JEN LEIK FNP Practice Questions &
Answers
What is the name of the immune process that is responsible for anaphylactic reactions?
A) IgE-mediated reaction
B) Serious allergic reaction
C) Antibody reaction
D) Atopic reaction ✔️✔️A) IgE-mediated reaction
Anaphylaxis is an immunoglobulin E (IgE)-mediated reaction (also known as IgE-mediated type
2). IgE immediate reactions such as anaphylaxis trigger mast cell degranulation and release of
potent mediators such as histamines, leukotrienes, and prostaglandins, which immediately induce
con- striction of smooth muscle, swelling, vasodilation, and other pathologic changes in the body
that may be fatal.
A 76-year-old woman reports that for the previous 4 months, she has noticed severe stiffness and
aching in her neck and both shoulders and hips that is worsened by movement. She reports
having a difficult time getting out of bed because of the severe stiffness and pain. It is difficult
for her to put on a jacket or blouse or to fasten her bra. Along with these symptoms, she also has
a low-grade fever, fatigue, loss of appetite, and weight loss. Starting yesterday, the vision in her
,right eye has progressively worsened. She has annual eye exams and denies that she has
glaucoma. Which of the following conditions is most likely?
A) Rheumatoid arthritis (RA)
B) Degenerative joint disease
C) Polymyalgia rheumatica (PMR)
D) Fibromyalgia ✔️✔️C) Polymyalgia rheumatica(PMR)
Polymyalgia rheumatica (PMR )is associated with a high risk of giant cell arteritis (GCA) or
temporal arteritis (15%-30%). The new onset of vision loss and the location of the pain (neck,
both shoulders/hips) are the most important clues. PMR is a rheumatic condition that involves
joints and the arteries. Temporal arteritis can cause permanent blindness. The sedimentation rate
is very high (40 mm/hr to 100 mm/hr). Almost all will have elevated C-reactive protein levels
(up to 99%). These patients are managed by rheumatologists via long-term steroids.
A 50-year-old woman of Irish descent presents with history of lethargy, feeling weak, nausea,
anorexia with diarrhea and abdominal pain. The woman's skin appears tanned, but she denies
prolonged sun exposure. During physical exam, the skin appears tan with hyperpigmentation of
the nipple area, the gums, and the lips. The electrolyte panel reveals hyperkalemia and
hyponatremia. She reports craving salty foods. Which of the following is most likely?
A) Addison's disease
B) Cushing's disease
,C) Metabolic syndrome
D) Cutaneous drug reaction ✔️✔️A) Addison's disease
Addison's disease is also known as primary adrenal insufficiency. The most common cause of
damage to the adrenal cortex (the outer layer of the gland) is autoimmune destruction. The
adrenal cortex produces glucocorticoids (cortisol) and mineralocorticoids (aldosterone).
Aldosterone regulates sodium retention and potassium excretion through the kidneys (affects
blood pressure). Electrolyte abnormalities are high potassium and low sodium. In primary
disease (Addison's), serum cortisol is low, ACTH is high, and serum aldosterone is low. If the
patient is not treated, severe stress (illness, accident) may cause an adrenal crisis ("Addisonian"
crisis), which can be fatal.
An elderly Hispanic male has been taking finasteride (Proscar) for several months. The nurse
practitioner decides to check the prostate specific antigen (PSA). The PSA result is 10 ng/mL.
The patient's baseline PSA was 30 ng/mL. Which of the following is the next step?
A) Add the baseline PSA value to the treatment PSA value
B) The treatment PSA value is the correct value
C) Multiply the treatment PSA value by 2
D) Divide the baseline PSA value by the treatment PSA value ✔️✔️C) Multiply the treatment
PSA value by 2
, Before starting a prescription of Proscar, obtain the baseline PSA. Recheck the PSA again within
2 to 3 months during treatment to assess the patient's response (treatment PSA). For this
example, the corrected treatment PSA is 20 (multiply 10 x 2 = 20). When com- paring the
corrected treatment PSA (20) with the baseline PSA (30), the value is lower (means the prostate
has shrunk in size). The patient's symptoms will also improve, including less nocturia, less
dribbling, and stronger urinary stream.
A nurse practitioner is teaching a 54-year-old woman with stress urinary incontinence about
Kegel exercises. The patient is instructed to tighten her pelvic floor muscles for a count of 10 and
then to relax them for a count of 10. The nurse practitioner instructs the patient that Kegel
exercises should be done consistently every day at what frequency?
A) Perform 30 exercises each time in the morning and the evening
B) Perform 20 exercises each time 2 times a day
C) Perform 15 exercises each time 3 to 4 times a day
D) Perform 10 exercises each time 3 times a day ✔️✔️D) Perform 10 exercises each time 3
times a day
Weak pelvic floor muscles increase the risk of urinary and fecal incontinence. Educate a female
patient that the pelvic floor muscles are the ones that she uses when she consciously holds/ stops
the flow of urine when she urinates. Warn her that the anal sphincter will also tighten with the
vaginal muscles. Advise the patient to relax the abdomen and the thighs when doing the
Answers
What is the name of the immune process that is responsible for anaphylactic reactions?
A) IgE-mediated reaction
B) Serious allergic reaction
C) Antibody reaction
D) Atopic reaction ✔️✔️A) IgE-mediated reaction
Anaphylaxis is an immunoglobulin E (IgE)-mediated reaction (also known as IgE-mediated type
2). IgE immediate reactions such as anaphylaxis trigger mast cell degranulation and release of
potent mediators such as histamines, leukotrienes, and prostaglandins, which immediately induce
con- striction of smooth muscle, swelling, vasodilation, and other pathologic changes in the body
that may be fatal.
A 76-year-old woman reports that for the previous 4 months, she has noticed severe stiffness and
aching in her neck and both shoulders and hips that is worsened by movement. She reports
having a difficult time getting out of bed because of the severe stiffness and pain. It is difficult
for her to put on a jacket or blouse or to fasten her bra. Along with these symptoms, she also has
a low-grade fever, fatigue, loss of appetite, and weight loss. Starting yesterday, the vision in her
,right eye has progressively worsened. She has annual eye exams and denies that she has
glaucoma. Which of the following conditions is most likely?
A) Rheumatoid arthritis (RA)
B) Degenerative joint disease
C) Polymyalgia rheumatica (PMR)
D) Fibromyalgia ✔️✔️C) Polymyalgia rheumatica(PMR)
Polymyalgia rheumatica (PMR )is associated with a high risk of giant cell arteritis (GCA) or
temporal arteritis (15%-30%). The new onset of vision loss and the location of the pain (neck,
both shoulders/hips) are the most important clues. PMR is a rheumatic condition that involves
joints and the arteries. Temporal arteritis can cause permanent blindness. The sedimentation rate
is very high (40 mm/hr to 100 mm/hr). Almost all will have elevated C-reactive protein levels
(up to 99%). These patients are managed by rheumatologists via long-term steroids.
A 50-year-old woman of Irish descent presents with history of lethargy, feeling weak, nausea,
anorexia with diarrhea and abdominal pain. The woman's skin appears tanned, but she denies
prolonged sun exposure. During physical exam, the skin appears tan with hyperpigmentation of
the nipple area, the gums, and the lips. The electrolyte panel reveals hyperkalemia and
hyponatremia. She reports craving salty foods. Which of the following is most likely?
A) Addison's disease
B) Cushing's disease
,C) Metabolic syndrome
D) Cutaneous drug reaction ✔️✔️A) Addison's disease
Addison's disease is also known as primary adrenal insufficiency. The most common cause of
damage to the adrenal cortex (the outer layer of the gland) is autoimmune destruction. The
adrenal cortex produces glucocorticoids (cortisol) and mineralocorticoids (aldosterone).
Aldosterone regulates sodium retention and potassium excretion through the kidneys (affects
blood pressure). Electrolyte abnormalities are high potassium and low sodium. In primary
disease (Addison's), serum cortisol is low, ACTH is high, and serum aldosterone is low. If the
patient is not treated, severe stress (illness, accident) may cause an adrenal crisis ("Addisonian"
crisis), which can be fatal.
An elderly Hispanic male has been taking finasteride (Proscar) for several months. The nurse
practitioner decides to check the prostate specific antigen (PSA). The PSA result is 10 ng/mL.
The patient's baseline PSA was 30 ng/mL. Which of the following is the next step?
A) Add the baseline PSA value to the treatment PSA value
B) The treatment PSA value is the correct value
C) Multiply the treatment PSA value by 2
D) Divide the baseline PSA value by the treatment PSA value ✔️✔️C) Multiply the treatment
PSA value by 2
, Before starting a prescription of Proscar, obtain the baseline PSA. Recheck the PSA again within
2 to 3 months during treatment to assess the patient's response (treatment PSA). For this
example, the corrected treatment PSA is 20 (multiply 10 x 2 = 20). When com- paring the
corrected treatment PSA (20) with the baseline PSA (30), the value is lower (means the prostate
has shrunk in size). The patient's symptoms will also improve, including less nocturia, less
dribbling, and stronger urinary stream.
A nurse practitioner is teaching a 54-year-old woman with stress urinary incontinence about
Kegel exercises. The patient is instructed to tighten her pelvic floor muscles for a count of 10 and
then to relax them for a count of 10. The nurse practitioner instructs the patient that Kegel
exercises should be done consistently every day at what frequency?
A) Perform 30 exercises each time in the morning and the evening
B) Perform 20 exercises each time 2 times a day
C) Perform 15 exercises each time 3 to 4 times a day
D) Perform 10 exercises each time 3 times a day ✔️✔️D) Perform 10 exercises each time 3
times a day
Weak pelvic floor muscles increase the risk of urinary and fecal incontinence. Educate a female
patient that the pelvic floor muscles are the ones that she uses when she consciously holds/ stops
the flow of urine when she urinates. Warn her that the anal sphincter will also tighten with the
vaginal muscles. Advise the patient to relax the abdomen and the thighs when doing the
