LEIK FNP Practice Questions EXAM
QUESTION AND ANSWER FALL 2025/26 -
THE UNIVERSITY OF TEXAS AT
ARLINGTON
Cardiovascular System
Question 1: A 58-year-old man presents with substernal chest pressure that began
while he was mowing the lawn. The discomfort radiates to his left arm and is associated
with diaphoresis and nausea. The pain has persisted for 25 minutes despite resting.
What is the most appropriate next step?
A. Schedule an outpatient exercise stress test
B. Obtain an ECG and activate emergency evaluation for suspected acute coronary
syndrome
C. Treat with an antacid and reassess in 1 hour
D. Diagnose stable angina and prescribe routine follow-up
Correct Answer: B
Rationale: Persistent substernal pressure with radiation, diaphoresis, and nausea is
highly concerning for acute coronary syndrome (ACS). The patient requires immediate
,ECG evaluation and emergency management rather than outpatient testing. Stable
angina typically occurs predictably with exertion and resolves with rest, whereas
persistent symptoms suggest an acute process.
Question 2: A 72-year-old woman reports progressive dyspnea, orthopnea, and
bilateral ankle swelling. Examination reveals elevated jugular venous pressure, bibasilar
crackles, and an S3 gallop. Which diagnosis is most likely?
A. Chronic obstructive pulmonary disease
B. Heart failure with volume overload
C. Pulmonary embolism
D. Nephrotic syndrome
Correct Answer: B
Rationale: Orthopnea, peripheral edema, elevated JVP, pulmonary crackles, and an S3
strongly support congestive heart failure with fluid overload. COPD generally produces
wheezing and prolonged expiration, while pulmonary embolism usually has an acute
presentation. Nephrotic syndrome can cause edema but does not typically produce JVP
elevation, pulmonary crackles, and an S3.
Question 3: A patient presents with intermittent palpitations and an irregularly irregular
pulse. What arrhythmia should be suspected?
A. Atrial flutter
B. Atrial fibrillation
C. Ventricular tachycardia
D. Sinus arrhythmia
, Correct Answer: B
Rationale: Atrial fibrillation classically produces an irregularly irregular rhythm caused
by chaotic atrial electrical activity. Patients may report palpitations, fatigue, dyspnea,
dizziness, or may be asymptomatic. ECG confirmation is required, and management
includes assessment of hemodynamic stability, ventricular rate, rhythm considerations,
and thromboembolic risk.
Question 4: Which finding most strongly suggests peripheral arterial disease rather
than chronic venous insufficiency?
A. Dependent edema
B. Brown skin discoloration around the ankles
C. Diminished pedal pulses and pain with walking relieved by rest
D. Medial malleolar ulceration
Correct Answer: C
Rationale: Diminished pedal pulses and intermittent claudication (pain with walking
that is relieved by rest) are classic findings of peripheral arterial disease. Dependent
edema, brown skin discoloration (hemosiderin staining), and medial malleolar ulcers are
more characteristic of chronic venous insufficiency.
Respiratory System
Question 5: A 28-year-old student presents with a hacking cough productive of small
amounts of sputum, a runny nose, and a low-grade fever. Physical examination reveals
QUESTION AND ANSWER FALL 2025/26 -
THE UNIVERSITY OF TEXAS AT
ARLINGTON
Cardiovascular System
Question 1: A 58-year-old man presents with substernal chest pressure that began
while he was mowing the lawn. The discomfort radiates to his left arm and is associated
with diaphoresis and nausea. The pain has persisted for 25 minutes despite resting.
What is the most appropriate next step?
A. Schedule an outpatient exercise stress test
B. Obtain an ECG and activate emergency evaluation for suspected acute coronary
syndrome
C. Treat with an antacid and reassess in 1 hour
D. Diagnose stable angina and prescribe routine follow-up
Correct Answer: B
Rationale: Persistent substernal pressure with radiation, diaphoresis, and nausea is
highly concerning for acute coronary syndrome (ACS). The patient requires immediate
,ECG evaluation and emergency management rather than outpatient testing. Stable
angina typically occurs predictably with exertion and resolves with rest, whereas
persistent symptoms suggest an acute process.
Question 2: A 72-year-old woman reports progressive dyspnea, orthopnea, and
bilateral ankle swelling. Examination reveals elevated jugular venous pressure, bibasilar
crackles, and an S3 gallop. Which diagnosis is most likely?
A. Chronic obstructive pulmonary disease
B. Heart failure with volume overload
C. Pulmonary embolism
D. Nephrotic syndrome
Correct Answer: B
Rationale: Orthopnea, peripheral edema, elevated JVP, pulmonary crackles, and an S3
strongly support congestive heart failure with fluid overload. COPD generally produces
wheezing and prolonged expiration, while pulmonary embolism usually has an acute
presentation. Nephrotic syndrome can cause edema but does not typically produce JVP
elevation, pulmonary crackles, and an S3.
Question 3: A patient presents with intermittent palpitations and an irregularly irregular
pulse. What arrhythmia should be suspected?
A. Atrial flutter
B. Atrial fibrillation
C. Ventricular tachycardia
D. Sinus arrhythmia
, Correct Answer: B
Rationale: Atrial fibrillation classically produces an irregularly irregular rhythm caused
by chaotic atrial electrical activity. Patients may report palpitations, fatigue, dyspnea,
dizziness, or may be asymptomatic. ECG confirmation is required, and management
includes assessment of hemodynamic stability, ventricular rate, rhythm considerations,
and thromboembolic risk.
Question 4: Which finding most strongly suggests peripheral arterial disease rather
than chronic venous insufficiency?
A. Dependent edema
B. Brown skin discoloration around the ankles
C. Diminished pedal pulses and pain with walking relieved by rest
D. Medial malleolar ulceration
Correct Answer: C
Rationale: Diminished pedal pulses and intermittent claudication (pain with walking
that is relieved by rest) are classic findings of peripheral arterial disease. Dependent
edema, brown skin discoloration (hemosiderin staining), and medial malleolar ulcers are
more characteristic of chronic venous insufficiency.
Respiratory System
Question 5: A 28-year-old student presents with a hacking cough productive of small
amounts of sputum, a runny nose, and a low-grade fever. Physical examination reveals
