disorientation, and dementia.
14. A second triple screen on a 35-year-old primigravida reveals abnormally low lev- els
of the alpha fetoprotein and estriol and high levels of human chorionic gonad- otropin.
Which of the following interventions is the best choice for this patient?
A. Order an ultrasound
B. Order a computed tomography (CT) scan of the abdomen
C. Order a 24-hour urine for protein clearance
D. Assess for a history of illicit drug or alcohol use
Correct Answer: A. Order an ultrasound
Expert Rationale: 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.
,15. All of the following are true statements about diverticula except:
A. Diverticula are located in the colon
B. A low-fiber diet is associated with the condition
C. Most diverticula in the colon are infected with gram-negative bacteria
D. Supplementingwithfibersuchaspsyllium(Meta mucil)isrecommended
Correct Answer: C. Most diverticula in the colon are infected with gram-negative bacteria
Expert Rationale: Diverticuli in the colon can be infected with both gram-negative and gram-
positive bacteria.
16. Patients who are diagnosed with gonorrhea should also be treated for which of the
following infections?
A. Chancroid
B. Chlamydia trachomatis
C. Herpes genitalis
D. PID (pelvic inflammatory disease)
Correct Answer: B. Chlamydia trachomatis
Expert Rationale: When diagnosed with gonorrhea, the patient should also be treated for
Chlamydia trachomatis.
17. Kyphosis is a late sign of:
A. Old age
B. Osteopenia
C. Osteoporosis
D. Osteoarthritis
Correct Answer: C. Osteoporosis
Expert Rationale: Kyphosis is a curvature of the spine that causes a rounding of the back,
which leads to a slouching posture. Severe thinning of the bones (osteoporosis) contributes to
this curvature in the spine. Symptoms that may occur with severe cases of kyphosis include
difficulty breathing, fatigue, and back pain.
,18. A 35-year-old primigravida who is at 28 weeks of gestation is expecting twins. What
would you would expect her alpha fetoprotein (AFP) values to be?
A. Normal
B. Higher than normal
C. Lower than normal
D. None of the above
Correct Answer: B. Higher than normal
Expert Rationale: Alpha fetoprotein is produced in the fetal and maternal liver. Higher levels of
alpha fetoprotein are commonly seen in multiple gestations due to the growing fetuses and
enlargement of the livers.
19. Which of the following antihypertensive medications has beneficial effects for an
elderly White female with osteoporosis?
A. Calcium channel blocker
B. Angiotensin-converting enzyme (ACE) inhibitor
C. Beta-blocker
D. Diuretic
Correct Answer: A. Calcium channel blocker
Expert Rationale: Calcium channel blockers act by blocking the cal- cium channels in the heart
muscle and the blood vessels, thereby keeping more calcium in the bones.
20. The Lachman maneuver is used to detect which of the following?
A. Knee instability
B. Nerve damage of the knee due to past knee injuries
C. The integrity of the patellar tendon
D. Tears on the meniscus of the knee
Correct Answer: A. Knee instability
Expert Rationale: The Lachman maneuver is a test performed to assess for knee instability.
Knee instability indicates a tear of the anterior cruciate ligament.
21. When an adolescent male's penis grows more in length than width, at which of the
following Tanner stages is he classified?
A. Tanner Stage II
B. Tanner Stage III
C. Tanner Stage IV
D. Tanner Stage V
Correct Answer: B. Tanner Stage III
Expert Rationale: Tanner Stage III in males consists of penis lengthening and darker, coarse
pubic hair, which begins to curl
,22. Fetal TORCH infections can cause microcephaly, mental retardation, hepatospleno-
megaly, and intrauterine growth retardation. The acronym TORCH stands for:
A. Toxoplasma gondii, other infections, rubella, cytomegalovirus, and herpes
B. Toxic shock syndrome, ocular infections, rubella, cytomegalovirus, and herpes zoster
C. Tetanus, ophthalmic infections, roseola, cancer, and head abnormalities
D. Toxins, other infections, roseola, candidiasis, and head abnormalities
Correct Answer: A. Toxoplasmagondii, other infections, rubella, cytomegalovirus, and
herpes
Expert Rationale: The acronym TORCH stands for Toxoplasma gondii, other infections,
rubella, cytomegalovirus, and herpes. Although several of the conditions listed in the other
answer options can also cause fetal problems, they are not included in the TORCH acronym.
23. Human papilloma virus (HPV) infection of the larynx has been associated with:
A. Laryngeal neoplasia
B. Esophageal stricture
C. Cervical cancer
D. Metaplasia of esophageal squamous cells
Correct Answer: A. Laryngeal neoplasia
Expert Rationale: HPV infection of the larynx has been associated with laryngeal neoplasia;
HPV infection of the cervix is associated with cervical cancer.
24. Mr. Brown is a 65-year-old carpenter complaining of morning stiffness and pain in
both his hands and right knee upon awakening. He feels some relief after warming up.
On exam, the nurse notices the presence of Heberden's nodes. Which of the fol- lowing
is most likely?
A. Osteoporosis
B. Rheumatoid arthritis
C. Degenerative joint disease
D. Reiter's syndrome
Correct Answer: C. Degenerative joint disease
Expert Rationale: Heberden's nodes are commonly seen in degenerative joint disease.
Heberden's nodes are bony nodules located on the distal interphalangeal joints (DIPs).
, 25. What does a positive posterior drawer sign in a 10-year-old soccer player signify?
A. An abnormal knee
B. Instability of the knee
C. A large amount of swelling on the knee
D. An injury of the meniscus
Correct Answer: B. Instability of the knee
Expert Rationale: The drawer sign is performed on the knee or ankle to assess for knee
instability. The affected knee will have more laxity when compared to the unaffected knee.
26. A multigravida who is at 28 weeks of gestation has a fundal height of 29 cm. Which of
the following is the best recommendation for this patient?
A. Advise the mother that her pregnancy is progressing well
B. Order an ultrasound of the uterus
C. Refer her to an obstetrician for an amniocentesis
D. Recommend bed rest with bathroom privileges
Correct Answer: A. Advise the mother that her pregnancy is progressing well
Expert Rationale: From 20-35 weeks' gestation, fundal height should equal weeks gestation. If
greater than 2 cm within the gestational week of pregnancy, further testing should be performed
to evaluate fetal growth
27. A multigravida who is at 34 weeks of gestation wants to know at what level her
uterine fundus should be. The best answer is to advise the mother that her fun- dus is:
A. Midway between the umbilicus and the lower ribs
B. At the level of the umbilicus
C. From 33 to 35 cm
D. From 32 to 34 cm
Correct Answer: C. From 33 to 35 cm
Expert Rationale: After 20 weeks gestation, fundal height in centimeters should measure
approximately the same as the number of weeks of gestation
