LEIK FNP Certification Exam 2 2024
x x x x x x
x
A xnurse xpractitioner xworking xin xa xcommunity xhealth xclinic xsees xa xmale xpatient xwho
xexpresses xconcern xabout xstarting xa xhomosexual xrelationship xwith xa xnew xpartner. xWhich
xof xthe xfollowing x
is xthe xbest xplan xto xfollow xduring xthis xvisit? x(Select xall xthat xapply.) x
Contact xthe xpatient's xpartner xto xschedule xHIV xtesting x
Educate xthe xpatient xabout xusing xbarrier xdevices xduring xsex x
Prescribe xdaily xoral xPrEP x
Draw xa xblood xsample xfor xa xcombination xHIV xantigen/antibody xtest x
Schedule xa xfollow-up xappointment xin x1 xmonth xto xreview xtest xresults xand xdiscuss xoptions
xfor xPrEP x- xEducate xthe xpatient xabout xusing xbarrier xdevices xduring xsex; xdraw xa xblood
xsample xfor xa xcombination xHIV xantigen/antibody xtest; xschedule xa xfollow-up xappointment
xin x1 xmonth xto xreview xtest xresults xand xdiscuss xoptions xfor xPrEP x
x
Education xon xusing xbarriers xduring xsexual xactivity x(e.g., xcondom/dental xdams) xis
ximportant. xDaily xoral xpreexposure xprophylaxis x(PrEP), xsuch xas xtenofovir xemtricitabine, xis
xrecommended xfor xsexually xactive xpersons xwho xare xat xrisk xfor xHIV. xPrEP xis xused xin
xHIV-negative xpersons, xso xthe xnurse xpractitioner xmust xwait xfor xthe xtest xresults xbefore
xprescribing. xIt xis xappropriate xto xschedule xa x1-month xfollow-up xto xreview xthe xtest xresults
xand xdiscuss xPrEP xoptions x(if xtest xis xnegative). xIt xis xnot xappropriate xethically xor xlegally
xto xcontact xthe xpartner; xhowever, xit xwould xbe xappropriate xfor xthe xpatient xto xencourage xhis
xpartner xto xget xtested. x
x
An xolder xadult xmale xpresents xwith xcomplaints xof xsharp xflank xand xback xpain. xThe xpatient
xhas xdifficulty xanswering xquestions xbecause xof xseverity xof xpain. xBlood xpressure xis x90/60
xmmHg. x
The xpatient xhas xa x20-pack-year xsmoking xhistory. xAbdomen xis xdistended xupon xpalpitation.
xWhich xdiagnosis xis xmost xlikely? x
Congestive xheart xfailure x
Infective xendocarditis x
Dissecting xabdominal xaortic xaneurysm x
Acute xmyocardial xinfarction x- xDissecting xabdominal xaortic xaneurysm. x
Dissecting xabdominal xaortic xaneurysm xis xa xsudden xonset xof xsevere, xsharp, xexcruciating
xpain xlocated xin xthe xabdomen, xback, xor xflank xarea, xaccompanied xby xa xdistended xabdomen
xand xhypotension. xOlder xmale xadults xwith xa xsmoking xhistory xand xhypertension xare xat
xhigher xrisk. xCongestive xheart xfailure xsymptoms xare xdyspnea, xfatigue, xdry xcough, xand
xswollen xfeet xand xankles. xPatients xwith xinfective xendocarditis xpresent xwith xfever, xchills,
xand xmalaise, xalong xwith xthe xpresence xof xa xnew xmurmur. xAcute xmyocardial xinfarction
xgenerally xpresents xwith xa xgradual xonset xof xintense xand xheavy xchest xdiscomfort xthat xfeels
xlike xa xsqueezing, xtightness, xand xheavy xpressure xin xthe xchest. x
x
Mrs. xHarris xa x67-year-old xwoman xwho xis xin xthe xearly xstages xof xAlzheimer xdisease. xShe
xsuffers x
x
from xmild xdementia. xIn xthis xtype xof xAlzheimer xdementia xwhich xof xthe xfollowing xwould
xyou
x
use xas xthe xmainstay
xtreatment?
,x
x
Vitamin xE x1000 xIU xtwice
xdaily
x
cholinesterase
xinhibitors
x
NSAIDS
Selgiline x5 xmg xtwice xdaily x- xcholinesterase
xinhibitors
x
The xmainstay xtreatment xfor xmild xto xmoderate xstage xAlzheimer-type xdementia xis xthe xuse
xof xcholinesterase xinhibitors. xThese xinclude xdonepezil x(Aricept), xrivastigmine x(Exelon),
xand xgalantamine x(Razadyne). xThey xhave xa xclear, xalthough xminor xand xtime-limited
xbenefit. x
x
When xlistening xto xyour x86-year-old xpatient's xheart xmurmur, xyou xnote xthat xit xis xso xloud
xthat xit x
can xbe xheard xwith xthe xstethoscope xcompletely xoff xthe xchest. xHow xdo xyou xgrade xthe
xmurmur?
x
IV/VI. x
I/VI. x
V/VI. x
VI/VI. x- xVI/VI. x
x
Grading xheart xmurmurs xfollows xthis xsystem: xI/VI: xHeart xmurmur xmakes xfaint xsound xand
xmay xnot xbe xheard xwhen xpatient xchanges xposition. xII/VI: xHeart xmurmur xis xquiet xbut xcan
xbe xheard xas xsoon xas xthe xstethoscope xis xplaced xon xthe xchest. xIII/VI: xHeart xmurmur xis
xmoderately xloud. xIV/VI: xHeart xmurmur xis xloud xand xaccompanied xby xa xpalpable xthrill.
xV/VI: xHeart xmurmur xis xvery xloud xand xcan xbe xheard xwith xthe xstethoscope xpartially xoff
xthe xchest. xVI/VI: xHeart xmurmur xis xvery xloud xand xcan xbe xheard xwith xthe xstethoscope
xcompletely xoff xthe xpatient's xchest. x
x
Which xof xthe xfollowing xpersons xwould xnot xbe xa xcandidate xfor xthe xantipneumococcal
xvaccine? x
x
x
a x65-year-old xhealthy xfemale xliving xwith xher
xfamily
x
a x35-year-old xpatient xwith xHIV
xinfection
x
a x58-year-old xmale xresident xof xa xnursing
xhome
a x55-year-old xfemale xliving xalone x- xa x55-year-old xfemale xliving
xalone
x
The xantipneumococcal xvaccine xis xnot xindicated xfor xan xotherwise xhealthy xperson xwho xis
xunder xthe xage xof x65 xunless xthere xare xother xhealth xfactors xinvolved. xLiving xalone xhas xno
xbearing xon xthe xneed xfor xthe xvaccine. xThe xvaccine xis xindicated xfor xpersons xwith xHIV
xinfection, xpersons xliving xin xnursing xhomes, xand xall xadults x65 xyears xor xolder xregardless xof
xhealth xstatus. x
x
,Which xof xthe xfollowing xdiseases xis xmore xlikely xto xcause xchronic xpelvic xpain xrather xthan
xacute x
x
pelvic
xpain?
x
ectopic
xpregnancy xPID
xovarian xcysts x
interstitial xcystitis x- xinterstitial xcystitisInterstitial xcystitis xis xmore xlikely xto xcause xchronic
xpelvic xpain xrather xthan xacute xpelvic xpain xas xin xthe xother xchoices. xOther xcauses xof
xchronic xpelvic xpain xinclude: xendometriosis, xleiomyomas, xand xmalignancy. x
x
You xhave xa x58-year-old xmale xpatient xwith xpossible xpancreatic xcancer. xYou xwill xnot
xorder xan x
x
abdominal xultrasound xfor xdiagnosis xbecause xit xis xlimited xby xwhich xof xthe
xfollowing?
x
x
previous xhistory xof xpancreatic
xdisease
x
patient's
xage
x
the xpresence xof xintestinal
xgas
size xof xtumor x- xthe xpresence xof xintestinal
xgas
x
The xusefulness xof xabdominal xultrasound xis xlimited xby xthe xpresence xof xintestinal
xgas. x
x
Abdominal xCT xscan xis xmore xhelpful xin xidentifying xpancreatic
xcancer.
x
A x58-year-old xmale xpresents xin xthe xoffice xwith xa xglucose xof x309 xmg/dL xand xis
xsymptomatic x
x
for xType xII xdiabetes xmellitus. xWhat xshould xbe xdone xto xmanage xhim
xFIRST?
x
Start xinsulin x
Start xmetformin xplus xpioglitazone x
Have xhim xreturn xtomorrow xto xrecheck xhis xblood xglucose x
Start xmetformin x- xStart xinsulin x
x
Most xoral xagents xwill xhave xlittle xeffect xon xhis xglucose xand xit xshould xbe xlowered
ximmediately. xTherefore, xinsulin xis xthe xbest xagent xto xreduce xthe xblood xsugar xso xthat xoral
xagents xwill xhave xa xchance xto xwork. xHe xshould xreturn xto xthe xclinic xthe xnext xday xfor xa
xrecheck xof xthe xblood xglucose xand xmedication xadjustment. x
x
Utilization xreview xcan xbest xbe xdescribed xas xwhich xof xthe xfollowing? x
x
a xsystem xof xmonitoring xand xassessing xfor xhigh-risk xareas xand
xprocedures xthe xprocess xof xevaluating xthe xappropriateness xof xinpatient
xhospitalization xthe xprocess xused xfor xaccreditation x
, the xprocess xused xfor xcase xmanagement x- xthe xprocess xof xevaluating xthe xappropriateness xof
xinpatient xhospitalization x
x
A xutilization xreview xis xthe xprocess xof xevaluating xthe xappropriateness xof xinpatient
xhospitalization. xProof xof xthe xmedical xnecessity xfor xthe xpatient's xhospitalization xis xdone
xmainly xthrough xchart xreviews. xIf xthe xreviewer xand xpayor xdo xnot xagree, xthe xclaim xcan xbe
xdenied, xresulting xin xdenial xof xpayment xto xthe xhealth xfacility. x
x
John xis xa xpatient xwith xacute xrenal xfailure. xHis xinability xto xregulate xelectrolytes
xmight xbe x
x
evidenced xby xall xbut xwhich xof xthe xfollowing
xconditions?
x
hyperkalemia xhyperlipidemia
xhypocalcemia xhypernatremia
x- xhyperlipidemia x
x
This xpatient's xinability xto xregulate xelectrolytes xmight xbe xevidenced xby xhyperkalemia,
xhypernatremia, xhyponatremia, xhypokalemia, xhypermagnesemia, xhyperphosphatemia, xand
xhypocalcemia. xHyperlipidemia xis xabnormally xelevated xlevels xof xany xor xall xlipids xand/or
xlipoproteins xin xthe xblood. x
x
Which xof xthe xfollowing xstatements xabout xevaluation xand xfollow-up xof xa xpatient xwith
xIBD xis x
x
least
xaccurate?
x
Most xpatients xfollow xa xcyclic xcourse xof xremission xand xflare-up. x
An xestimated x50% xto x65% xof xpatients xwith xCrohn's xdisease xundergo xsurgery xat xsome
xpoint xin xtheir xlives xfor xintestinal xresection xor xcolectomy. x
Overall xmortality xfor xulcerative xcolitis xis xbetween x35% xand x40%. x
Ulcerative xcolitis xpatients xhave xa xrisk xfor xserious xcomplications xsuch xas xhemorrhage
xand x
x
perforation. x- xOverall xmortality xfor xulcerative xcolitis xis xbetween x35% xand
x40%.
x
This xis xnot xaccurate. xThe xoverall xmortality xfor xulcerative xcolitis xis xmuch xlower x- xbetween
x12% xand x15%. xThis xis xbecause xof xrisk xfor xserious xcomplications xsuch xas xhemorrhage,
xperforation, xand xtoxic xmegacolon. x
x
A xpatient xwho xhas xbeen xprescribed xmiconazole xfor xathlete's xfoot xasks xhow xlong xhe
xshould xuse x
x
the xmedication. xWhich xof xthe xfollowing xis xan xappropriate xresponse xto xthis
xpatient?
x
The xpatient xshould xuse xthe xmedication xfor x3 xdays. x
The xpatient xshould xuse xthe xmedication xfor x1 xmonth. x
The xpatient xshould xuse xthe xmedication xuntil xsymptoms xare xgone. x
The xpatient xshould xuse xthe xmedication xfor x2 xweeks. x- xThe xpatient xshould xuse xthe
xmedication xfor x1 xmonth x x
x
x x x x x x
x
A xnurse xpractitioner xworking xin xa xcommunity xhealth xclinic xsees xa xmale xpatient xwho
xexpresses xconcern xabout xstarting xa xhomosexual xrelationship xwith xa xnew xpartner. xWhich
xof xthe xfollowing x
is xthe xbest xplan xto xfollow xduring xthis xvisit? x(Select xall xthat xapply.) x
Contact xthe xpatient's xpartner xto xschedule xHIV xtesting x
Educate xthe xpatient xabout xusing xbarrier xdevices xduring xsex x
Prescribe xdaily xoral xPrEP x
Draw xa xblood xsample xfor xa xcombination xHIV xantigen/antibody xtest x
Schedule xa xfollow-up xappointment xin x1 xmonth xto xreview xtest xresults xand xdiscuss xoptions
xfor xPrEP x- xEducate xthe xpatient xabout xusing xbarrier xdevices xduring xsex; xdraw xa xblood
xsample xfor xa xcombination xHIV xantigen/antibody xtest; xschedule xa xfollow-up xappointment
xin x1 xmonth xto xreview xtest xresults xand xdiscuss xoptions xfor xPrEP x
x
Education xon xusing xbarriers xduring xsexual xactivity x(e.g., xcondom/dental xdams) xis
ximportant. xDaily xoral xpreexposure xprophylaxis x(PrEP), xsuch xas xtenofovir xemtricitabine, xis
xrecommended xfor xsexually xactive xpersons xwho xare xat xrisk xfor xHIV. xPrEP xis xused xin
xHIV-negative xpersons, xso xthe xnurse xpractitioner xmust xwait xfor xthe xtest xresults xbefore
xprescribing. xIt xis xappropriate xto xschedule xa x1-month xfollow-up xto xreview xthe xtest xresults
xand xdiscuss xPrEP xoptions x(if xtest xis xnegative). xIt xis xnot xappropriate xethically xor xlegally
xto xcontact xthe xpartner; xhowever, xit xwould xbe xappropriate xfor xthe xpatient xto xencourage xhis
xpartner xto xget xtested. x
x
An xolder xadult xmale xpresents xwith xcomplaints xof xsharp xflank xand xback xpain. xThe xpatient
xhas xdifficulty xanswering xquestions xbecause xof xseverity xof xpain. xBlood xpressure xis x90/60
xmmHg. x
The xpatient xhas xa x20-pack-year xsmoking xhistory. xAbdomen xis xdistended xupon xpalpitation.
xWhich xdiagnosis xis xmost xlikely? x
Congestive xheart xfailure x
Infective xendocarditis x
Dissecting xabdominal xaortic xaneurysm x
Acute xmyocardial xinfarction x- xDissecting xabdominal xaortic xaneurysm. x
Dissecting xabdominal xaortic xaneurysm xis xa xsudden xonset xof xsevere, xsharp, xexcruciating
xpain xlocated xin xthe xabdomen, xback, xor xflank xarea, xaccompanied xby xa xdistended xabdomen
xand xhypotension. xOlder xmale xadults xwith xa xsmoking xhistory xand xhypertension xare xat
xhigher xrisk. xCongestive xheart xfailure xsymptoms xare xdyspnea, xfatigue, xdry xcough, xand
xswollen xfeet xand xankles. xPatients xwith xinfective xendocarditis xpresent xwith xfever, xchills,
xand xmalaise, xalong xwith xthe xpresence xof xa xnew xmurmur. xAcute xmyocardial xinfarction
xgenerally xpresents xwith xa xgradual xonset xof xintense xand xheavy xchest xdiscomfort xthat xfeels
xlike xa xsqueezing, xtightness, xand xheavy xpressure xin xthe xchest. x
x
Mrs. xHarris xa x67-year-old xwoman xwho xis xin xthe xearly xstages xof xAlzheimer xdisease. xShe
xsuffers x
x
from xmild xdementia. xIn xthis xtype xof xAlzheimer xdementia xwhich xof xthe xfollowing xwould
xyou
x
use xas xthe xmainstay
xtreatment?
,x
x
Vitamin xE x1000 xIU xtwice
xdaily
x
cholinesterase
xinhibitors
x
NSAIDS
Selgiline x5 xmg xtwice xdaily x- xcholinesterase
xinhibitors
x
The xmainstay xtreatment xfor xmild xto xmoderate xstage xAlzheimer-type xdementia xis xthe xuse
xof xcholinesterase xinhibitors. xThese xinclude xdonepezil x(Aricept), xrivastigmine x(Exelon),
xand xgalantamine x(Razadyne). xThey xhave xa xclear, xalthough xminor xand xtime-limited
xbenefit. x
x
When xlistening xto xyour x86-year-old xpatient's xheart xmurmur, xyou xnote xthat xit xis xso xloud
xthat xit x
can xbe xheard xwith xthe xstethoscope xcompletely xoff xthe xchest. xHow xdo xyou xgrade xthe
xmurmur?
x
IV/VI. x
I/VI. x
V/VI. x
VI/VI. x- xVI/VI. x
x
Grading xheart xmurmurs xfollows xthis xsystem: xI/VI: xHeart xmurmur xmakes xfaint xsound xand
xmay xnot xbe xheard xwhen xpatient xchanges xposition. xII/VI: xHeart xmurmur xis xquiet xbut xcan
xbe xheard xas xsoon xas xthe xstethoscope xis xplaced xon xthe xchest. xIII/VI: xHeart xmurmur xis
xmoderately xloud. xIV/VI: xHeart xmurmur xis xloud xand xaccompanied xby xa xpalpable xthrill.
xV/VI: xHeart xmurmur xis xvery xloud xand xcan xbe xheard xwith xthe xstethoscope xpartially xoff
xthe xchest. xVI/VI: xHeart xmurmur xis xvery xloud xand xcan xbe xheard xwith xthe xstethoscope
xcompletely xoff xthe xpatient's xchest. x
x
Which xof xthe xfollowing xpersons xwould xnot xbe xa xcandidate xfor xthe xantipneumococcal
xvaccine? x
x
x
a x65-year-old xhealthy xfemale xliving xwith xher
xfamily
x
a x35-year-old xpatient xwith xHIV
xinfection
x
a x58-year-old xmale xresident xof xa xnursing
xhome
a x55-year-old xfemale xliving xalone x- xa x55-year-old xfemale xliving
xalone
x
The xantipneumococcal xvaccine xis xnot xindicated xfor xan xotherwise xhealthy xperson xwho xis
xunder xthe xage xof x65 xunless xthere xare xother xhealth xfactors xinvolved. xLiving xalone xhas xno
xbearing xon xthe xneed xfor xthe xvaccine. xThe xvaccine xis xindicated xfor xpersons xwith xHIV
xinfection, xpersons xliving xin xnursing xhomes, xand xall xadults x65 xyears xor xolder xregardless xof
xhealth xstatus. x
x
,Which xof xthe xfollowing xdiseases xis xmore xlikely xto xcause xchronic xpelvic xpain xrather xthan
xacute x
x
pelvic
xpain?
x
ectopic
xpregnancy xPID
xovarian xcysts x
interstitial xcystitis x- xinterstitial xcystitisInterstitial xcystitis xis xmore xlikely xto xcause xchronic
xpelvic xpain xrather xthan xacute xpelvic xpain xas xin xthe xother xchoices. xOther xcauses xof
xchronic xpelvic xpain xinclude: xendometriosis, xleiomyomas, xand xmalignancy. x
x
You xhave xa x58-year-old xmale xpatient xwith xpossible xpancreatic xcancer. xYou xwill xnot
xorder xan x
x
abdominal xultrasound xfor xdiagnosis xbecause xit xis xlimited xby xwhich xof xthe
xfollowing?
x
x
previous xhistory xof xpancreatic
xdisease
x
patient's
xage
x
the xpresence xof xintestinal
xgas
size xof xtumor x- xthe xpresence xof xintestinal
xgas
x
The xusefulness xof xabdominal xultrasound xis xlimited xby xthe xpresence xof xintestinal
xgas. x
x
Abdominal xCT xscan xis xmore xhelpful xin xidentifying xpancreatic
xcancer.
x
A x58-year-old xmale xpresents xin xthe xoffice xwith xa xglucose xof x309 xmg/dL xand xis
xsymptomatic x
x
for xType xII xdiabetes xmellitus. xWhat xshould xbe xdone xto xmanage xhim
xFIRST?
x
Start xinsulin x
Start xmetformin xplus xpioglitazone x
Have xhim xreturn xtomorrow xto xrecheck xhis xblood xglucose x
Start xmetformin x- xStart xinsulin x
x
Most xoral xagents xwill xhave xlittle xeffect xon xhis xglucose xand xit xshould xbe xlowered
ximmediately. xTherefore, xinsulin xis xthe xbest xagent xto xreduce xthe xblood xsugar xso xthat xoral
xagents xwill xhave xa xchance xto xwork. xHe xshould xreturn xto xthe xclinic xthe xnext xday xfor xa
xrecheck xof xthe xblood xglucose xand xmedication xadjustment. x
x
Utilization xreview xcan xbest xbe xdescribed xas xwhich xof xthe xfollowing? x
x
a xsystem xof xmonitoring xand xassessing xfor xhigh-risk xareas xand
xprocedures xthe xprocess xof xevaluating xthe xappropriateness xof xinpatient
xhospitalization xthe xprocess xused xfor xaccreditation x
, the xprocess xused xfor xcase xmanagement x- xthe xprocess xof xevaluating xthe xappropriateness xof
xinpatient xhospitalization x
x
A xutilization xreview xis xthe xprocess xof xevaluating xthe xappropriateness xof xinpatient
xhospitalization. xProof xof xthe xmedical xnecessity xfor xthe xpatient's xhospitalization xis xdone
xmainly xthrough xchart xreviews. xIf xthe xreviewer xand xpayor xdo xnot xagree, xthe xclaim xcan xbe
xdenied, xresulting xin xdenial xof xpayment xto xthe xhealth xfacility. x
x
John xis xa xpatient xwith xacute xrenal xfailure. xHis xinability xto xregulate xelectrolytes
xmight xbe x
x
evidenced xby xall xbut xwhich xof xthe xfollowing
xconditions?
x
hyperkalemia xhyperlipidemia
xhypocalcemia xhypernatremia
x- xhyperlipidemia x
x
This xpatient's xinability xto xregulate xelectrolytes xmight xbe xevidenced xby xhyperkalemia,
xhypernatremia, xhyponatremia, xhypokalemia, xhypermagnesemia, xhyperphosphatemia, xand
xhypocalcemia. xHyperlipidemia xis xabnormally xelevated xlevels xof xany xor xall xlipids xand/or
xlipoproteins xin xthe xblood. x
x
Which xof xthe xfollowing xstatements xabout xevaluation xand xfollow-up xof xa xpatient xwith
xIBD xis x
x
least
xaccurate?
x
Most xpatients xfollow xa xcyclic xcourse xof xremission xand xflare-up. x
An xestimated x50% xto x65% xof xpatients xwith xCrohn's xdisease xundergo xsurgery xat xsome
xpoint xin xtheir xlives xfor xintestinal xresection xor xcolectomy. x
Overall xmortality xfor xulcerative xcolitis xis xbetween x35% xand x40%. x
Ulcerative xcolitis xpatients xhave xa xrisk xfor xserious xcomplications xsuch xas xhemorrhage
xand x
x
perforation. x- xOverall xmortality xfor xulcerative xcolitis xis xbetween x35% xand
x40%.
x
This xis xnot xaccurate. xThe xoverall xmortality xfor xulcerative xcolitis xis xmuch xlower x- xbetween
x12% xand x15%. xThis xis xbecause xof xrisk xfor xserious xcomplications xsuch xas xhemorrhage,
xperforation, xand xtoxic xmegacolon. x
x
A xpatient xwho xhas xbeen xprescribed xmiconazole xfor xathlete's xfoot xasks xhow xlong xhe
xshould xuse x
x
the xmedication. xWhich xof xthe xfollowing xis xan xappropriate xresponse xto xthis
xpatient?
x
The xpatient xshould xuse xthe xmedication xfor x3 xdays. x
The xpatient xshould xuse xthe xmedication xfor x1 xmonth. x
The xpatient xshould xuse xthe xmedication xuntil xsymptoms xare xgone. x
The xpatient xshould xuse xthe xmedication xfor x2 xweeks. x- xThe xpatient xshould xuse xthe
xmedication xfor x1 xmonth x x
x
