LEIK FNP LATEST 2026 PRACTICE EXAM QUESTIONS
AND SOLUTIONS RATED A+
✔✔All of the following are complications of severe preeclampsia except: - ✔✔Placenta
previa
Severe preeclampsia can cause placental abruption, but not placenta previa (placenta
implants over internal os). Serious complications include hypertensive encephalopathy,
liver failure, kidney failure, pulmonary edema, seizures, retinal detachment,
disseminated intravascular coagulation, and death.
✔✔Fetal TORCH infections: - ✔✔he 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 do not
comprise the TORCH disorders.
✔✔Which is a MINOR criterion that is not required for diagnosis of PID? - ✔✔Oral temp
>101F (38C)
Pelvic inflammatory disease (PID) is a clinical diagnosis. The presence of at least one of
the major criteria (cervical motion tenderness, adnexal tenderness, uterine tenderness)
when combined with the history is highly suggestive of PID. Minor criteria are not
necessary, but they help to support the diagnosis of PID (oral temperature >101°F
[>38°C]), mucopurulent cervical or vaginal discharge, elevated sedimentation rate,
elevated C-reactive protein, large amount of WBCs on saline microscopy of the vaginal
fluid, or laboratory documentation of cervical infection with Neisseria gonorrhoeae or
Chlamydia trachomatis).
✔✔A 28-year-old multipara who is at 32 weeks gestation presents to your office
complaining of a sudden onset of small amounts of bright-red vaginal bleeding. She has
had several episodes and appears anxious. On exam, her uterus is soft to palpation.
Which of the following is most likely? - ✔✔Placenta Previa
Placenta previa occurs when the placenta implants abnormally, partially, or wholly, in
the lower segment of the uterus or over the internal os. A classic presentation is
painless bright-red vaginal bleeding in the second and/or third trimester. Do not perform
digital cervical in any pregnant women with bleeding until the position of the uterus is
known (abdominal ultrasound). Avoid vaginal exam, sexual intercourse, or rectal exam if
placenta previa is suspected.
✔✔A 30-year-old woman who is sexually active complains of a large amount of milk-like
vaginal discharge for several weeks. A microscopy slide reveals a large number of cells
that have blurred margins. Very few white blood cells are seen. The vaginal pH is at 6.0.
What is most likely? - ✔✔In bacterial vaginosis (BV), the normal hydrogen peroxide-
producing lactobacilli are replaced by an overgrowth of anaerobic bacteria. BV is a
,vaginosis (does not cause inflammation) rather than a vaginitis. No symptoms may be
present or the patient's history may include strong vaginal odor ("fishy" odor) and
increased vaginal discharge (milky white, thin, adherent discharge or dull gray
discharge). Findings include alkaline pH greater than 4.5, the presence of clue cells
(wet smear using microscopy), and positive "whiff test" (a strong "fishy" odor when
vaginal discharge is mixed with one drop of potassium hydroxide [KOH]). Clue cells are
squamous epithelial cells dotted with large numbers of bacteria that obscure borders.
✔✔A young primigravida reports to you that she is starting to feel the baby's
movements in her uterus. This is considered to be which of the following? -
✔✔Presumptive sign
Presumptive signs are sensations that are felt by the mother, but they could also be
caused by other conditions. They are some of the earliest symptoms of pregnancy, such
as nausea, fatigue, breast tenderness, amenorrhea, and quickening (16 to 20 weeks).
✔✔You are reviewing a Pap smear result for a 25-year-old woman. Which of the
following cells should be obtained in a Pap smear sample to be classified as a
satisfactory specimen? - ✔✔An optimal Pap smear sample contains sufficient mature
and metaplastic squamous cells to indicate adequate sampling from the transformation
zone and sufficient endocervical cells to indicate that the upper limit of the
transformation zone was sampled, and to provide a sample for screening for
adenocarcinoma and its precursors.
✔✔Which of the following findings is most likely in young primigravidas with pregnancy-
induced hypertension? - ✔✔Common signs and symptoms of pregnancy-induced
hypertension include edema of the face and the upper extremities, weight gain, blurred
vision, elevated blood pressure, proteinuria, and headaches.
✔✔Precocious puberty is defined as the onset of secondary sexual characteristics
before the age of: - ✔✔Before 8 yo in girls, before 9 yo in boys
✔✔A patient diagnosed with bacterial vaginosis should be advised that her male sexual
partner: - ✔✔Bacterial vaginosis is a bacterial infection, but is not considered a sexually
transmitted disease for which the partner needs treatment. Studies show that men
rarely carry this infection.
✔✔A 25-year-old woman presents with severe right-sided pelvic pain that began 48
hours ago. She reports small amounts of vaginal bleeding. The pain is aggravated by
jumping or any movement that jars her pelvis. The best initial intervention is which of the
following? - ✔✔Severe right-sided pain with vaginal bleeding in a 25-year-old patient
requires an evaluation for pregnancy by initially performing a urine hCGtest, which can
be done quickly in the primary care clinic. A serum hCGtest can also be drawn at the
same visit. If a ruptured ectopic pregnancy is suspected, call 911
,✔✔A postmenopausal woman complains of random episodes of vaginal bleeding for the
past 6 months. Which of the following is recommended management for this condition?
- ✔✔Random episodes of vaginal bleeding in a postmenopausal woman are not normal.
Endometrial biopsy is needed to evaluate a specimen of the endometrial lining for
abnormal cells, which may indicate cancer.
✔✔A 44-year-old woman who is undergoing treatment for infertility complains of not
having had a menstrual period for a few months. The night before, she started spotting
and is now having cramp-like pains in her pelvic area. Her blood pressure (BP) is
160/80 mmHg, pulse is 110 beats/min, and she is afebrile. Her labs reveal mild anemia
with mild leukocytosis. On pelvic exam, the uterine fundus is noted to be above the
symphysis pubis. The cervical os is dilated at 3 cm. Which of the following is most
likely? - ✔✔Inevitable abortion
Inevitable abortion is defined as vaginal bleeding with pain, cervical dilation, and/or
cervical effacement. Threatened abortion is defined as vaginal bleeding with absent or
minimal pain and a closed, long, and thick cervix. Incomplete abortion involves
moderate to diffuse vaginal bleeding, with the passage of tissue and painful uterine
cramping or contractions. Acute pelvic inflammatory disease is a sudden onset of
inflammation and pain that affects the pelvic area, cervix, uterus, and ovaries, and is
caused by infection.
✔✔Primary carbohydrate in breast milk and formula - ✔✔lactose
✔✔Hegar's signs is considered: - ✔✔Hegar's sign is softening of the lower portion of the
uterus and is considered a probable sign of pregnancy.
✔✔A girl whose breasts form a secondary mound is at which Tanner stage? - ✔✔The
breast bud stage is Tanner stage II. In Tanner stage IV, the areola and papilla form a
secondary mound. Tanner stages for breast development are I, prepuberty; II, breast
bud; III, breast and areola one mound; IV, breast and areola secondary mound; and V,
adult pattern.
✔✔Fundus at 20 weeks gestation - ✔✔level of umbilicus
✔✔The Pap smear result for a 22-year-old sexually active college student whose
partner uses condoms inconsistently reveals a large number of white blood cells and
blood along with inflammatory changes. During the speculum exam, the cervix bled very
easily (friable), and a small amount of purulent discharge was present on the cervical
surface. No cervical motion tenderness was noted during the bimanual vaginal exam.
What is the next step in the management of this patient? - ✔✔The patient has signs and
symptoms of mucopurulent cervicitis (friable cervix, purulent discharge) and should be
tested for chlamydia and gonorrhea. Empiric treatment for mucopurulent cervicitis
should be started (doxycycline BID for 7 days) even if these tests are negative, but the
, patient's cervix appears infected. Douching increases the risk of pelvic inflammatory
disease (PID) and is not recommended.
✔✔A 22-year-old sexually active woman is complaining of amenorrhea and new-onset
bloody vaginal spotting. On examination, her left adnexa is tender and cervical motion
tenderness is positive. Which test should the nurse practitioner order initially? - ✔✔urine
pregnancy test
The patient's history of amenorrhea and new onset of bloody vaginal spotting combined
with positive physical findings of left adnexal tenderness and cervical motion tenderness
are highly suggestive of an ectopic pregnancy rather than pelvic inflammatory disease
(PID). Refer this patient to the emergency department if ectopic pregnancy is
suspected. The presence of amenorrhea should be treated as a pregnancy until proven
otherwise.
✔✔The following are acceptable methods of birth control for breastfeeding mothers
except: - ✔✔Low-dose oral contraceptives that contain estradiol are contraindicated for
breastfeeding mothers. Estrogen is an FDA pregnancy category X drug and it should
not be given to pregnant, suspect pregnant, or breastfeeding women. Breastfeeding
women may use progestin-only pills (POP), but they are not as effective as combined
oral contraceptives. They are more effective if breastfeeding (100%). Mechanical forms
of birth control (condoms, diaphragms) and the IUDare other options of birth control for
this population.
✔✔A 25-year-old woman complains of dysuria, severe vaginal pruritus, and a
malodorous vaginal discharge. Pelvic examination reveals a strawberry-colored cervix
and frothy yellow discharge. Microscopic examination of the discharge reveals mobile
organisms that have flagella. The correct pharmacological therapy for the condition is: -
✔✔Trichomoniasis symptoms include dysuria, severe vaginal pruritus, and malodorous
vaginal discharge. Wet prep microscopic examination should show trichomonads that
are pear-shaped and have several flagella (whiplike tails) at one end. The Centers for
Disease Control and Prevention (CDC) recommendation for treatment is metronidazole.
A single dose is effective treatment in most cases of Trichomonasinfections.
✔✔A pelvic exam on a woman who is 12 weeks pregnant would reveal that her uterus
is located at which of the following areas? - ✔✔At 12 weeks gestation, the uterus is
approximately the size of a grapefruit and would be felt just above the suprapubic bone
on bimanual exam.
✔✔Treatment for mild preeclampsia includes all of the following except: -
✔✔Recommended care for women diagnosed with preeclampsia includes bed rest with
bathroom privileges, weight and blood pressure monitoring, and closely following urine
protein and serum protein, creatinine, and platelet counts. Oral medications are not
used as first-line treatment.
AND SOLUTIONS RATED A+
✔✔All of the following are complications of severe preeclampsia except: - ✔✔Placenta
previa
Severe preeclampsia can cause placental abruption, but not placenta previa (placenta
implants over internal os). Serious complications include hypertensive encephalopathy,
liver failure, kidney failure, pulmonary edema, seizures, retinal detachment,
disseminated intravascular coagulation, and death.
✔✔Fetal TORCH infections: - ✔✔he 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 do not
comprise the TORCH disorders.
✔✔Which is a MINOR criterion that is not required for diagnosis of PID? - ✔✔Oral temp
>101F (38C)
Pelvic inflammatory disease (PID) is a clinical diagnosis. The presence of at least one of
the major criteria (cervical motion tenderness, adnexal tenderness, uterine tenderness)
when combined with the history is highly suggestive of PID. Minor criteria are not
necessary, but they help to support the diagnosis of PID (oral temperature >101°F
[>38°C]), mucopurulent cervical or vaginal discharge, elevated sedimentation rate,
elevated C-reactive protein, large amount of WBCs on saline microscopy of the vaginal
fluid, or laboratory documentation of cervical infection with Neisseria gonorrhoeae or
Chlamydia trachomatis).
✔✔A 28-year-old multipara who is at 32 weeks gestation presents to your office
complaining of a sudden onset of small amounts of bright-red vaginal bleeding. She has
had several episodes and appears anxious. On exam, her uterus is soft to palpation.
Which of the following is most likely? - ✔✔Placenta Previa
Placenta previa occurs when the placenta implants abnormally, partially, or wholly, in
the lower segment of the uterus or over the internal os. A classic presentation is
painless bright-red vaginal bleeding in the second and/or third trimester. Do not perform
digital cervical in any pregnant women with bleeding until the position of the uterus is
known (abdominal ultrasound). Avoid vaginal exam, sexual intercourse, or rectal exam if
placenta previa is suspected.
✔✔A 30-year-old woman who is sexually active complains of a large amount of milk-like
vaginal discharge for several weeks. A microscopy slide reveals a large number of cells
that have blurred margins. Very few white blood cells are seen. The vaginal pH is at 6.0.
What is most likely? - ✔✔In bacterial vaginosis (BV), the normal hydrogen peroxide-
producing lactobacilli are replaced by an overgrowth of anaerobic bacteria. BV is a
,vaginosis (does not cause inflammation) rather than a vaginitis. No symptoms may be
present or the patient's history may include strong vaginal odor ("fishy" odor) and
increased vaginal discharge (milky white, thin, adherent discharge or dull gray
discharge). Findings include alkaline pH greater than 4.5, the presence of clue cells
(wet smear using microscopy), and positive "whiff test" (a strong "fishy" odor when
vaginal discharge is mixed with one drop of potassium hydroxide [KOH]). Clue cells are
squamous epithelial cells dotted with large numbers of bacteria that obscure borders.
✔✔A young primigravida reports to you that she is starting to feel the baby's
movements in her uterus. This is considered to be which of the following? -
✔✔Presumptive sign
Presumptive signs are sensations that are felt by the mother, but they could also be
caused by other conditions. They are some of the earliest symptoms of pregnancy, such
as nausea, fatigue, breast tenderness, amenorrhea, and quickening (16 to 20 weeks).
✔✔You are reviewing a Pap smear result for a 25-year-old woman. Which of the
following cells should be obtained in a Pap smear sample to be classified as a
satisfactory specimen? - ✔✔An optimal Pap smear sample contains sufficient mature
and metaplastic squamous cells to indicate adequate sampling from the transformation
zone and sufficient endocervical cells to indicate that the upper limit of the
transformation zone was sampled, and to provide a sample for screening for
adenocarcinoma and its precursors.
✔✔Which of the following findings is most likely in young primigravidas with pregnancy-
induced hypertension? - ✔✔Common signs and symptoms of pregnancy-induced
hypertension include edema of the face and the upper extremities, weight gain, blurred
vision, elevated blood pressure, proteinuria, and headaches.
✔✔Precocious puberty is defined as the onset of secondary sexual characteristics
before the age of: - ✔✔Before 8 yo in girls, before 9 yo in boys
✔✔A patient diagnosed with bacterial vaginosis should be advised that her male sexual
partner: - ✔✔Bacterial vaginosis is a bacterial infection, but is not considered a sexually
transmitted disease for which the partner needs treatment. Studies show that men
rarely carry this infection.
✔✔A 25-year-old woman presents with severe right-sided pelvic pain that began 48
hours ago. She reports small amounts of vaginal bleeding. The pain is aggravated by
jumping or any movement that jars her pelvis. The best initial intervention is which of the
following? - ✔✔Severe right-sided pain with vaginal bleeding in a 25-year-old patient
requires an evaluation for pregnancy by initially performing a urine hCGtest, which can
be done quickly in the primary care clinic. A serum hCGtest can also be drawn at the
same visit. If a ruptured ectopic pregnancy is suspected, call 911
,✔✔A postmenopausal woman complains of random episodes of vaginal bleeding for the
past 6 months. Which of the following is recommended management for this condition?
- ✔✔Random episodes of vaginal bleeding in a postmenopausal woman are not normal.
Endometrial biopsy is needed to evaluate a specimen of the endometrial lining for
abnormal cells, which may indicate cancer.
✔✔A 44-year-old woman who is undergoing treatment for infertility complains of not
having had a menstrual period for a few months. The night before, she started spotting
and is now having cramp-like pains in her pelvic area. Her blood pressure (BP) is
160/80 mmHg, pulse is 110 beats/min, and she is afebrile. Her labs reveal mild anemia
with mild leukocytosis. On pelvic exam, the uterine fundus is noted to be above the
symphysis pubis. The cervical os is dilated at 3 cm. Which of the following is most
likely? - ✔✔Inevitable abortion
Inevitable abortion is defined as vaginal bleeding with pain, cervical dilation, and/or
cervical effacement. Threatened abortion is defined as vaginal bleeding with absent or
minimal pain and a closed, long, and thick cervix. Incomplete abortion involves
moderate to diffuse vaginal bleeding, with the passage of tissue and painful uterine
cramping or contractions. Acute pelvic inflammatory disease is a sudden onset of
inflammation and pain that affects the pelvic area, cervix, uterus, and ovaries, and is
caused by infection.
✔✔Primary carbohydrate in breast milk and formula - ✔✔lactose
✔✔Hegar's signs is considered: - ✔✔Hegar's sign is softening of the lower portion of the
uterus and is considered a probable sign of pregnancy.
✔✔A girl whose breasts form a secondary mound is at which Tanner stage? - ✔✔The
breast bud stage is Tanner stage II. In Tanner stage IV, the areola and papilla form a
secondary mound. Tanner stages for breast development are I, prepuberty; II, breast
bud; III, breast and areola one mound; IV, breast and areola secondary mound; and V,
adult pattern.
✔✔Fundus at 20 weeks gestation - ✔✔level of umbilicus
✔✔The Pap smear result for a 22-year-old sexually active college student whose
partner uses condoms inconsistently reveals a large number of white blood cells and
blood along with inflammatory changes. During the speculum exam, the cervix bled very
easily (friable), and a small amount of purulent discharge was present on the cervical
surface. No cervical motion tenderness was noted during the bimanual vaginal exam.
What is the next step in the management of this patient? - ✔✔The patient has signs and
symptoms of mucopurulent cervicitis (friable cervix, purulent discharge) and should be
tested for chlamydia and gonorrhea. Empiric treatment for mucopurulent cervicitis
should be started (doxycycline BID for 7 days) even if these tests are negative, but the
, patient's cervix appears infected. Douching increases the risk of pelvic inflammatory
disease (PID) and is not recommended.
✔✔A 22-year-old sexually active woman is complaining of amenorrhea and new-onset
bloody vaginal spotting. On examination, her left adnexa is tender and cervical motion
tenderness is positive. Which test should the nurse practitioner order initially? - ✔✔urine
pregnancy test
The patient's history of amenorrhea and new onset of bloody vaginal spotting combined
with positive physical findings of left adnexal tenderness and cervical motion tenderness
are highly suggestive of an ectopic pregnancy rather than pelvic inflammatory disease
(PID). Refer this patient to the emergency department if ectopic pregnancy is
suspected. The presence of amenorrhea should be treated as a pregnancy until proven
otherwise.
✔✔The following are acceptable methods of birth control for breastfeeding mothers
except: - ✔✔Low-dose oral contraceptives that contain estradiol are contraindicated for
breastfeeding mothers. Estrogen is an FDA pregnancy category X drug and it should
not be given to pregnant, suspect pregnant, or breastfeeding women. Breastfeeding
women may use progestin-only pills (POP), but they are not as effective as combined
oral contraceptives. They are more effective if breastfeeding (100%). Mechanical forms
of birth control (condoms, diaphragms) and the IUDare other options of birth control for
this population.
✔✔A 25-year-old woman complains of dysuria, severe vaginal pruritus, and a
malodorous vaginal discharge. Pelvic examination reveals a strawberry-colored cervix
and frothy yellow discharge. Microscopic examination of the discharge reveals mobile
organisms that have flagella. The correct pharmacological therapy for the condition is: -
✔✔Trichomoniasis symptoms include dysuria, severe vaginal pruritus, and malodorous
vaginal discharge. Wet prep microscopic examination should show trichomonads that
are pear-shaped and have several flagella (whiplike tails) at one end. The Centers for
Disease Control and Prevention (CDC) recommendation for treatment is metronidazole.
A single dose is effective treatment in most cases of Trichomonasinfections.
✔✔A pelvic exam on a woman who is 12 weeks pregnant would reveal that her uterus
is located at which of the following areas? - ✔✔At 12 weeks gestation, the uterus is
approximately the size of a grapefruit and would be felt just above the suprapubic bone
on bimanual exam.
✔✔Treatment for mild preeclampsia includes all of the following except: -
✔✔Recommended care for women diagnosed with preeclampsia includes bed rest with
bathroom privileges, weight and blood pressure monitoring, and closely following urine
protein and serum protein, creatinine, and platelet counts. Oral medications are not
used as first-line treatment.
