LEIK FNP COMPREHENSIVE EXAM
PREP QUESTIONS AND ANSWERS
1. A 65-year-old patient presents with a harsh, crescendo-decrescendo systolic murmur heard
best at the second right intercostal space, which radiates to the carotid arteries. What is the
most likely diagnosis?
A. Mitral Regurgitation
B. Mitral Stenosis
C. Aortic Stenosis
D. Aortic Regurgitation
Answer: C
Conceptual Explanation: Aortic stenosis is characterized by a systolic murmur at the right
upper sternal border that radiates to the neck. It is common in elderly patients due to
calcification.
2. Which of the following findings is most characteristic of Grave’s Disease?
A. Positive TPO antibodies and cold intolerance
B. Weight gain and bradycardia
,C. Pretibial myxedema and exophthalmos
D. Delayed relaxation of deep tendon reflexes
Answer: C
Conceptual Explanation: Grave’s disease, an autoimmune hyperthyroidism, often
presents with specific findings like exophthalmos (bulging eyes) and pretibial myxedema
(skin thickening).
3. A patient with a history of hypertension and diabetes is found to have a blood pressure of
155/95 mmHg. According to JNC 8 guidelines, what is the initial recommended drug class for
this patient?
A. Beta-blocker
B. Calcium Channel Blocker
C. ACE Inhibitor or ARB
D. Loop Diuretic
Answer: C
Conceptual Explanation: For diabetic patients with hypertension, ACE inhibitors or ARBs
are first-line because they provide renal protection in addition to blood pressure control.
4. A 24-year-old female presents with a ‘herald patch’ followed by a ‘Christmas tree’
distribution of smaller maculopapular lesions on her back. What is the likely diagnosis?
A. Pityriasis Rosea
, B. Psoriasis
C. Tinea Corporis
D. Eczema
Answer: A
Conceptual Explanation: Pityriasis Rosea typically starts with a herald patch and evolves
into a Christmas tree pattern along skin cleavage lines.
5. Which of the following is the first-line treatment for an adult with Acute Bacterial
Rhinosinusitis who has no allergies?
A. Amoxicillin-Clavulanate
B. Azithromycin
C. Doxycycline
D. Levofloxacin
Answer: A
Conceptual Explanation: Amoxicillin-clavulanate (Augmentin) is the first-line antibiotic
choice due to its coverage against S. pneumoniae and H. influenzae.
6. What is the goal A1C for a healthy 70-year-old patient with few co-morbidities?
A. Less than 7.0%
B. Less than 6.0%
PREP QUESTIONS AND ANSWERS
1. A 65-year-old patient presents with a harsh, crescendo-decrescendo systolic murmur heard
best at the second right intercostal space, which radiates to the carotid arteries. What is the
most likely diagnosis?
A. Mitral Regurgitation
B. Mitral Stenosis
C. Aortic Stenosis
D. Aortic Regurgitation
Answer: C
Conceptual Explanation: Aortic stenosis is characterized by a systolic murmur at the right
upper sternal border that radiates to the neck. It is common in elderly patients due to
calcification.
2. Which of the following findings is most characteristic of Grave’s Disease?
A. Positive TPO antibodies and cold intolerance
B. Weight gain and bradycardia
,C. Pretibial myxedema and exophthalmos
D. Delayed relaxation of deep tendon reflexes
Answer: C
Conceptual Explanation: Grave’s disease, an autoimmune hyperthyroidism, often
presents with specific findings like exophthalmos (bulging eyes) and pretibial myxedema
(skin thickening).
3. A patient with a history of hypertension and diabetes is found to have a blood pressure of
155/95 mmHg. According to JNC 8 guidelines, what is the initial recommended drug class for
this patient?
A. Beta-blocker
B. Calcium Channel Blocker
C. ACE Inhibitor or ARB
D. Loop Diuretic
Answer: C
Conceptual Explanation: For diabetic patients with hypertension, ACE inhibitors or ARBs
are first-line because they provide renal protection in addition to blood pressure control.
4. A 24-year-old female presents with a ‘herald patch’ followed by a ‘Christmas tree’
distribution of smaller maculopapular lesions on her back. What is the likely diagnosis?
A. Pityriasis Rosea
, B. Psoriasis
C. Tinea Corporis
D. Eczema
Answer: A
Conceptual Explanation: Pityriasis Rosea typically starts with a herald patch and evolves
into a Christmas tree pattern along skin cleavage lines.
5. Which of the following is the first-line treatment for an adult with Acute Bacterial
Rhinosinusitis who has no allergies?
A. Amoxicillin-Clavulanate
B. Azithromycin
C. Doxycycline
D. Levofloxacin
Answer: A
Conceptual Explanation: Amoxicillin-clavulanate (Augmentin) is the first-line antibiotic
choice due to its coverage against S. pneumoniae and H. influenzae.
6. What is the goal A1C for a healthy 70-year-old patient with few co-morbidities?
A. Less than 7.0%
B. Less than 6.0%
