LEIK FNP LATEST 2026 CORE EXAM MANUAL
QUESTIONS AND SOLUTIONS RATED A+
✔✔According to the HIPAA of 1996, which of the following examples demonstrates
noncompliance?
A) The sign-in sheet on the front desk is covered so that other patients' names are not
visible to new patients.
B) The medical assistant calls the patient who is in the waiting room using his/her first
name.
C) A patient's chart that is hanging on the door of the examination room is turned
backward.
D) The nurse practitioner calls the daughter of an elderly diabetic patient and leaves a
detailed message on her answering machine regarding her mother's laboratory results.
III. - ✔✔Correct Answer: Option D D) The nurse practitioner calls the daughter of an
elderly diabetic patient and leaves a detailed message on her answering machine
regarding her mother's laboratory results.
Option b ok- can use or first name
Option D demonstrates two examples of HIPAA noncompliance. First, there is no
mention that the patient gave consent for her daughter to have access to her medical
information. Second, the NP did not follow the "minimum necessary requirement" rule
when she left a detailed message on the daughter's answering machine. 2) The best
action in this case is for the NP to call the elderly patient's home and to leave only her
name, the name of the clinic, and phone number that the patient can call back.
✔✔"Will performing this action prevent the disease or the social condition from
happening?" If it does, then it is considered as .........prevention (if it does not, then it is
........prevention). - ✔✔Does then primary of not then secondary
✔✔Primary
Prevent Disease/Injury/Condition) - ✔✔Youth violence prevention (e.g., youth
recreational center for high-risk inner-city youth, mentoring teens, teaching teens better
communication skills).
Bullying prevention (e.g., antibullying school programs).
Personal safety promotion (e.g., seatbelts, airbags, helmets).
Disease prevention (e.g., immunizations, using sunscreen).
,Healthy lifestyle promotion (e.g., sleep 7-8 hours/night, avoid sunlight 10 a.m. to 4 p.m.,
healthy diet, exercise).
Promotion of OSHA laws (e.g., workplace
✔✔Secondary Prevention (Detect Disease/Condition as Early as Possible) - ✔✔Any
laboratory test to screen for a disease (e.g., CBC for anemia, TSH for thyroid disease).
U.S. Preventive Services Task Force (USPSTF) screening recommendations (e.g.,
mammograms, PSA, purified protein derivative [PPD]).
Screening for high-risk behavior (e.g., asking a patient about the number of sexual
partners), screening for suicide risk (e.g., assess suicide risk, check for signs and
symptoms of depression).
Personal actions to detect cancer (e.g., BSE, GSE).
✔✔Tertiary Prevention (Limiting Further Harm and Disability) - ✔✔All types of
rehabilitation (e.g., cardiac rehab, PT, OT, speech therapy, addiction/drug rehab).
Support groups (e.g., breast cancer patients, alcoholics with Alcoholics Anonymous).
Exercise for an obese person (if the person is healthy, then it is primary prevention).
✔✔An 18-year-old female presents in the college health clinic complaining of a strong
odor in her vagina. She reports that she had an abortion about 3 weeks ago and
recently completed her prescription of antibiotics. The NP performs a vaginal speculum
exam and notes a large amount of grayish to off-white discharge coating the patient's
vaginal walls. It has a milk-like consistency. During microscopy, the slide reveals mature
squamous epithelial cells with numerous bacteria noted on the cell borders. The vaginal
pH is at 6.0. Which of the following conditions is most likely?
A) Trichomoniasis B) Bacterial vaginosis C) Candida vulvovaginitis D) Hormonal
changes - ✔✔BV
1) The vaginal pH is alkaline (pH of 6.0). 2) Rule out Candida because it is classified as
a yeast organism (not a bacteria). 3) Rule out Trichomonas because it is a protozoa or
unicellular flagellated organism. 4) The odor and discharge are not due to hormonal
changes in an 18-year-old female.
✔✔BV
(CAN) - ✔✔Bacterial vaginosis (BV) has an alkaline pH (vagina normally has an acidic
pH of 4.0).
, BV is not considered an STD (it is caused by an imbalance of vaginal bacteria). The sex
partner does not need to be treated. It is a vaginosis (not a vaginitis).
BV does not cause inflammation (the vulvovagina will not be red or irritated). The
microscopy slide will have very few WBCs and a large number of clue cells.
****Alkaline, not std, clue cell (remember by CAN)
✔✔Candida
WTC
RI
WP-HS
NGI - ✔✔vaginal discharge in Candida infection is of a white color with a thick and curd-
like consistency.
It frequently causes redness and itching in the vulvovagina due to inflammation.
microscopy in candidiasis will show a large number of WBCs, pseudohyphae, and
spores ("spaghetti and meatballs").
Candida yeast is normal flora of the gastrointestinal (GI) tract and in some women's
vaginas.
✔✔Trichomonas infection (or trichomoniasis)
CBG
RI
STD - ✔✔Vaginal dc copious, bubbly, and green in color.
It causes a lot of inflammation resulting in itching and redness of the vulvovagina.
It is considered a sexually transmitted infection. The sex partner also needs treatment.
✔✔A previously healthy 30-year-old complains of an acute onset of fever and chills
accompanied by a productive cough with purulent sputum and a loss of appetite. The
patient denies receiving an antibiotic in the previous 3 months. The NP diagnoses
community-acquired pneumonia (CAP). The Infectious Diseases Society of America
(IDSA) and the American Thoracic Society (ATS) treatment guidelines recommend
which of the following as the preferred first-line treatment for this patient?
A) Macrolides
B) Antitussives
C) Cephalosporins
D) Fluoroquinolones with gram-positive bacteria activity - ✔✔Macrolide
QUESTIONS AND SOLUTIONS RATED A+
✔✔According to the HIPAA of 1996, which of the following examples demonstrates
noncompliance?
A) The sign-in sheet on the front desk is covered so that other patients' names are not
visible to new patients.
B) The medical assistant calls the patient who is in the waiting room using his/her first
name.
C) A patient's chart that is hanging on the door of the examination room is turned
backward.
D) The nurse practitioner calls the daughter of an elderly diabetic patient and leaves a
detailed message on her answering machine regarding her mother's laboratory results.
III. - ✔✔Correct Answer: Option D D) The nurse practitioner calls the daughter of an
elderly diabetic patient and leaves a detailed message on her answering machine
regarding her mother's laboratory results.
Option b ok- can use or first name
Option D demonstrates two examples of HIPAA noncompliance. First, there is no
mention that the patient gave consent for her daughter to have access to her medical
information. Second, the NP did not follow the "minimum necessary requirement" rule
when she left a detailed message on the daughter's answering machine. 2) The best
action in this case is for the NP to call the elderly patient's home and to leave only her
name, the name of the clinic, and phone number that the patient can call back.
✔✔"Will performing this action prevent the disease or the social condition from
happening?" If it does, then it is considered as .........prevention (if it does not, then it is
........prevention). - ✔✔Does then primary of not then secondary
✔✔Primary
Prevent Disease/Injury/Condition) - ✔✔Youth violence prevention (e.g., youth
recreational center for high-risk inner-city youth, mentoring teens, teaching teens better
communication skills).
Bullying prevention (e.g., antibullying school programs).
Personal safety promotion (e.g., seatbelts, airbags, helmets).
Disease prevention (e.g., immunizations, using sunscreen).
,Healthy lifestyle promotion (e.g., sleep 7-8 hours/night, avoid sunlight 10 a.m. to 4 p.m.,
healthy diet, exercise).
Promotion of OSHA laws (e.g., workplace
✔✔Secondary Prevention (Detect Disease/Condition as Early as Possible) - ✔✔Any
laboratory test to screen for a disease (e.g., CBC for anemia, TSH for thyroid disease).
U.S. Preventive Services Task Force (USPSTF) screening recommendations (e.g.,
mammograms, PSA, purified protein derivative [PPD]).
Screening for high-risk behavior (e.g., asking a patient about the number of sexual
partners), screening for suicide risk (e.g., assess suicide risk, check for signs and
symptoms of depression).
Personal actions to detect cancer (e.g., BSE, GSE).
✔✔Tertiary Prevention (Limiting Further Harm and Disability) - ✔✔All types of
rehabilitation (e.g., cardiac rehab, PT, OT, speech therapy, addiction/drug rehab).
Support groups (e.g., breast cancer patients, alcoholics with Alcoholics Anonymous).
Exercise for an obese person (if the person is healthy, then it is primary prevention).
✔✔An 18-year-old female presents in the college health clinic complaining of a strong
odor in her vagina. She reports that she had an abortion about 3 weeks ago and
recently completed her prescription of antibiotics. The NP performs a vaginal speculum
exam and notes a large amount of grayish to off-white discharge coating the patient's
vaginal walls. It has a milk-like consistency. During microscopy, the slide reveals mature
squamous epithelial cells with numerous bacteria noted on the cell borders. The vaginal
pH is at 6.0. Which of the following conditions is most likely?
A) Trichomoniasis B) Bacterial vaginosis C) Candida vulvovaginitis D) Hormonal
changes - ✔✔BV
1) The vaginal pH is alkaline (pH of 6.0). 2) Rule out Candida because it is classified as
a yeast organism (not a bacteria). 3) Rule out Trichomonas because it is a protozoa or
unicellular flagellated organism. 4) The odor and discharge are not due to hormonal
changes in an 18-year-old female.
✔✔BV
(CAN) - ✔✔Bacterial vaginosis (BV) has an alkaline pH (vagina normally has an acidic
pH of 4.0).
, BV is not considered an STD (it is caused by an imbalance of vaginal bacteria). The sex
partner does not need to be treated. It is a vaginosis (not a vaginitis).
BV does not cause inflammation (the vulvovagina will not be red or irritated). The
microscopy slide will have very few WBCs and a large number of clue cells.
****Alkaline, not std, clue cell (remember by CAN)
✔✔Candida
WTC
RI
WP-HS
NGI - ✔✔vaginal discharge in Candida infection is of a white color with a thick and curd-
like consistency.
It frequently causes redness and itching in the vulvovagina due to inflammation.
microscopy in candidiasis will show a large number of WBCs, pseudohyphae, and
spores ("spaghetti and meatballs").
Candida yeast is normal flora of the gastrointestinal (GI) tract and in some women's
vaginas.
✔✔Trichomonas infection (or trichomoniasis)
CBG
RI
STD - ✔✔Vaginal dc copious, bubbly, and green in color.
It causes a lot of inflammation resulting in itching and redness of the vulvovagina.
It is considered a sexually transmitted infection. The sex partner also needs treatment.
✔✔A previously healthy 30-year-old complains of an acute onset of fever and chills
accompanied by a productive cough with purulent sputum and a loss of appetite. The
patient denies receiving an antibiotic in the previous 3 months. The NP diagnoses
community-acquired pneumonia (CAP). The Infectious Diseases Society of America
(IDSA) and the American Thoracic Society (ATS) treatment guidelines recommend
which of the following as the preferred first-line treatment for this patient?
A) Macrolides
B) Antitussives
C) Cephalosporins
D) Fluoroquinolones with gram-positive bacteria activity - ✔✔Macrolide
