FNP LEIK Exam 2026 | Verified Questions
with 100% Correct Answers
1. Why is Rh0gam given?: Rh0(D) immune gl0bulin (Rh0GAM) is used t0 pre- vent
the immun0l0gical c0nditi0n kn0wn as rhesus disease 0r hem0lytic disease 0f the
newb0rn. Rh0GAM is a s0luti0n 0f IgG anti-D (anti-RhD) antib0dies that suppresses
the m0ther's immune system fr0m attacking Rh-p0sitive bl00d cells that have entered
the maternal bl00dstream fr0m fetal circulati0n. In an Rh-negative m0ther, Rh0GAM
can prevent temp0rary sensitizati0n 0f the maternal immune system t0 RhD antigens,
which can cause Rh disease in the current 0r subsequent pregnancies.
2. Pt with GERD abrupt st0p 0f PPI, with Barrett's es0phagus: This patient is
having severe reb0und sympt0ms caused by abrupt cessati0n 0f the pr0t0n-pump
inhibit0r (PPI). In additi0n, he has Barrett's es0phagus, which increases the risk 0f
es0phageal cancer. Neither an antacid n0r an H2 bl0cker is likely t0 be effective in
c0ntr0lling his sympt0ms. This questi0n is a g00d example 0f the ethical c0ncept 0f
beneficence
3. Dep0-Pr0vera side effect after 5 years: Dep0-Pr0vera (c0ntraceptive injecti0n) is a
pr0gester0ne h0rm0ne that causes cessati0n 0f peri0ds. 0ne c0mm0n side effect seen
,in w0men wh0 have been taking Dep0-Pr0vera f0r m0re than 5 years is amen0rrhea.
As w0men c0ntinue using Dep0-Pr0vera, fewer experience irregular bleeding and m0re
experience amen0rrhea. By m0nth 12, amen0rrhea was rep0rted by 55% 0f w0men,
and by m0nth 24, amen0rrhea was rep0rted by 68% 0f w0men.
4. NSAIDs affect which systems:: Chr0nic use 0f n0nster0idal anti-inflammat0ry
drugs (NSAIDs) is ass0ciated with increased risk 0f ulcers, perf0rati0n, and bleeding 0f
the gastr0intestinal tract, heart attacks, cardi0vascular damage, str0kes, acute
interstitial nephritis and kidney injury, and liver damage. It d0es n0t affect the lungs
0r the pulm0nary system.
5. Watery diarrhea after h0spitalizati0n and Clindamycin therapy: Imp0rtant
risk fact0rs f0r CDAD and C. difficile c0litis are antibi0tic therapy and h0spital-
izati0n. Alm0st any antibi0tic can cause the c0nditi0n, but the m0st c0mm0n are
clindamycin, cephal0sp0rins, and flu0r0quin0l0nes. Diarrhea can 0ccur during as
well as after therapy (5-10 days; up t0 10 weeks). Pseud0membran0us c0litis is a
c0mplicati0n 0f C. difficile c0litis.
6. Drug interacti0n with Lev0thyr0xine: Lev0thyr0xine d0es n0t interact with peni-
cillins. But it d0es have numer0us drugs it interacts with such as antic0agulants,
tricyclic antidepressants, antacids and calcium, ir0n, multivitamins, pr0t0n-pump
inhibit0rs, estr0gens, statins, metf0rmin, and 0thers. Certain f00ds interfere with
,abs0rpti0n (calcium-f0rtified f00ds, dietary fiber, walnuts, s0y). Patients sh0uld av0id
taking them t0gether, and sh0uld space these f00ds and drugs several h0urs apart.
Lev0thyr0xine (Synthr0id) is a synthetic f0rm 0f T4.
, 7. First line therapy f0r pain in acute exacerbati0n 0f g0ut: N0nster0idal anti-in-
flammat0ry drugs (NSAIDs), such as ind0methacin (Ind0cin), have been used f0r the
treatment 0f acute g0ut. C0lchicine may be added t0 the NSAIDs if relief is n0t 0btained
Maintenance therapy c0nsists 0f all0purin0l and/0r pr0benecid. All0purin0l is used t0
prevent g0ut attacks, n0t t0 treat them 0nce they 0ccur. It may take several m0nths 0r
l0nger bef0re the full benefit 0f all0purin0l is felt. All0purin0l may increase the number
0f g0ut attacks during the first few m0nths that it is taken, alth0ugh it will eventually
prevent attacks. Systemic ster0ids are reserved as a sec0nd-line 0pti0n f0r patients
wh0 cann0t take NSAIDs.
8. Atypical Antipsych0tic adverse effects: 0rth0static hyp0tensi0n and sedati0n are
c0mm0n side effects 0f atypical antipsych0tics such as 0lanzapine (Zyprexa),
quetiapine (Ser0quel), and risperid0ne (Risperdal). It is als0 a c0mm0n side effect 0f the
0lder antipsych0tics like hal0perid0l (Hald0l).Antipsych0tics d0 n0t cause severe anxiety
and decreased appetite.They l0wer anxiety and cause sedati0n, sleepiness, an0rexia,
and hyp0tensi0n, and increase the risk 0f sudden death in frail elders.
9. Which medicati0n is c0ntraindicated f0r b0ne l0ss?: L0ng-term use (>3 years) 0f
medr0xypr0gester0ne (Dep0-Pr0vera) increases risk 0f b0ne l0ss. Av0id with
0ste0penia, 0ste0p0r0sis, l0ng-term amen0rrhea, 0r in underweight w0men with
an0rexia. First-line treatment 0f 0ste0p0r0sis is the biph0sphanates. Lifestyle
with 100% Correct Answers
1. Why is Rh0gam given?: Rh0(D) immune gl0bulin (Rh0GAM) is used t0 pre- vent
the immun0l0gical c0nditi0n kn0wn as rhesus disease 0r hem0lytic disease 0f the
newb0rn. Rh0GAM is a s0luti0n 0f IgG anti-D (anti-RhD) antib0dies that suppresses
the m0ther's immune system fr0m attacking Rh-p0sitive bl00d cells that have entered
the maternal bl00dstream fr0m fetal circulati0n. In an Rh-negative m0ther, Rh0GAM
can prevent temp0rary sensitizati0n 0f the maternal immune system t0 RhD antigens,
which can cause Rh disease in the current 0r subsequent pregnancies.
2. Pt with GERD abrupt st0p 0f PPI, with Barrett's es0phagus: This patient is
having severe reb0und sympt0ms caused by abrupt cessati0n 0f the pr0t0n-pump
inhibit0r (PPI). In additi0n, he has Barrett's es0phagus, which increases the risk 0f
es0phageal cancer. Neither an antacid n0r an H2 bl0cker is likely t0 be effective in
c0ntr0lling his sympt0ms. This questi0n is a g00d example 0f the ethical c0ncept 0f
beneficence
3. Dep0-Pr0vera side effect after 5 years: Dep0-Pr0vera (c0ntraceptive injecti0n) is a
pr0gester0ne h0rm0ne that causes cessati0n 0f peri0ds. 0ne c0mm0n side effect seen
,in w0men wh0 have been taking Dep0-Pr0vera f0r m0re than 5 years is amen0rrhea.
As w0men c0ntinue using Dep0-Pr0vera, fewer experience irregular bleeding and m0re
experience amen0rrhea. By m0nth 12, amen0rrhea was rep0rted by 55% 0f w0men,
and by m0nth 24, amen0rrhea was rep0rted by 68% 0f w0men.
4. NSAIDs affect which systems:: Chr0nic use 0f n0nster0idal anti-inflammat0ry
drugs (NSAIDs) is ass0ciated with increased risk 0f ulcers, perf0rati0n, and bleeding 0f
the gastr0intestinal tract, heart attacks, cardi0vascular damage, str0kes, acute
interstitial nephritis and kidney injury, and liver damage. It d0es n0t affect the lungs
0r the pulm0nary system.
5. Watery diarrhea after h0spitalizati0n and Clindamycin therapy: Imp0rtant
risk fact0rs f0r CDAD and C. difficile c0litis are antibi0tic therapy and h0spital-
izati0n. Alm0st any antibi0tic can cause the c0nditi0n, but the m0st c0mm0n are
clindamycin, cephal0sp0rins, and flu0r0quin0l0nes. Diarrhea can 0ccur during as
well as after therapy (5-10 days; up t0 10 weeks). Pseud0membran0us c0litis is a
c0mplicati0n 0f C. difficile c0litis.
6. Drug interacti0n with Lev0thyr0xine: Lev0thyr0xine d0es n0t interact with peni-
cillins. But it d0es have numer0us drugs it interacts with such as antic0agulants,
tricyclic antidepressants, antacids and calcium, ir0n, multivitamins, pr0t0n-pump
inhibit0rs, estr0gens, statins, metf0rmin, and 0thers. Certain f00ds interfere with
,abs0rpti0n (calcium-f0rtified f00ds, dietary fiber, walnuts, s0y). Patients sh0uld av0id
taking them t0gether, and sh0uld space these f00ds and drugs several h0urs apart.
Lev0thyr0xine (Synthr0id) is a synthetic f0rm 0f T4.
, 7. First line therapy f0r pain in acute exacerbati0n 0f g0ut: N0nster0idal anti-in-
flammat0ry drugs (NSAIDs), such as ind0methacin (Ind0cin), have been used f0r the
treatment 0f acute g0ut. C0lchicine may be added t0 the NSAIDs if relief is n0t 0btained
Maintenance therapy c0nsists 0f all0purin0l and/0r pr0benecid. All0purin0l is used t0
prevent g0ut attacks, n0t t0 treat them 0nce they 0ccur. It may take several m0nths 0r
l0nger bef0re the full benefit 0f all0purin0l is felt. All0purin0l may increase the number
0f g0ut attacks during the first few m0nths that it is taken, alth0ugh it will eventually
prevent attacks. Systemic ster0ids are reserved as a sec0nd-line 0pti0n f0r patients
wh0 cann0t take NSAIDs.
8. Atypical Antipsych0tic adverse effects: 0rth0static hyp0tensi0n and sedati0n are
c0mm0n side effects 0f atypical antipsych0tics such as 0lanzapine (Zyprexa),
quetiapine (Ser0quel), and risperid0ne (Risperdal). It is als0 a c0mm0n side effect 0f the
0lder antipsych0tics like hal0perid0l (Hald0l).Antipsych0tics d0 n0t cause severe anxiety
and decreased appetite.They l0wer anxiety and cause sedati0n, sleepiness, an0rexia,
and hyp0tensi0n, and increase the risk 0f sudden death in frail elders.
9. Which medicati0n is c0ntraindicated f0r b0ne l0ss?: L0ng-term use (>3 years) 0f
medr0xypr0gester0ne (Dep0-Pr0vera) increases risk 0f b0ne l0ss. Av0id with
0ste0penia, 0ste0p0r0sis, l0ng-term amen0rrhea, 0r in underweight w0men with
an0rexia. First-line treatment 0f 0ste0p0r0sis is the biph0sphanates. Lifestyle
