Leik FNP Practice Exam Family Nurse Practitioner
Certification Review with Practice Questions and
Answers 2026/2027
Question 1
A 55-year-old male with hypertension and hyperlipidemia presents for a wellness visit.
According to USPSTF, which colorectal cancer screening is recommended for average-risk adults
starting at age 45?
A) Colonoscopy every 10 years only
B) Colonoscopy every 10 years, CT colonography every 5 years, or annual FIT
C) Sigmoidoscopy every 5 years only
D) No screening until age 50
Answer
Answer: B
Rationale
USPSTF recommends colorectal cancer screening for adults 45-75 using any of several accepted
methods, including colonoscopy, CT colonography, or stool-based tests.
Question 2
A 32-year-old female presents with dysuria, frequency, and suprapubic pain. Urinalysis shows
nitrites and leukocyte esterase. She is not pregnant and has no allergies. What is the first-line
antibiotic?
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) Trimethoprim-sulfamethoxazole DS BID x 3 days
Answer
,Answer: B
Rationale
Nitrofurantoin is first-line for uncomplicated cystitis. TMP-SMX is an alternative if local resistance
<20%; fluoroquinolones are reserved for complicated cases.
Question 3
A 62-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 for cardiovascular and renal protection?
A) Glipizide
B) Empagliflozin (SGLT2 inhibitor)
C) Pioglitazone
D) Insulin glargine
Answer
Answer: B
Rationale
SGLT2 inhibitors reduce cardiovascular events and slow CKD progression in patients with type 2
diabetes.
Question 4
A 45-year-old female presents with a 3-day history of unilateral throbbing headache, nausea,
and photophobia. She has had similar episodes before. What is the first-line acute treatment?
A) Propranolol
B) Sumatriptan
C) Amitriptyline
D) Topiramate
Answer
2
,Answer: B
Rationale
Triptans are first-line for acute moderate to severe migraine. Propranolol and topiramate are for
prophylaxis.
Question 5
A 28-year-old female requests contraception. She has a history of migraine with aura. Which
contraceptive is contraindicated?
A) Levonorgestrel IUD
B) Combined oral contraceptive (estrogen-containing)
C) Progestin-only pill
D) Copper IUD
Answer
Answer: B
Rationale
Estrogen-containing contraceptives increase stroke risk in women with migraine with aura.
Question 6
A 70-year-old male presents with a 2-week history of progressive dyspnea, orthopnea, and
bilateral pedal edema. Exam reveals JVD and crackles. Which medication is first-line for acute
symptom relief?
A) Lisinopril
B) Furosemide
C) Metoprolol
D) Spironolactone
Answer
3
, Answer: B
Rationale
Loop diuretics rapidly reduce preload and relieve pulmonary congestion in acute heart failure.
Question 7
A 50-year-old female presents with a painless, firm lump in her left breast. Mammogram shows
a spiculated mass. What is the next step?
A) Repeat mammogram in 6 months
B) Ultrasound-guided core needle biopsy
C) MRI breast
D) Excisional biopsy
Answer
Answer: B
Rationale
Suspicious breast mass requires tissue diagnosis. Core needle biopsy is preferred.
Question 8
A 32-year-old male presents with a 2-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 first-
line antibiotic?
A) Levofloxacin
B) Azithromycin or doxycycline
C) Amoxicillin
D) Ceftriaxone plus azithromycin
Answer
Answer: B
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Certification Review with Practice Questions and
Answers 2026/2027
Question 1
A 55-year-old male with hypertension and hyperlipidemia presents for a wellness visit.
According to USPSTF, which colorectal cancer screening is recommended for average-risk adults
starting at age 45?
A) Colonoscopy every 10 years only
B) Colonoscopy every 10 years, CT colonography every 5 years, or annual FIT
C) Sigmoidoscopy every 5 years only
D) No screening until age 50
Answer
Answer: B
Rationale
USPSTF recommends colorectal cancer screening for adults 45-75 using any of several accepted
methods, including colonoscopy, CT colonography, or stool-based tests.
Question 2
A 32-year-old female presents with dysuria, frequency, and suprapubic pain. Urinalysis shows
nitrites and leukocyte esterase. She is not pregnant and has no allergies. What is the first-line
antibiotic?
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) Trimethoprim-sulfamethoxazole DS BID x 3 days
Answer
,Answer: B
Rationale
Nitrofurantoin is first-line for uncomplicated cystitis. TMP-SMX is an alternative if local resistance
<20%; fluoroquinolones are reserved for complicated cases.
Question 3
A 62-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 for cardiovascular and renal protection?
A) Glipizide
B) Empagliflozin (SGLT2 inhibitor)
C) Pioglitazone
D) Insulin glargine
Answer
Answer: B
Rationale
SGLT2 inhibitors reduce cardiovascular events and slow CKD progression in patients with type 2
diabetes.
Question 4
A 45-year-old female presents with a 3-day history of unilateral throbbing headache, nausea,
and photophobia. She has had similar episodes before. What is the first-line acute treatment?
A) Propranolol
B) Sumatriptan
C) Amitriptyline
D) Topiramate
Answer
2
,Answer: B
Rationale
Triptans are first-line for acute moderate to severe migraine. Propranolol and topiramate are for
prophylaxis.
Question 5
A 28-year-old female requests contraception. She has a history of migraine with aura. Which
contraceptive is contraindicated?
A) Levonorgestrel IUD
B) Combined oral contraceptive (estrogen-containing)
C) Progestin-only pill
D) Copper IUD
Answer
Answer: B
Rationale
Estrogen-containing contraceptives increase stroke risk in women with migraine with aura.
Question 6
A 70-year-old male presents with a 2-week history of progressive dyspnea, orthopnea, and
bilateral pedal edema. Exam reveals JVD and crackles. Which medication is first-line for acute
symptom relief?
A) Lisinopril
B) Furosemide
C) Metoprolol
D) Spironolactone
Answer
3
, Answer: B
Rationale
Loop diuretics rapidly reduce preload and relieve pulmonary congestion in acute heart failure.
Question 7
A 50-year-old female presents with a painless, firm lump in her left breast. Mammogram shows
a spiculated mass. What is the next step?
A) Repeat mammogram in 6 months
B) Ultrasound-guided core needle biopsy
C) MRI breast
D) Excisional biopsy
Answer
Answer: B
Rationale
Suspicious breast mass requires tissue diagnosis. Core needle biopsy is preferred.
Question 8
A 32-year-old male presents with a 2-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 first-
line antibiotic?
A) Levofloxacin
B) Azithromycin or doxycycline
C) Amoxicillin
D) Ceftriaxone plus azithromycin
Answer
Answer: B
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