ESTUDYR
GKA LEIK FNP PRACTICE MOST TESTED QUESTIONS
AND ANSWERS GRADED A+ WITH RATIONALES
A 72-year-old woman on HCTZ has increased ibuprofen use and still in pain. Which statement
best explains ibuprofen’s effect?
A) It increases the chances of adverse effects to her health
B) It inhibits the effect of renal prostaglandins and blunts the effectiveness of the diuretic ✅
C) It prolongs the therapeutic effects of hydrochlorothiazide and other diuretics
D) None of the statements are true
Rationale: NSAIDs block prostaglandin-mediated renal vasodilation → reduce diuretic efficacy
and risk renal ischemia/prerenal failure.
All of the following mostly affect the labia/vagina EXCEPT:
A) Bacterial vaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis ✅
Rationale: Chlamydia primarily infects cervix, endometrium, tubes — less commonly causes
vulvovaginal signs.
Testing obturator and iliopsoas muscles helps evaluate for:
A) Cholecystitis
B) Acute appendicitis ✅
C) Inguinal hernia
D) Gastric ulcer
Rationale: Positive psoas/obturator signs suggest irritation from an inflamed appendix.
Treatment for mild preeclampsia includes all EXCEPT:
A) Bed rest except bathroom privileges
B) Close monitoring weight & BP
C) Close follow-up of urine protein, creatinine, platelets
D) A prescription of methyldopa to control BP (as first-line outpatient) ✅
Rationale: Oral antihypertensives are not first-line outpatient for mild preeclampsia;
conservative monitoring is recommended.
Medicare Part A covers all EXCEPT:
A) Inpatient hospitalizations
B) Medicines administered while hospitalized
,ESTUDYR
C) Nursing home care (custodial care) ✅
D) Surgeons (hospital-based coverage for inpatient procedures)
Rationale: Custodial long-term nursing home care is generally not covered by Medicare A.
Young adult with hacking cough, low-grade fever, lower-lobe infiltrate — most likely:
A) Streptococcal pneumonia
B) Mycoplasma pneumoniae ✅
C) Acute bronchitis
D) Legionnaires’ disease
Rationale: Mycoplasma commonly causes atypical pneumonia in young adults with mild
symptoms and patchy infiltrates.
A 39-yr migrant worker 2.5 days after PPD: minimal induration considered positive?
A) 3 mm
B) 5 mm
C) 10 mm ✅
D) 15 mm
Rationale: 10 mm is threshold for low-risk persons like recent immigrants from high-prevalence
areas; 5 mm is for high-risk contacts.
Regarding durable power of attorney, which is FALSE:
A) Agent’s decisions are legally binding
B) Agent can make financial and medical decisions
C) Agent can decide about termination of life support if designated
D) The patient’s spouse can override the agent’s decisions ✅
Rationale: The appointed agent’s decisions hold; spouse cannot automatically override.
Which is FALSE about Munchausen syndrome:
A) It is considered a mental illness
B) The patient has a medical illness that causes an anxiety reaction and denial ✅
C) Patient fakes illness to gain attention from providers
D) Patient has inconsistent history and frequent hospitalizations
Rationale: Munchausen is fabrication/falsification of illness; not due to an actual medical illness
causing denial.
Antihypertensive to avoid in emphysema:
A) Calcium channel blockers
B) ACE inhibitors
C) Beta-blockers ✅
D) Diuretics
,ESTUDYR
Rationale: Nonselective β-blockers (and high doses of cardioselective agents) can worsen
bronchospasm/FEV1.
30-yr-old chef with pruritic hives, no airway symptoms. Most appropriate first step:
A) Perform a complete and thorough history (correct) ✅
B) Prescribe diphenhydramine 25 mg PO QID
C) Give IM epinephrine 1:1000 stat
D) Call 911
Rationale: With no anaphylaxis, obtain history to identify triggers and appropriate therapy.
Young primigravida with pregnancy-induced HTN — most likely finding:
A) Abdominal cramping and constipation
B) Edema of face and upper extremities ✅
C) Shortness of breath
D) Dysuria and frequency
Rationale: Facial/upper extremity edema, weight gain, proteinuria, elevated BP are common.
Symptom associated with B12 deficiency anemia:
A) Spoon-shaped nails and pica
B) An abnormal neurological exam
C) A vegan diet
D) Tingling and numbness of both feet ✅
Rationale: Neuropathy (paresthesias) is characteristic of B12 deficiency.
Abnormal triple screen in 35-yr primigravida (low AFP & estriol, high hCG) — best next step:
A) Order an ultrasound ✅
B) Order CT abdomen
C) Order 24-hr urine protein
D) Assess illicit drug use history
Rationale: Ultrasound evaluates fetal anatomy and markers (e.g., Down syndrome indicators).
Which statement about diverticula is FALSE:
A) Diverticula are located in colon
B) Low-fiber diet associated
C) Most colonic diverticula are infected with gram-negative bacteria ✅
D) Fiber supplementation (psyllium) recommended
Rationale: Diverticula may be colonized by mixed flora; not all are infected — C is
overstated/false as written.
Patients diagnosed with gonorrhea should also be treated for:
A) Chancroid
, ESTUDYR
B) Chlamydia trachomatis ✅
C) Herpes genitalis
D) PID (PID is a complication, not coinfection treatment)
Rationale: Co-treatment for chlamydia is recommended due to high co-infection rates.
Kyphosis is a late sign of:
A) Old age
B) Osteopenia
C) Osteoporosis ✅
D) Osteoarthritis
Rationale: Vertebral compression fractures from osteoporosis can lead to kyphosis.
A 35-yr primigravida with twins — expected AFP:
A) Normal
B) Higher than normal ✅
C) Lower than normal
D) None of the above
Rationale: Multiple gestation increases maternal serum AFP due to more fetal sources.
Antihypertensive beneficial in elderly white female with osteoporosis:
A) Calcium channel blocker ✅
B) ACE inhibitor
C) Beta-blocker
D) Diuretic
Rationale: CCBs do not cause calcium loss and are neutral/beneficial for bone; thiazide diuretics
also help bone but CCB listed per note.
Lachman maneuver detects:
A) Knee instability (ACL integrity) ✅
B) Nerve damage of knee
C) Integrity of patellar tendon
D) Meniscal tear
Rationale: Lachman test assesses anterior cruciate ligament laxity.
Adolescent male whose penis grows in length (not width) is Tanner:
A) Tanner II
B) Tanner III ✅
C) Tanner IV
D) Tanner V
Rationale: Stage III = penis lengthening and increased pubic hair coarseness.
GKA LEIK FNP PRACTICE MOST TESTED QUESTIONS
AND ANSWERS GRADED A+ WITH RATIONALES
A 72-year-old woman on HCTZ has increased ibuprofen use and still in pain. Which statement
best explains ibuprofen’s effect?
A) It increases the chances of adverse effects to her health
B) It inhibits the effect of renal prostaglandins and blunts the effectiveness of the diuretic ✅
C) It prolongs the therapeutic effects of hydrochlorothiazide and other diuretics
D) None of the statements are true
Rationale: NSAIDs block prostaglandin-mediated renal vasodilation → reduce diuretic efficacy
and risk renal ischemia/prerenal failure.
All of the following mostly affect the labia/vagina EXCEPT:
A) Bacterial vaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis ✅
Rationale: Chlamydia primarily infects cervix, endometrium, tubes — less commonly causes
vulvovaginal signs.
Testing obturator and iliopsoas muscles helps evaluate for:
A) Cholecystitis
B) Acute appendicitis ✅
C) Inguinal hernia
D) Gastric ulcer
Rationale: Positive psoas/obturator signs suggest irritation from an inflamed appendix.
Treatment for mild preeclampsia includes all EXCEPT:
A) Bed rest except bathroom privileges
B) Close monitoring weight & BP
C) Close follow-up of urine protein, creatinine, platelets
D) A prescription of methyldopa to control BP (as first-line outpatient) ✅
Rationale: Oral antihypertensives are not first-line outpatient for mild preeclampsia;
conservative monitoring is recommended.
Medicare Part A covers all EXCEPT:
A) Inpatient hospitalizations
B) Medicines administered while hospitalized
,ESTUDYR
C) Nursing home care (custodial care) ✅
D) Surgeons (hospital-based coverage for inpatient procedures)
Rationale: Custodial long-term nursing home care is generally not covered by Medicare A.
Young adult with hacking cough, low-grade fever, lower-lobe infiltrate — most likely:
A) Streptococcal pneumonia
B) Mycoplasma pneumoniae ✅
C) Acute bronchitis
D) Legionnaires’ disease
Rationale: Mycoplasma commonly causes atypical pneumonia in young adults with mild
symptoms and patchy infiltrates.
A 39-yr migrant worker 2.5 days after PPD: minimal induration considered positive?
A) 3 mm
B) 5 mm
C) 10 mm ✅
D) 15 mm
Rationale: 10 mm is threshold for low-risk persons like recent immigrants from high-prevalence
areas; 5 mm is for high-risk contacts.
Regarding durable power of attorney, which is FALSE:
A) Agent’s decisions are legally binding
B) Agent can make financial and medical decisions
C) Agent can decide about termination of life support if designated
D) The patient’s spouse can override the agent’s decisions ✅
Rationale: The appointed agent’s decisions hold; spouse cannot automatically override.
Which is FALSE about Munchausen syndrome:
A) It is considered a mental illness
B) The patient has a medical illness that causes an anxiety reaction and denial ✅
C) Patient fakes illness to gain attention from providers
D) Patient has inconsistent history and frequent hospitalizations
Rationale: Munchausen is fabrication/falsification of illness; not due to an actual medical illness
causing denial.
Antihypertensive to avoid in emphysema:
A) Calcium channel blockers
B) ACE inhibitors
C) Beta-blockers ✅
D) Diuretics
,ESTUDYR
Rationale: Nonselective β-blockers (and high doses of cardioselective agents) can worsen
bronchospasm/FEV1.
30-yr-old chef with pruritic hives, no airway symptoms. Most appropriate first step:
A) Perform a complete and thorough history (correct) ✅
B) Prescribe diphenhydramine 25 mg PO QID
C) Give IM epinephrine 1:1000 stat
D) Call 911
Rationale: With no anaphylaxis, obtain history to identify triggers and appropriate therapy.
Young primigravida with pregnancy-induced HTN — most likely finding:
A) Abdominal cramping and constipation
B) Edema of face and upper extremities ✅
C) Shortness of breath
D) Dysuria and frequency
Rationale: Facial/upper extremity edema, weight gain, proteinuria, elevated BP are common.
Symptom associated with B12 deficiency anemia:
A) Spoon-shaped nails and pica
B) An abnormal neurological exam
C) A vegan diet
D) Tingling and numbness of both feet ✅
Rationale: Neuropathy (paresthesias) is characteristic of B12 deficiency.
Abnormal triple screen in 35-yr primigravida (low AFP & estriol, high hCG) — best next step:
A) Order an ultrasound ✅
B) Order CT abdomen
C) Order 24-hr urine protein
D) Assess illicit drug use history
Rationale: Ultrasound evaluates fetal anatomy and markers (e.g., Down syndrome indicators).
Which statement about diverticula is FALSE:
A) Diverticula are located in colon
B) Low-fiber diet associated
C) Most colonic diverticula are infected with gram-negative bacteria ✅
D) Fiber supplementation (psyllium) recommended
Rationale: Diverticula may be colonized by mixed flora; not all are infected — C is
overstated/false as written.
Patients diagnosed with gonorrhea should also be treated for:
A) Chancroid
, ESTUDYR
B) Chlamydia trachomatis ✅
C) Herpes genitalis
D) PID (PID is a complication, not coinfection treatment)
Rationale: Co-treatment for chlamydia is recommended due to high co-infection rates.
Kyphosis is a late sign of:
A) Old age
B) Osteopenia
C) Osteoporosis ✅
D) Osteoarthritis
Rationale: Vertebral compression fractures from osteoporosis can lead to kyphosis.
A 35-yr primigravida with twins — expected AFP:
A) Normal
B) Higher than normal ✅
C) Lower than normal
D) None of the above
Rationale: Multiple gestation increases maternal serum AFP due to more fetal sources.
Antihypertensive beneficial in elderly white female with osteoporosis:
A) Calcium channel blocker ✅
B) ACE inhibitor
C) Beta-blocker
D) Diuretic
Rationale: CCBs do not cause calcium loss and are neutral/beneficial for bone; thiazide diuretics
also help bone but CCB listed per note.
Lachman maneuver detects:
A) Knee instability (ACL integrity) ✅
B) Nerve damage of knee
C) Integrity of patellar tendon
D) Meniscal tear
Rationale: Lachman test assesses anterior cruciate ligament laxity.
Adolescent male whose penis grows in length (not width) is Tanner:
A) Tanner II
B) Tanner III ✅
C) Tanner IV
D) Tanner V
Rationale: Stage III = penis lengthening and increased pubic hair coarseness.
