LEIK FNP FINAL EXAM QUESTIONS
AND ANSWERS (2026/2027)
1. A 65-year-old male with a history of hypertension and chronic kidney disease (Stage 3)
presents for a follow-up. Which of the following antihypertensive medications is most
appropriate for renal protection?
A. Amlodipine
B. Metoprolol
C. Hydrochlorothiazide
D. Lisinopril
Answer: D
Conceptual Explanation: ACE inhibitors like Lisinopril or ARBs are the first-line
treatment for patients with CKD and hypertension because they provide renoprotective
effects by reducing intraglomerular pressure and proteinuria.
2. A 24-year-old female presents with a midsystolic click followed by a late systolic murmur at
the apex. What is the most likely diagnosis?
A. Mitral Valve Prolapse
,B. Aortic Stenosis
C. Mitral Regurgitation
D. Atrial Septal Defect
Answer: A
Conceptual Explanation: Mitral Valve Prolapse (MVP) is classically characterized by a
midsystolic click, often followed by a late systolic murmur best heard at the apex.
3. A patient tests positive for H. pylori. Which of the following is the recommended first-line
‘quadruple therapy’ regimen?
A. Amoxicillin, Clarithromycin, and Omeprazole
B. Ciprofloxacin, Metronidazole, Tetracycline, and a PPI
C. Azithromycin, Amoxicillin, Metronidazole, and a PPI
D. Bismuth subsalicylate, Metronidazole, Tetracycline, and a PPI
Answer: D
Conceptual Explanation: Bismuth-based quadruple therapy (Bismuth, Metronidazole,
Tetracycline, and a PPI) is a preferred first-line treatment for H. pylori, especially in areas
with high clarithromycin resistance.
4. According to the GINA guidelines, a patient with asthma who has symptoms more than
twice a month but not daily is classified as:
A. Intermittent (Step 1)
, B. Moderate Persistent (Step 3)
C. Mild Persistent (Step 2)
D. Severe Persistent (Step 4)
Answer: C
Conceptual Explanation: Mild persistent asthma involves symptoms more than twice a
week but less than daily. Step 2 therapy usually involves low-dose inhaled corticosteroids
(ICS) or PRN ICS-formoterol.
5. A 35-year-old female presents with weight loss, heat intolerance, and a fine tremor. Her
TSH is < 0.01 mIU/L and Free T4 is elevated. What is the most likely diagnosis?
A. Graves’ Disease
B. Hashimoto’s Thyroiditis
C. Subacute Thyroiditis
D. Myxedema Coma
Answer: A
Conceptual Explanation: Low TSH and high Free T4 indicate hyperthyroidism. Graves’
disease is the most common cause, often presenting with weight loss, tremor, and
exophthalmos.
AND ANSWERS (2026/2027)
1. A 65-year-old male with a history of hypertension and chronic kidney disease (Stage 3)
presents for a follow-up. Which of the following antihypertensive medications is most
appropriate for renal protection?
A. Amlodipine
B. Metoprolol
C. Hydrochlorothiazide
D. Lisinopril
Answer: D
Conceptual Explanation: ACE inhibitors like Lisinopril or ARBs are the first-line
treatment for patients with CKD and hypertension because they provide renoprotective
effects by reducing intraglomerular pressure and proteinuria.
2. A 24-year-old female presents with a midsystolic click followed by a late systolic murmur at
the apex. What is the most likely diagnosis?
A. Mitral Valve Prolapse
,B. Aortic Stenosis
C. Mitral Regurgitation
D. Atrial Septal Defect
Answer: A
Conceptual Explanation: Mitral Valve Prolapse (MVP) is classically characterized by a
midsystolic click, often followed by a late systolic murmur best heard at the apex.
3. A patient tests positive for H. pylori. Which of the following is the recommended first-line
‘quadruple therapy’ regimen?
A. Amoxicillin, Clarithromycin, and Omeprazole
B. Ciprofloxacin, Metronidazole, Tetracycline, and a PPI
C. Azithromycin, Amoxicillin, Metronidazole, and a PPI
D. Bismuth subsalicylate, Metronidazole, Tetracycline, and a PPI
Answer: D
Conceptual Explanation: Bismuth-based quadruple therapy (Bismuth, Metronidazole,
Tetracycline, and a PPI) is a preferred first-line treatment for H. pylori, especially in areas
with high clarithromycin resistance.
4. According to the GINA guidelines, a patient with asthma who has symptoms more than
twice a month but not daily is classified as:
A. Intermittent (Step 1)
, B. Moderate Persistent (Step 3)
C. Mild Persistent (Step 2)
D. Severe Persistent (Step 4)
Answer: C
Conceptual Explanation: Mild persistent asthma involves symptoms more than twice a
week but less than daily. Step 2 therapy usually involves low-dose inhaled corticosteroids
(ICS) or PRN ICS-formoterol.
5. A 35-year-old female presents with weight loss, heat intolerance, and a fine tremor. Her
TSH is < 0.01 mIU/L and Free T4 is elevated. What is the most likely diagnosis?
A. Graves’ Disease
B. Hashimoto’s Thyroiditis
C. Subacute Thyroiditis
D. Myxedema Coma
Answer: A
Conceptual Explanation: Low TSH and high Free T4 indicate hyperthyroidism. Graves’
disease is the most common cause, often presenting with weight loss, tremor, and
exophthalmos.
