LEIK FNP Exam Prep 2026/2027, 300+ FNP
Practice Questions, Detailed Rationales
(Digital Download)
Question 1
A 55-year-old male with no prior medical history presents with a blood pressure of 158/94
mmHg on two separate visits. What is the most appropriate initial management?
A) Start lisinopril 10 mg daily
B) Initiate lifestyle modifications and reassess in 3-6 months
C) Start hydrochlorothiazide 25 mg daily
D) Refer to cardiology
Answer
Answer: B
Rationale
For stage 1 hypertension without ASCVD or target organ damage, lifestyle changes are first-line.
Question 2
A 32-year-old female presents with dysuria, frequency, and suprapubic pain. Urinalysis shows
leukocytes and nitrites. She is not pregnant. Which antibiotic is first-line?
A) Ciprofloxacin 500 mg BID x 3 days
B) Nitrofurantoin 100 mg BID x 5 days
C) Amoxicillin 500 mg TID x 7 days
D) Doxycycline 100 mg BID x 7 days
Answer
Answer: B
,Rationale
Nitrofurantoin is first-line for uncomplicated cystitis; fluoroquinolones reserved for complicated cases.
Question 3
A 68-year-old male with type 2 diabetes has an A1c of 8.5% on metformin 1000 mg BID. Which
medication is most appropriate to add?
A) Glipizide
B) Empagliflozin (SGLT2 inhibitor)
C) Pioglitazone
D) Insulin glargine
Answer
Answer: B
Rationale
SGLT2 inhibitors have cardiovascular and renal benefits and are preferred add-on therapy in type 2
diabetes with high CV risk.
Question 4
A 45-year-old female presents with fatigue, weight gain, and cold intolerance. TSH is 15 mIU/L
and free T4 is low. What is the appropriate initial treatment?
A) Liothyronine (T3)
B) Levothyroxine 1.6 mcg/kg/day
C) Methimazole
D) Radioactive iodine
Answer
Answer: B
2
,Rationale
Levothyroxine is standard therapy for hypothyroidism; start at full replacement dose in healthy adults.
Question 5
A 28-year-old female at 28 weeks gestation presents with blood pressure 150/95 mmHg and 2+
proteinuria. She has no severe features. What is the diagnosis?
A) Gestational hypertension
B) Preeclampsia without severe features
C) Chronic hypertension
D) HELLP syndrome
Answer
Answer: B
Rationale
New hypertension after 20 weeks with proteinuria defines preeclampsia; no severe features present.
Question 6
A 6-year-old child presents with a barking cough, stridor, and low-grade fever. What is the most
likely diagnosis?
A) Epiglottitis
B) Croup (laryngotracheobronchitis)
C) Bronchiolitis
D) Asthma
Answer
Answer: B
Rationale
3
, Croup presents with a barking cough, stridor, and hoarseness; treat with dexamethasone and
supportive care.
Question 7
A 70-year-old female with osteoporosis has a T-score of −2.8 at the femoral neck. She has no
prior fractures. What is the first-line medication?
A) Raloxifene
B) Alendronate
C) Teriparatide
D) Denosumab
Answer
Answer: B
Rationale
Bisphosphonates are first-line for osteoporosis to reduce fracture risk.
Question 8
A 35-year-old male presents with a 3-day history of fever, productive cough, and pleuritic chest
pain. Chest X-ray shows a right lower lobe infiltrate. He has no comorbidities. What is the
appropriate outpatient antibiotic?
A) Azithromycin
B) Azithromycin or doxycycline
C) Levofloxacin
D) Amoxicillin
Answer
Answer: B
Rationale
4
Practice Questions, Detailed Rationales
(Digital Download)
Question 1
A 55-year-old male with no prior medical history presents with a blood pressure of 158/94
mmHg on two separate visits. What is the most appropriate initial management?
A) Start lisinopril 10 mg daily
B) Initiate lifestyle modifications and reassess in 3-6 months
C) Start hydrochlorothiazide 25 mg daily
D) Refer to cardiology
Answer
Answer: B
Rationale
For stage 1 hypertension without ASCVD or target organ damage, lifestyle changes are first-line.
Question 2
A 32-year-old female presents with dysuria, frequency, and suprapubic pain. Urinalysis shows
leukocytes and nitrites. She is not pregnant. Which antibiotic is first-line?
A) Ciprofloxacin 500 mg BID x 3 days
B) Nitrofurantoin 100 mg BID x 5 days
C) Amoxicillin 500 mg TID x 7 days
D) Doxycycline 100 mg BID x 7 days
Answer
Answer: B
,Rationale
Nitrofurantoin is first-line for uncomplicated cystitis; fluoroquinolones reserved for complicated cases.
Question 3
A 68-year-old male with type 2 diabetes has an A1c of 8.5% on metformin 1000 mg BID. Which
medication is most appropriate to add?
A) Glipizide
B) Empagliflozin (SGLT2 inhibitor)
C) Pioglitazone
D) Insulin glargine
Answer
Answer: B
Rationale
SGLT2 inhibitors have cardiovascular and renal benefits and are preferred add-on therapy in type 2
diabetes with high CV risk.
Question 4
A 45-year-old female presents with fatigue, weight gain, and cold intolerance. TSH is 15 mIU/L
and free T4 is low. What is the appropriate initial treatment?
A) Liothyronine (T3)
B) Levothyroxine 1.6 mcg/kg/day
C) Methimazole
D) Radioactive iodine
Answer
Answer: B
2
,Rationale
Levothyroxine is standard therapy for hypothyroidism; start at full replacement dose in healthy adults.
Question 5
A 28-year-old female at 28 weeks gestation presents with blood pressure 150/95 mmHg and 2+
proteinuria. She has no severe features. What is the diagnosis?
A) Gestational hypertension
B) Preeclampsia without severe features
C) Chronic hypertension
D) HELLP syndrome
Answer
Answer: B
Rationale
New hypertension after 20 weeks with proteinuria defines preeclampsia; no severe features present.
Question 6
A 6-year-old child presents with a barking cough, stridor, and low-grade fever. What is the most
likely diagnosis?
A) Epiglottitis
B) Croup (laryngotracheobronchitis)
C) Bronchiolitis
D) Asthma
Answer
Answer: B
Rationale
3
, Croup presents with a barking cough, stridor, and hoarseness; treat with dexamethasone and
supportive care.
Question 7
A 70-year-old female with osteoporosis has a T-score of −2.8 at the femoral neck. She has no
prior fractures. What is the first-line medication?
A) Raloxifene
B) Alendronate
C) Teriparatide
D) Denosumab
Answer
Answer: B
Rationale
Bisphosphonates are first-line for osteoporosis to reduce fracture risk.
Question 8
A 35-year-old male presents with a 3-day history of fever, productive cough, and pleuritic chest
pain. Chest X-ray shows a right lower lobe infiltrate. He has no comorbidities. What is the
appropriate outpatient antibiotic?
A) Azithromycin
B) Azithromycin or doxycycline
C) Levofloxacin
D) Amoxicillin
Answer
Answer: B
Rationale
4
