LEIK FNP Certification Exam 1 2024
x x x x x x
x
A x72-year-old xwoman xhas xbeen xon xhydrochlorothiazide x12.5 xmg xfor xmany xyears xto
xcontrol xher xStage xII xhypertension. xHer xblood xpressure x(BP) xat xthis xvisit xis x168/96. xShe xis
xcurrently xcomplaining xof xpain xon xher xright xhip xand xon xboth xknees. xShe xhas xincreased
xher xdose xof xibuprofen x(Motrin) xfrom x400 xmg x3 xtimes xday x(TID) xto x800 xmg xTID. xShe xis
xstill xin xpain xand xwould xlike xsomething xstronger. xWhich xof xthe xfollowing xstatements xis
xthe xbest xexplanation xof xthe xeffects xof xibuprofen x(Motrin) xon xher xdisease? x
x
A) It xincreases xthe xchances xof xadverse xeffects xto xher xhealth x
B) It xinhibits xthe xeffect xof xrenal xprostaglandins xand xblunts xthe xeffectiveness xof xthe
xdiuretic x
C) It xprolongs xthe xtherapeutic xeffects xof xhydrochlorothiazide xand xother xdiuretics x
D) None xof xthe xstatements xare xtrue x- xB) xIt xinhibits xthe xeffect xof xrenal xprostaglandins xand
xblunts xthe xeffectiveness xof xthe xdiuretic. x
x
NSAIDs xand xASA xinhibit xthe xvasodilatory xeffects xof xprostaglandins, xwhich xpredisposes
xthe xkidney xto xischemia. xNSAIDs xand xdiuretics xcan xcause xacute xprerenal xfailure xby
xdecreasing xrenal xblood xflow. x
x
2. xAll xof xthe xfollowing xare xinfections xthat xaffect xmostly xthe xlabia xand xvagina xexcept: x
x
x
A)
xBacterialvaginosis
x
B)
xCandidiasis
x
C)
xTrichomoniasis
D) xChlamydia xtrachomatis x - x D) x Chlamydia
xtrachomatis
x
Infections xthat xcommonly xaffect xthe xlabia xand xvagina xinclude xbacterial xvaginosis,
xcandidiasis,
and xtrichomoniasis. xChlamydia xtrachomatis xcommonly xaffects xthe xcervix, xendometrial
xlining x, x
x
fallopian xtubes, xand xpelvic
xcavity.
x
The xnurse xpractitioner xwould xtest xthe xobturator xand xiliopsoas xmuscle xto xevaluate xfor: x
x
A) Cholecystitis x
B) Acute xappendicitis x
C) Inguinal xhernia x
D) Gastriculcer x- xB) xAcute xappendicitis. x
x
Signs xand xsymptoms xof xan xacute xabdomen xinclude xinvol- xuntary xguarding, xrebound
xtenderness, xboardlike xabdomen, xand xa xpositive xobtu- xrator xand xpsoas xsign. xA xpositive
xobturator xsign xoccurs xwhen xpain xis xelicted xby xinternal xrotation xof xthe xright xhip xfrom x90
xdegrees xhip/knee xflexion. xThe xpsoas xsign xis xpositive xwhen xpain xoccurs xwith xpassive
xextension xof xthe xthigh xwhile xthe xpatient xis xlying xon xhis/her xside xwith xknees xextended, xor
xwhen xpain xoccurs xwith xactive xflexion xof xhis/her xthigh xat xthe xhip. x
,x
Treatment xfor xmild xpreeclampsia xincludes xall xof xthe xfollowing xexcept: x
x
x
A) xBed xrest xexcept xfor xbathroom
xprivileges
x
B) xClose xmonitoring xof xweight xand
xblood xpressure
C) xClose xfollow-up xof xurinary xprotein, xserum xcreatinine,
xand xplatelet xcount
D) xA xprescription xof xmethyldopa x(Aldomet) xto xcontrol xblood xpressure x-
xD) xA xprescription xof x
x
methyldopa x(Aldomet) xto xcontrol
xblood xpressure x
x
Recommended xcare xfor xwomen xdiagnosed xwith xpreeclampsia xincludes xbed xrest xwith xbath-
xroom xprivileges, xweight xand xBP xmonitoring, xand xclosely xfollowing xurine xprotein xand
xserum xprotein, xcreatinine, xand xplatelet xcounts. xOral xmedications xare xnot xused xas xfirst-line
xtreatment. x
x
All xof xthe xfollowing xservices xare xcovered xunder xMedicare xPart xA xexcept: x
x
A) Inpatienthospitalizations x
B) Medicines xadministered xto xa xpatient xwhile xhospitalized x
C) Nursing xhome xcare x
D) Surgeons x- xC) xNursing xhome xcare x
x
Medicare xA xcoverage xincludes xinpatient xhospitalization xand xskilled xcare xgiven xin xa
xcertified xskilled xnursing xfacility. xMost xnursing xhome xcare xis xcustodial xcare x(help xwith
xbathing, xdressing, xusing xa xbathroom, xand xeating). xThis xcare xis xnot xcovered xby xMedicare
xA. x
x
A x28-year-old xstudent xis xseen xin xthe xschool xhealth xclinic xwith xcomplaints xof xa xhacking
xcough xthat xis xproductive xof xsmall xamounts xof xsputum xand xa xrunny xnose. xHe xdoes xnot
xtake xany xmedications, xdenies xany xallergies, xand xhas xno xsignificant xmedical xhistory.
xPhysical xexamination xreveals xa xlow-grade xtemperature xof x99.9 xdegrees xFahrenheit,
xrespirations xof x16/min, xa xpulse xof x90 xbeats xper xminute, xand xdiffuse xfine xcrackles xin xthe
xbase xof xthe xlungs. xA xchest xradiograph x(x-ray) xshows xdiffuse xinfiltrates xon xthe xlower xlobe
xof xthe xright xlung. xThe xtotal xwhite xblood xcell xcount xis x10,500/uL. xWhat xis xthe xmost
xlikely xdiagnosis? x
x
A) Streptococcal xpneumonia x
B) Mycoplasma xpneumonia x
C) Acute xbronchitis x
D) Legionnaires xdisease x- xB) xMycoplasma xpneumonia x x
x
Mycoplasma xpneumonia xis xthe xorganism xmost xcom- xmonly xseen xin xchildren xand xyoung
xadults. xIt xis xeasily xspread xfrom xdroplets, xfrom xsneezing xand xcoughing, xin xclose
xproximity. xDiagnosis xis xbased xon xsymptoms xand xx-ray xresults xof xinfiltrates xin xlower
xlobes. x
x
,A x39-year-old xmigrant xworker xpresents xto xthe xclinic x2.5 xdays xafter xa xpurified xprotein
xderivative x(PPD) xtest. xWhat xminimum xsize xof xinduration xwould xbe xconsidered xposi- xtive
xfor xthis xpatient? x
x
A) x3 xmm xB) x5 xmm xC) x10 xmm xD) x15 xmm x- xC) x10 xmm x x
x
The xPPD xis xadministered xon xthe xvolar xaspect xof xthe xlower xarm xand xread x48 xhours xafter
xthe xtest xis xgiven. xThe xPPD xresult xmust xhave xinduration xand xmeasure x10 xmm xor xgreater
xto xbe xpositive xin xa xlow-risk xpatient. xInduration x(firmness xwith xpalpation) xmust xbe
xpresent. xIf xthe xsite xhas xerythema xbut xno xinduration, xresult xwould xbe xnegative. xColor xis
xnot ximportant. x
x
All xof xthe xfollowing xare xcorrect xstatements xregarding xthe xrole xof xthe xperson xnamed
xin xa x
x
durable xpower xof xattorney
xexcept:
x
A) The xagent's xdecisions xare xlegally xbinding x
B) The xagent xcan xmake xdecisions xin xother xareas xof xthe xpatient's xlife xsuch xas xfinancial
xissues x
C) The xagent xcan xdecide xfor xthe xpatient xwho xis xon xlife xsupport xwhen xthat xlife xsupport
xcan xbe xterminated x
D) The xpatient's xspouse xhas xa xright xto xoverride xthe xagent's xdecisions x- xD) xThe xpatient's
xspouse xhas xa xright xto xoverride xthe xagent's xdecisions x x
x
The xperson xnamed xin xa xdurable xpower xof xattorney x(the xagent) xis xdesignated xby xthe
xpatient xto xmake xall xmedical xdecisions, xas xwell xas xany xdecisions xregarding xthe xpatient's
xprivate xaffairs xin xthe xevent xthat xthe xpatient xbecomes xincompetent xand xunable xto xmake
xhis/her xown xdecisions. xNo xone xhas xthe xability xto xoverride xthe xagent's xdecision. x
x
All xof xthe xfollowing xare xtrue xstatements xregarding xMunchausen xsyndrome xexcept: x
x
A) It xis xconsidered xa xmental xillness x
B) The xpatient xhas xa xmedical xillness xthat xcauses xan xanxiety xreaction xand xdenial x
C) The xpatient xfakes xan xillness xin xorder xto xgain xattention xfrom xhealth xcare xproviders xD)
xThe xpatient xhas xan xinconsistent xmedical xhistory xalong xwith xa xpast xhistory xof xfrequent
xhospitalizations x- xB) xThe xpatient xhas xa xmedical xillness xthat xcauses xan xanxiety xreaction
xand xdenial x x
x
Munchausen xsyndrome xis xa xpsychiatric xdisorder xin xwhich xthe xpatient xfakes xa xmedical
xillness xor x
x
disorder xto xgain xattention xfrom xhealth xcare xprovid- xers. xThese xpatients xcommonly xuse
xthe
x
emergency xdepartment xfrequently xto xgain
xattention.
x
Which xof xthe xfollowing xantihypertensive xmedications xshould xthe xnurse xpractitioner
xavoid x
x
when xtreating xpatients xwith
xemphysema?
x
A) Calcium xchannel xblockers x
, B) Angiotensin-converting xenzyme x(ACE) xinhibitors x
C) Beta-blockers x
D) Diuretics x- xC) xBeta-blockers x x
x
Beta-blockers xshould xbe xavoided xin xpatients xwith xa xhistory xof xemphysema. xStudies xhave
xshown xevidence xof xa xreduction xin xforced xexpiratory xvolume xin x1 xsecond x(FEV1),
xincreased xairway xhyperresponsiveness, xand xinhibition xof xbronchodilator xresponse xto xbeta
xagonists xin xpatients xreceiving xnon-selective xbeta- xblockers xand xhigh xdoses xof
xcardioselective xbetablockers. x
x
A x30-year-old xchef xcomplains xof xpruritic xhives xover xher xchest xand xarms xbut xdenies
xdifficulty x
swallowing xor xbreathing. xShe xreports xa xfamily xhistory xof xallergic xrhinitis xand xasthma.
xWhich x
x
of xthe xfollowing xinterventions xis xmost
xappropriate?
x
A) Perform xa xcomplete xand xthorough xhistory x
B) Prescribe xan xoral xantihistamine xsuch xas xdiphenhydramine x25 xmg xPO xQID x
C) Give xan xinjection xof xepinephrine x1:1000 xintramuscularly xstat x x
D) Call x911 x- xA) xPerform xa xcomplete xand xthorough xhistory x x
x
Prior xto xprescribing xmedications, xa xcomplete xand xthorough xhistory xmust xbe xperformed xto
xdetermine xpossible xcauses xof xhives. xThe xpatient xdenied xdifficulty xwith xswallowing xand
xbreathing, xso xthere xwas xno xmedical xemergency xto xrequire xcalling x911. x
x
Which xof xthe xfollowing xfindings xis xmost xlikely xin xyoung xprimigravidas xwith
xpregnancy-
x
induced
xhypertension?
x
x
A) xAbdominal xcramping xand
xconstipation
x
B) xEdema xof xthe xface xand xthe xupper
xextremities
x
C) xShortness xof
xbreath
D) xDysuria xand xfrequency x- xB) xEdema xof xthe xface xand xthe xupper
xextremities x
x
Common xsigns xand xsymptoms xof xpregnancy-induced xhypertension xinclude xedema xof xthe
xface x
x
and xthe xupper xextremities, xweight xgain, xblurred x vision, xelevated xBP, xproteinuria,
xand
x
headaches.
x
Which xof xthe xfollowing xsymptoms xis xassociated x with xB12 xdeficiency xanemia? x
x
x
A) xSpoon-shaped xnails xand
xpica
x x x x x x
x
A x72-year-old xwoman xhas xbeen xon xhydrochlorothiazide x12.5 xmg xfor xmany xyears xto
xcontrol xher xStage xII xhypertension. xHer xblood xpressure x(BP) xat xthis xvisit xis x168/96. xShe xis
xcurrently xcomplaining xof xpain xon xher xright xhip xand xon xboth xknees. xShe xhas xincreased
xher xdose xof xibuprofen x(Motrin) xfrom x400 xmg x3 xtimes xday x(TID) xto x800 xmg xTID. xShe xis
xstill xin xpain xand xwould xlike xsomething xstronger. xWhich xof xthe xfollowing xstatements xis
xthe xbest xexplanation xof xthe xeffects xof xibuprofen x(Motrin) xon xher xdisease? x
x
A) It xincreases xthe xchances xof xadverse xeffects xto xher xhealth x
B) It xinhibits xthe xeffect xof xrenal xprostaglandins xand xblunts xthe xeffectiveness xof xthe
xdiuretic x
C) It xprolongs xthe xtherapeutic xeffects xof xhydrochlorothiazide xand xother xdiuretics x
D) None xof xthe xstatements xare xtrue x- xB) xIt xinhibits xthe xeffect xof xrenal xprostaglandins xand
xblunts xthe xeffectiveness xof xthe xdiuretic. x
x
NSAIDs xand xASA xinhibit xthe xvasodilatory xeffects xof xprostaglandins, xwhich xpredisposes
xthe xkidney xto xischemia. xNSAIDs xand xdiuretics xcan xcause xacute xprerenal xfailure xby
xdecreasing xrenal xblood xflow. x
x
2. xAll xof xthe xfollowing xare xinfections xthat xaffect xmostly xthe xlabia xand xvagina xexcept: x
x
x
A)
xBacterialvaginosis
x
B)
xCandidiasis
x
C)
xTrichomoniasis
D) xChlamydia xtrachomatis x - x D) x Chlamydia
xtrachomatis
x
Infections xthat xcommonly xaffect xthe xlabia xand xvagina xinclude xbacterial xvaginosis,
xcandidiasis,
and xtrichomoniasis. xChlamydia xtrachomatis xcommonly xaffects xthe xcervix, xendometrial
xlining x, x
x
fallopian xtubes, xand xpelvic
xcavity.
x
The xnurse xpractitioner xwould xtest xthe xobturator xand xiliopsoas xmuscle xto xevaluate xfor: x
x
A) Cholecystitis x
B) Acute xappendicitis x
C) Inguinal xhernia x
D) Gastriculcer x- xB) xAcute xappendicitis. x
x
Signs xand xsymptoms xof xan xacute xabdomen xinclude xinvol- xuntary xguarding, xrebound
xtenderness, xboardlike xabdomen, xand xa xpositive xobtu- xrator xand xpsoas xsign. xA xpositive
xobturator xsign xoccurs xwhen xpain xis xelicted xby xinternal xrotation xof xthe xright xhip xfrom x90
xdegrees xhip/knee xflexion. xThe xpsoas xsign xis xpositive xwhen xpain xoccurs xwith xpassive
xextension xof xthe xthigh xwhile xthe xpatient xis xlying xon xhis/her xside xwith xknees xextended, xor
xwhen xpain xoccurs xwith xactive xflexion xof xhis/her xthigh xat xthe xhip. x
,x
Treatment xfor xmild xpreeclampsia xincludes xall xof xthe xfollowing xexcept: x
x
x
A) xBed xrest xexcept xfor xbathroom
xprivileges
x
B) xClose xmonitoring xof xweight xand
xblood xpressure
C) xClose xfollow-up xof xurinary xprotein, xserum xcreatinine,
xand xplatelet xcount
D) xA xprescription xof xmethyldopa x(Aldomet) xto xcontrol xblood xpressure x-
xD) xA xprescription xof x
x
methyldopa x(Aldomet) xto xcontrol
xblood xpressure x
x
Recommended xcare xfor xwomen xdiagnosed xwith xpreeclampsia xincludes xbed xrest xwith xbath-
xroom xprivileges, xweight xand xBP xmonitoring, xand xclosely xfollowing xurine xprotein xand
xserum xprotein, xcreatinine, xand xplatelet xcounts. xOral xmedications xare xnot xused xas xfirst-line
xtreatment. x
x
All xof xthe xfollowing xservices xare xcovered xunder xMedicare xPart xA xexcept: x
x
A) Inpatienthospitalizations x
B) Medicines xadministered xto xa xpatient xwhile xhospitalized x
C) Nursing xhome xcare x
D) Surgeons x- xC) xNursing xhome xcare x
x
Medicare xA xcoverage xincludes xinpatient xhospitalization xand xskilled xcare xgiven xin xa
xcertified xskilled xnursing xfacility. xMost xnursing xhome xcare xis xcustodial xcare x(help xwith
xbathing, xdressing, xusing xa xbathroom, xand xeating). xThis xcare xis xnot xcovered xby xMedicare
xA. x
x
A x28-year-old xstudent xis xseen xin xthe xschool xhealth xclinic xwith xcomplaints xof xa xhacking
xcough xthat xis xproductive xof xsmall xamounts xof xsputum xand xa xrunny xnose. xHe xdoes xnot
xtake xany xmedications, xdenies xany xallergies, xand xhas xno xsignificant xmedical xhistory.
xPhysical xexamination xreveals xa xlow-grade xtemperature xof x99.9 xdegrees xFahrenheit,
xrespirations xof x16/min, xa xpulse xof x90 xbeats xper xminute, xand xdiffuse xfine xcrackles xin xthe
xbase xof xthe xlungs. xA xchest xradiograph x(x-ray) xshows xdiffuse xinfiltrates xon xthe xlower xlobe
xof xthe xright xlung. xThe xtotal xwhite xblood xcell xcount xis x10,500/uL. xWhat xis xthe xmost
xlikely xdiagnosis? x
x
A) Streptococcal xpneumonia x
B) Mycoplasma xpneumonia x
C) Acute xbronchitis x
D) Legionnaires xdisease x- xB) xMycoplasma xpneumonia x x
x
Mycoplasma xpneumonia xis xthe xorganism xmost xcom- xmonly xseen xin xchildren xand xyoung
xadults. xIt xis xeasily xspread xfrom xdroplets, xfrom xsneezing xand xcoughing, xin xclose
xproximity. xDiagnosis xis xbased xon xsymptoms xand xx-ray xresults xof xinfiltrates xin xlower
xlobes. x
x
,A x39-year-old xmigrant xworker xpresents xto xthe xclinic x2.5 xdays xafter xa xpurified xprotein
xderivative x(PPD) xtest. xWhat xminimum xsize xof xinduration xwould xbe xconsidered xposi- xtive
xfor xthis xpatient? x
x
A) x3 xmm xB) x5 xmm xC) x10 xmm xD) x15 xmm x- xC) x10 xmm x x
x
The xPPD xis xadministered xon xthe xvolar xaspect xof xthe xlower xarm xand xread x48 xhours xafter
xthe xtest xis xgiven. xThe xPPD xresult xmust xhave xinduration xand xmeasure x10 xmm xor xgreater
xto xbe xpositive xin xa xlow-risk xpatient. xInduration x(firmness xwith xpalpation) xmust xbe
xpresent. xIf xthe xsite xhas xerythema xbut xno xinduration, xresult xwould xbe xnegative. xColor xis
xnot ximportant. x
x
All xof xthe xfollowing xare xcorrect xstatements xregarding xthe xrole xof xthe xperson xnamed
xin xa x
x
durable xpower xof xattorney
xexcept:
x
A) The xagent's xdecisions xare xlegally xbinding x
B) The xagent xcan xmake xdecisions xin xother xareas xof xthe xpatient's xlife xsuch xas xfinancial
xissues x
C) The xagent xcan xdecide xfor xthe xpatient xwho xis xon xlife xsupport xwhen xthat xlife xsupport
xcan xbe xterminated x
D) The xpatient's xspouse xhas xa xright xto xoverride xthe xagent's xdecisions x- xD) xThe xpatient's
xspouse xhas xa xright xto xoverride xthe xagent's xdecisions x x
x
The xperson xnamed xin xa xdurable xpower xof xattorney x(the xagent) xis xdesignated xby xthe
xpatient xto xmake xall xmedical xdecisions, xas xwell xas xany xdecisions xregarding xthe xpatient's
xprivate xaffairs xin xthe xevent xthat xthe xpatient xbecomes xincompetent xand xunable xto xmake
xhis/her xown xdecisions. xNo xone xhas xthe xability xto xoverride xthe xagent's xdecision. x
x
All xof xthe xfollowing xare xtrue xstatements xregarding xMunchausen xsyndrome xexcept: x
x
A) It xis xconsidered xa xmental xillness x
B) The xpatient xhas xa xmedical xillness xthat xcauses xan xanxiety xreaction xand xdenial x
C) The xpatient xfakes xan xillness xin xorder xto xgain xattention xfrom xhealth xcare xproviders xD)
xThe xpatient xhas xan xinconsistent xmedical xhistory xalong xwith xa xpast xhistory xof xfrequent
xhospitalizations x- xB) xThe xpatient xhas xa xmedical xillness xthat xcauses xan xanxiety xreaction
xand xdenial x x
x
Munchausen xsyndrome xis xa xpsychiatric xdisorder xin xwhich xthe xpatient xfakes xa xmedical
xillness xor x
x
disorder xto xgain xattention xfrom xhealth xcare xprovid- xers. xThese xpatients xcommonly xuse
xthe
x
emergency xdepartment xfrequently xto xgain
xattention.
x
Which xof xthe xfollowing xantihypertensive xmedications xshould xthe xnurse xpractitioner
xavoid x
x
when xtreating xpatients xwith
xemphysema?
x
A) Calcium xchannel xblockers x
, B) Angiotensin-converting xenzyme x(ACE) xinhibitors x
C) Beta-blockers x
D) Diuretics x- xC) xBeta-blockers x x
x
Beta-blockers xshould xbe xavoided xin xpatients xwith xa xhistory xof xemphysema. xStudies xhave
xshown xevidence xof xa xreduction xin xforced xexpiratory xvolume xin x1 xsecond x(FEV1),
xincreased xairway xhyperresponsiveness, xand xinhibition xof xbronchodilator xresponse xto xbeta
xagonists xin xpatients xreceiving xnon-selective xbeta- xblockers xand xhigh xdoses xof
xcardioselective xbetablockers. x
x
A x30-year-old xchef xcomplains xof xpruritic xhives xover xher xchest xand xarms xbut xdenies
xdifficulty x
swallowing xor xbreathing. xShe xreports xa xfamily xhistory xof xallergic xrhinitis xand xasthma.
xWhich x
x
of xthe xfollowing xinterventions xis xmost
xappropriate?
x
A) Perform xa xcomplete xand xthorough xhistory x
B) Prescribe xan xoral xantihistamine xsuch xas xdiphenhydramine x25 xmg xPO xQID x
C) Give xan xinjection xof xepinephrine x1:1000 xintramuscularly xstat x x
D) Call x911 x- xA) xPerform xa xcomplete xand xthorough xhistory x x
x
Prior xto xprescribing xmedications, xa xcomplete xand xthorough xhistory xmust xbe xperformed xto
xdetermine xpossible xcauses xof xhives. xThe xpatient xdenied xdifficulty xwith xswallowing xand
xbreathing, xso xthere xwas xno xmedical xemergency xto xrequire xcalling x911. x
x
Which xof xthe xfollowing xfindings xis xmost xlikely xin xyoung xprimigravidas xwith
xpregnancy-
x
induced
xhypertension?
x
x
A) xAbdominal xcramping xand
xconstipation
x
B) xEdema xof xthe xface xand xthe xupper
xextremities
x
C) xShortness xof
xbreath
D) xDysuria xand xfrequency x- xB) xEdema xof xthe xface xand xthe xupper
xextremities x
x
Common xsigns xand xsymptoms xof xpregnancy-induced xhypertension xinclude xedema xof xthe
xface x
x
and xthe xupper xextremities, xweight xgain, xblurred x vision, xelevated xBP, xproteinuria,
xand
x
headaches.
x
Which xof xthe xfollowing xsymptoms xis xassociated x with xB12 xdeficiency xanemia? x
x
x
A) xSpoon-shaped xnails xand
xpica
