LEIK EXAM EDGE FNP REVIEW ACTUAL
QUESTIONS AND CORRECT ANSWERS
◉ An older adult male presents with complaints of sharp flank and
back pain. The patient has difficulty answering questions because of
severity of pain. Blood pressure is 90/60 mmHg. The patient has a
20-pack-year smoking history. Abdomen is distended upon
palpitation. Which diagnosis is most likely?
Congestive heart failure
Infective endocarditis
Dissecting abdominal aortic aneurysm
Acute myocardial infarction.
Answer: Dissecting abdominal aortic aneurysm.
Dissecting abdominal aortic aneurysm is a sudden onset of severe,
sharp, excruciating pain located in the abdomen, back, or flank area,
accompanied by a distended abdomen and hypotension. Older male
adults with a smoking history and hypertension are at higher risk.
Congestive heart failure symptoms are dyspnea, fatigue, dry cough,
and swollen feet and ankles. Patients with infective endocarditis
present with fever, chills, and malaise, along with the presence of a
new murmur. Acute myocardial infarction generally presents with a
gradual onset of intense and heavy chest discomfort that feels like a
squeezing, tightness, and heavy pressure in the chest.
,◉ Mrs. Harris a 67-year-old woman who is in the early stages of
Alzheimer disease. She suffers from mild dementia. In this type of
Alzheimer dementia which of the following would you use as the
mainstay treatment?
Vitamin E 1000 IU twice daily
cholinesterase inhibitors
NSAIDS
Selgiline 5 mg twice daily.
Answer: cholinesterase inhibitors
The mainstay treatment for mild to moderate stage Alzheimer-type
dementia is the use of cholinesterase inhibitors. These include
donepezil (Aricept), rivastigmine (Exelon), and galantamine
(Razadyne). They have a clear, although minor and time-limited
benefit.
◉ When listening to your 86-year-old patient's heart murmur, you
note that it is so loud that it can be heard with the stethoscope
completely off the chest. How do you grade the murmur?
IV/VI.
I/VI.
V/VI.
,VI/VI..
Answer: VI/VI.
Grading heart murmurs follows this system: I/VI: Heart murmur
makes faint sound and may not be heard when patient changes
position. II/VI: Heart murmur is quiet but can be heard as soon as
the stethoscope is placed on the chest. III/VI: Heart murmur is
moderately loud. IV/VI: Heart murmur is loud and accompanied by a
palpable thrill. V/VI: Heart murmur is very loud and can be heard
with the stethoscope partially off the chest. VI/VI: Heart murmur is
very loud and can be heard with the stethoscope completely off the
patient's chest.
◉ Which of the following persons would not be a candidate for the
antipneumococcal vaccine?
a 65-year-old healthy female living with her family
a 35-year-old patient with HIV infection
a 58-year-old male resident of a nursing home
a 55-year-old female living alone.
Answer: a 55-year-old female living alone
The antipneumococcal vaccine is not indicated for an otherwise
healthy person who is under the age of 65 unless there are other
health factors involved. Living alone has no bearing on the need for
, the vaccine. The vaccine is indicated for persons with HIV infection,
persons living in nursing homes, and all adults 65 years or older
regardless of health status.
◉ Which of the following diseases is more likely to cause chronic
pelvic pain rather than acute pelvic pain?
ectopic pregnancy
PID
ovarian cysts
interstitial cystitis.
Answer: interstitial cystitisInterstitial cystitis is more likely to cause
chronic pelvic pain rather than acute pelvic pain as in the other
choices. Other causes of chronic pelvic pain include: endometriosis,
leiomyomas, and malignancy.
◉ You have a 58-year-old male patient with possible pancreatic
cancer. You will not order an abdominal ultrasound for diagnosis
because it is limited by which of the following?
previous history of pancreatic disease
patient's age
the presence of intestinal gas
size of tumor.
QUESTIONS AND CORRECT ANSWERS
◉ An older adult male presents with complaints of sharp flank and
back pain. The patient has difficulty answering questions because of
severity of pain. Blood pressure is 90/60 mmHg. The patient has a
20-pack-year smoking history. Abdomen is distended upon
palpitation. Which diagnosis is most likely?
Congestive heart failure
Infective endocarditis
Dissecting abdominal aortic aneurysm
Acute myocardial infarction.
Answer: Dissecting abdominal aortic aneurysm.
Dissecting abdominal aortic aneurysm is a sudden onset of severe,
sharp, excruciating pain located in the abdomen, back, or flank area,
accompanied by a distended abdomen and hypotension. Older male
adults with a smoking history and hypertension are at higher risk.
Congestive heart failure symptoms are dyspnea, fatigue, dry cough,
and swollen feet and ankles. Patients with infective endocarditis
present with fever, chills, and malaise, along with the presence of a
new murmur. Acute myocardial infarction generally presents with a
gradual onset of intense and heavy chest discomfort that feels like a
squeezing, tightness, and heavy pressure in the chest.
,◉ Mrs. Harris a 67-year-old woman who is in the early stages of
Alzheimer disease. She suffers from mild dementia. In this type of
Alzheimer dementia which of the following would you use as the
mainstay treatment?
Vitamin E 1000 IU twice daily
cholinesterase inhibitors
NSAIDS
Selgiline 5 mg twice daily.
Answer: cholinesterase inhibitors
The mainstay treatment for mild to moderate stage Alzheimer-type
dementia is the use of cholinesterase inhibitors. These include
donepezil (Aricept), rivastigmine (Exelon), and galantamine
(Razadyne). They have a clear, although minor and time-limited
benefit.
◉ When listening to your 86-year-old patient's heart murmur, you
note that it is so loud that it can be heard with the stethoscope
completely off the chest. How do you grade the murmur?
IV/VI.
I/VI.
V/VI.
,VI/VI..
Answer: VI/VI.
Grading heart murmurs follows this system: I/VI: Heart murmur
makes faint sound and may not be heard when patient changes
position. II/VI: Heart murmur is quiet but can be heard as soon as
the stethoscope is placed on the chest. III/VI: Heart murmur is
moderately loud. IV/VI: Heart murmur is loud and accompanied by a
palpable thrill. V/VI: Heart murmur is very loud and can be heard
with the stethoscope partially off the chest. VI/VI: Heart murmur is
very loud and can be heard with the stethoscope completely off the
patient's chest.
◉ Which of the following persons would not be a candidate for the
antipneumococcal vaccine?
a 65-year-old healthy female living with her family
a 35-year-old patient with HIV infection
a 58-year-old male resident of a nursing home
a 55-year-old female living alone.
Answer: a 55-year-old female living alone
The antipneumococcal vaccine is not indicated for an otherwise
healthy person who is under the age of 65 unless there are other
health factors involved. Living alone has no bearing on the need for
, the vaccine. The vaccine is indicated for persons with HIV infection,
persons living in nursing homes, and all adults 65 years or older
regardless of health status.
◉ Which of the following diseases is more likely to cause chronic
pelvic pain rather than acute pelvic pain?
ectopic pregnancy
PID
ovarian cysts
interstitial cystitis.
Answer: interstitial cystitisInterstitial cystitis is more likely to cause
chronic pelvic pain rather than acute pelvic pain as in the other
choices. Other causes of chronic pelvic pain include: endometriosis,
leiomyomas, and malignancy.
◉ You have a 58-year-old male patient with possible pancreatic
cancer. You will not order an abdominal ultrasound for diagnosis
because it is limited by which of the following?
previous history of pancreatic disease
patient's age
the presence of intestinal gas
size of tumor.
