LEIK FNP EXAM PRACTICE
QUESTIONS (2026/2027) QUESTIONS
AND ANSWERS
1. A 65-year-old African American male with hypertension and Type 2 Diabetes presents for a
follow-up. His blood pressure is 152/94 mmHg. According to JNC-8 guidelines, which is the
best initial medication choice?
A. Lisinopril (ACE inhibitor)
B. Losartan (ARB)
C. Metoprolol (Beta-blocker)
D. Amlodipine (CCB)
Answer: D
Conceptual Explanation: For African American patients with or without diabetes, JNC-8
recommends starting with a Thiazide-type diuretic or a Calcium Channel Blocker (CCB).
While ACEIs are good for DM, CCBs/Thiazides have better BP reduction outcomes in this
specific population.
,2. A 24-year-old female presents with a ‘strawberry cervix’ and a malodorous, frothy, green-
yellow vaginal discharge. What is the most likely diagnosis?
A. Bacterial Vaginosis
B. Trichomoniasis
C. Chlamydia
D. Candidiasis
Answer: B
Conceptual Explanation: Trichomoniasis is characterized by a strawberry cervix
(petechiae), malodorous frothy green-yellow discharge, and a pH > 4.5.
3. Which of the following physical exam findings is most suggestive of Pyloric Stenosis in a 4-
week-old infant?
A. Sausage-shaped mass in the upper right quadrant
B. Projectile vomiting without weight loss
C. Currant jelly stools
D. Olive-shaped mass in the midepigastrium
Answer: D
Conceptual Explanation: An olive-shaped mass in the midepigastrium is a hallmark sign
of hypertrophic pyloric stenosis, usually presenting with projectile vomiting and weight
loss.
, 4. An EKG shows a sawtooth pattern with a rapid atrial rate. What is the most likely rhythm?
A. Atrial Flutter
B. Atrial Fibrillation
C. Ventricular Tachycardia
D. First-degree AV Block
Answer: A
Conceptual Explanation: Atrial flutter is classically described as having a ‘sawtooth’
pattern on the EKG.
5. A patient presents with sudden onset of severe eye pain, blurry vision, and seeing ‘halos’
around lights. The pupil is mid-dilated and non-reactive. What is the immediate action?
A. Prescribe antibiotic eye drops
B. Perform a fluorescein stain for corneal abrasion
C. Apply a warm compress and re-evaluate in 24 hours
D. Refer to ophthalmology immediately for suspected Acute Angle-Closure Glaucoma
Answer: D
Conceptual Explanation: Acute Angle-Closure Glaucoma is a medical emergency
characterized by severe pain, halos, and a fixed mid-dilated pupil; it requires immediate
specialist intervention to prevent permanent vision loss.
QUESTIONS (2026/2027) QUESTIONS
AND ANSWERS
1. A 65-year-old African American male with hypertension and Type 2 Diabetes presents for a
follow-up. His blood pressure is 152/94 mmHg. According to JNC-8 guidelines, which is the
best initial medication choice?
A. Lisinopril (ACE inhibitor)
B. Losartan (ARB)
C. Metoprolol (Beta-blocker)
D. Amlodipine (CCB)
Answer: D
Conceptual Explanation: For African American patients with or without diabetes, JNC-8
recommends starting with a Thiazide-type diuretic or a Calcium Channel Blocker (CCB).
While ACEIs are good for DM, CCBs/Thiazides have better BP reduction outcomes in this
specific population.
,2. A 24-year-old female presents with a ‘strawberry cervix’ and a malodorous, frothy, green-
yellow vaginal discharge. What is the most likely diagnosis?
A. Bacterial Vaginosis
B. Trichomoniasis
C. Chlamydia
D. Candidiasis
Answer: B
Conceptual Explanation: Trichomoniasis is characterized by a strawberry cervix
(petechiae), malodorous frothy green-yellow discharge, and a pH > 4.5.
3. Which of the following physical exam findings is most suggestive of Pyloric Stenosis in a 4-
week-old infant?
A. Sausage-shaped mass in the upper right quadrant
B. Projectile vomiting without weight loss
C. Currant jelly stools
D. Olive-shaped mass in the midepigastrium
Answer: D
Conceptual Explanation: An olive-shaped mass in the midepigastrium is a hallmark sign
of hypertrophic pyloric stenosis, usually presenting with projectile vomiting and weight
loss.
, 4. An EKG shows a sawtooth pattern with a rapid atrial rate. What is the most likely rhythm?
A. Atrial Flutter
B. Atrial Fibrillation
C. Ventricular Tachycardia
D. First-degree AV Block
Answer: A
Conceptual Explanation: Atrial flutter is classically described as having a ‘sawtooth’
pattern on the EKG.
5. A patient presents with sudden onset of severe eye pain, blurry vision, and seeing ‘halos’
around lights. The pupil is mid-dilated and non-reactive. What is the immediate action?
A. Prescribe antibiotic eye drops
B. Perform a fluorescein stain for corneal abrasion
C. Apply a warm compress and re-evaluate in 24 hours
D. Refer to ophthalmology immediately for suspected Acute Angle-Closure Glaucoma
Answer: D
Conceptual Explanation: Acute Angle-Closure Glaucoma is a medical emergency
characterized by severe pain, halos, and a fixed mid-dilated pupil; it requires immediate
specialist intervention to prevent permanent vision loss.
