LEIK FNP LATEST EXAMS SCRIPT ALL QUESTIONS
AND ANSWERS SURE A+
✔✔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 - ✔✔A)
Toxoplasmagondii, other infections, rubella, cytomegalovirus, and herpes
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.
✔✔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 - ✔✔A) Laryngeal neoplasia
HPV infection of the larynx has been associated with laryngeal neoplasia; HPV infection
of the cervix is associated with cervical cancer.
✔✔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 - ✔✔C) Degenerative joint disease
Heberden's nodes are commonly seen in degenerative joint disease. Heberden's nodes
are bony nodules located on the distal interphalangeal joints (DIPs).
✔✔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 - ✔✔B) Instability of the knee
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.
✔✔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 - ✔✔A) Advise the mother that her
pregnancy is progressing well
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
✔✔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 - ✔✔C) From 33 to 35 cm
After 20 weeks gestation, fundal height in centimeters should measure approximately
the same as the number of weeks of gestation
✔✔Which of the following laboratory tests is used in primary care to evaluate renal
function?
A) Electrolyte panel
B) Creatinine
C) Alkaline phosphatase
D) Blood urea nitrogen (BUN) to creatinine ratio - ✔✔B) Creatinine
Serum creatinine is measured to evaluate renal function. Creatinine is the end product
of creatine metabolism. Creatinine clearance is not affected by fluid or dietary intake of
meat.
✔✔All of the following are false statements regarding acute gastritis except:
A) Chronic intake of nonsteroidal anti-inflammatory drugs (NSAIDs) can cause the
disorder
B) Chronic lack of dietary fiber is the main cause of the disorder
C) The screening test for the disorder is the barium swallow test
D) The gold standard to evaluate the disorder is a colonoscopy - ✔✔C) The screening
test for the disorder is the barium swallow test
The gold standard for diagnosing gastric disease is biopsy of gastric and/or duodenal
tissue by upper endoscopy. Chronic use of NSAIDs disrupts the production of
prostaglandins, which decreases blood supply and then breaks down the protective
layer of the mucosa, which leads to gastric disease.
✔✔Signs and symptoms of depression include all of the following except:
A) Anhedonia and changes in appetite
B) Decreased energy and irritability
C) Apathy and low self-esteem
D) Apraxia and fatigue - ✔✔D) Apraxia and fatigue
Apraxia is a disorder of the nervous system in which the brain is affected and the patient
is unable to move the arms/legs when asked to do so. Common signs of depression
include anhedonia (loss of interest in activities that the patient finds pleasurable),
unintentional weight loss or gain, fatigue, change in appetite, insomnia or hypersomnia,
feelings of guilt and worthlessness, and recurrent thoughts of suicide.
, ✔✔Which of the following is an accurate description of eliciting for Murphy's sign?
A) Upon deep inspiration by the patient, palpate firmly in the right upper quad- rant of
the abdomen below the costovertebral angle
B) Bend the patient's hips and knees at 90 degrees, then passively rotate hip exter-
nally, then internally
C) Ask the patient to squat, then place the stethoscope on the apical area
D) Press into the abdomen deeply, then release it suddenly - ✔✔A) Upon deep
inspiration by the patient, palpate firmly in the right upper quad- rant of the abdomen
below the costovertebral angle
Murphy's sign is positive if pain occurs when performing RUQ palpation while the
patient takes a deep inspiration, causing the patient to abruptly stop the deep breath
due to pain. As the liver is palpated, it will descend and push up against the inflamed
gallbladder and cause sharp pain (cholecystitis).
✔✔A 28-year-old multipara who is at 32 weeks of 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?
A) Placenta abruptio
B) Placenta previa
C) Acute cervicitis
D) Molar pregnancy (hydatidiform mole) - ✔✔B) Placenta previa
Placenta previa occurs when abnormal implantation of the placenta occurs. A common
symptom of placenta previa is painless, bright red bleeding.
✔✔Epidemiologic studies show that Hashimoto's disease occurs most commonly in:
A) Middle-aged to older women
B) Smokers
C) Obese individuals
D) Older men - ✔✔A) Middle-aged to older women
Hashimoto's disease commonly occurs in middle-aged to older women.
✔✔A 48-year-old woman is told by a physician that she is starting menopause. All of the
following are possible findings except:
A) Hot flashes
AND ANSWERS SURE A+
✔✔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 - ✔✔A)
Toxoplasmagondii, other infections, rubella, cytomegalovirus, and herpes
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.
✔✔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 - ✔✔A) Laryngeal neoplasia
HPV infection of the larynx has been associated with laryngeal neoplasia; HPV infection
of the cervix is associated with cervical cancer.
✔✔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 - ✔✔C) Degenerative joint disease
Heberden's nodes are commonly seen in degenerative joint disease. Heberden's nodes
are bony nodules located on the distal interphalangeal joints (DIPs).
✔✔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 - ✔✔B) Instability of the knee
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.
✔✔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 - ✔✔A) Advise the mother that her
pregnancy is progressing well
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
✔✔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 - ✔✔C) From 33 to 35 cm
After 20 weeks gestation, fundal height in centimeters should measure approximately
the same as the number of weeks of gestation
✔✔Which of the following laboratory tests is used in primary care to evaluate renal
function?
A) Electrolyte panel
B) Creatinine
C) Alkaline phosphatase
D) Blood urea nitrogen (BUN) to creatinine ratio - ✔✔B) Creatinine
Serum creatinine is measured to evaluate renal function. Creatinine is the end product
of creatine metabolism. Creatinine clearance is not affected by fluid or dietary intake of
meat.
✔✔All of the following are false statements regarding acute gastritis except:
A) Chronic intake of nonsteroidal anti-inflammatory drugs (NSAIDs) can cause the
disorder
B) Chronic lack of dietary fiber is the main cause of the disorder
C) The screening test for the disorder is the barium swallow test
D) The gold standard to evaluate the disorder is a colonoscopy - ✔✔C) The screening
test for the disorder is the barium swallow test
The gold standard for diagnosing gastric disease is biopsy of gastric and/or duodenal
tissue by upper endoscopy. Chronic use of NSAIDs disrupts the production of
prostaglandins, which decreases blood supply and then breaks down the protective
layer of the mucosa, which leads to gastric disease.
✔✔Signs and symptoms of depression include all of the following except:
A) Anhedonia and changes in appetite
B) Decreased energy and irritability
C) Apathy and low self-esteem
D) Apraxia and fatigue - ✔✔D) Apraxia and fatigue
Apraxia is a disorder of the nervous system in which the brain is affected and the patient
is unable to move the arms/legs when asked to do so. Common signs of depression
include anhedonia (loss of interest in activities that the patient finds pleasurable),
unintentional weight loss or gain, fatigue, change in appetite, insomnia or hypersomnia,
feelings of guilt and worthlessness, and recurrent thoughts of suicide.
, ✔✔Which of the following is an accurate description of eliciting for Murphy's sign?
A) Upon deep inspiration by the patient, palpate firmly in the right upper quad- rant of
the abdomen below the costovertebral angle
B) Bend the patient's hips and knees at 90 degrees, then passively rotate hip exter-
nally, then internally
C) Ask the patient to squat, then place the stethoscope on the apical area
D) Press into the abdomen deeply, then release it suddenly - ✔✔A) Upon deep
inspiration by the patient, palpate firmly in the right upper quad- rant of the abdomen
below the costovertebral angle
Murphy's sign is positive if pain occurs when performing RUQ palpation while the
patient takes a deep inspiration, causing the patient to abruptly stop the deep breath
due to pain. As the liver is palpated, it will descend and push up against the inflamed
gallbladder and cause sharp pain (cholecystitis).
✔✔A 28-year-old multipara who is at 32 weeks of 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?
A) Placenta abruptio
B) Placenta previa
C) Acute cervicitis
D) Molar pregnancy (hydatidiform mole) - ✔✔B) Placenta previa
Placenta previa occurs when abnormal implantation of the placenta occurs. A common
symptom of placenta previa is painless, bright red bleeding.
✔✔Epidemiologic studies show that Hashimoto's disease occurs most commonly in:
A) Middle-aged to older women
B) Smokers
C) Obese individuals
D) Older men - ✔✔A) Middle-aged to older women
Hashimoto's disease commonly occurs in middle-aged to older women.
✔✔A 48-year-old woman is told by a physician that she is starting menopause. All of the
following are possible findings except:
A) Hot flashes