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Test Bank for LEIK Family nurse practitioner Certification Exam 2 2024
Test Bank for LEIK Family nurse practitioner Certification Exam 2 2024
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Test Bank forLEIK Family nurse practitioner
Certification Exam 2 2024
A nurse practitioner working in a community health clinic sees a male patient who expresses
concern about starting a homosexual relationship with a new partner. Which of the following
is the best plan to follow during this visit? (Select all that apply.)
Contact the patient's partner to schedule HIV testing
Educate the patient about using barrier devices during sex
Prescribe daily oral PrEP
Draw a blood sample for a combination HIV antigen/antibody test
Schedule a follow-up appointment in 1 month to review test results and discuss options for
PrEP - Educate the patient about using barrier devices during sex; draw a blood sample for a
combination HIV antigen/antibody test; schedule a follow-up appointment in 1 month to
review test results and discuss options for PrEP
Education on using barriers during sexual activity (e.g., condom/dental dams) is important.
Daily oral preexposure prophylaxis (PrEP), such as tenofovir emtricitabine, is recommended
for sexually active persons who are at risk for HIV. PrEP is used in HIV-negative persons, so
the nurse practitioner must wait for the test results before prescribing. It is appropriate to
schedule a 1-month follow-up to review the test results and discuss PrEP options (if test is
negative). It is not appropriate ethically or legally to contact the partner; however, it would be
appropriate for the patient to encourage his partner to get tested.
An older adult male presents with complaints of sharp flank and back pain. The patient has
difficulty answering questions because of severity of pain. Blood pressure is 90/60 mmHg.
The patient has a 20-pack-year smoking history. Abdomen is distended upon palpitation.
Which diagnosis is most likely?
Congestive heart failure
Infective endocarditis
Dissecting abdominal aortic aneurysm
Acute myocardial infarction - Dissecting abdominal aortic aneurysm.
Dissecting abdominal aortic aneurysm is a sudden onset of severe, sharp, excruciating pain
located in the abdomen, back, or flank area, accompanied by a distended abdomen and
hypotension. Older male adults with a smoking history and hypertension are at higher risk.
Congestive heart failure symptoms are dyspnea, fatigue, dry cough, and swollen feet and
ankles. Patients with infective endocarditis present with fever, chills, and malaise, along with
the presence of a new murmur. Acute myocardial infarction generally presents with a gradual
onset of intense and heavy chest discomfort that feels like a squeezing, tightness, and heavy
pressure in the chest.
Mrs. Harris a 67-year-old woman who is in the early stages of Alzheimer disease. She suffers
from mild dementia. In this type of Alzheimer dementia which of the following would you
use as the mainstay treatment?
Vitamin E 1000 IU twice daily
cholinesterase inhibitors
NSAIDS
Selgiline 5 mg twice daily - cholinesterase inhibitors
,The mainstay treatment for mild to moderate stage Alzheimer-type dementia is the use of
cholinesterase inhibitors. These include donepezil (Aricept), rivastigmine (Exelon), and
galantamine (Razadyne). They have a clear, although minor and time-limited benefit.
When listening to your 86-year-old patient's heart murmur, you note that it is so loud that it
can be heard with the stethoscope completely off the chest. How do you grade the murmur?
IV/VI.
I/VI.
V/VI.
VI/VI. - VI/VI.
Grading heart murmurs follows this system: I/VI: Heart murmur makes faint sound and may
not be heard when patient changes position. II/VI: Heart murmur is quiet but can be heard as
soon as the stethoscope is placed on the chest. III/VI: Heart murmur is moderately loud.
IV/VI: Heart murmur is loud and accompanied by a palpable thrill. V/VI: Heart murmur is
very loud and can be heard with the stethoscope partially off the chest. VI/VI: Heart murmur
is very loud and can be heard with the stethoscope completely off the patient's chest.
Which of the following persons would not be a candidate for the antipneumococcal vaccine?
a 65-year-old healthy female living with her family
a 35-year-old patient with HIV infection
a 58-year-old male resident of a nursing home
a 55-year-old female living alone - a 55-year-old female living alone
The antipneumococcal vaccine is not indicated for an otherwise healthy person who is under
the age of 65 unless there are other health factors involved. Living alone has no bearing on
the need for the vaccine. The vaccine is indicated for persons with HIV infection, persons
living in nursing homes, and all adults 65 years or older regardless of health status.
Which of the following diseases is more likely to cause chronic pelvic pain rather than acute
pelvic pain?
ectopic pregnancy
PID
ovarian cysts
interstitial cystitis - interstitial cystitisInterstitial cystitis is more likely to cause chronic pelvic
pain rather than acute pelvic pain as in the other choices. Other causes of chronic pelvic pain
include: endometriosis, leiomyomas, and malignancy.
You have a 58-year-old male patient with possible pancreatic cancer. You will not order an
abdominal ultrasound for diagnosis because it is limited by which of the following?
previous history of pancreatic disease
patient's age
the presence of intestinal gas
size of tumor - the presence of intestinal gas
,The usefulness of abdominal ultrasound is limited by the presence of intestinal gas.
Abdominal CT scan is more helpful in identifying pancreatic cancer.
A 58-year-old male presents in the office with a glucose of 309 mg/dL and is symptomatic
for Type II diabetes mellitus. What should be done to manage him FIRST?
Start insulin
Start metformin plus pioglitazone
Have him return tomorrow to recheck his blood glucose
Start metformin - Start insulin
Most oral agents will have little effect on his glucose and it should be lowered immediately.
Therefore, insulin is the best agent to reduce the blood sugar so that oral agents will have a
chance to work. He should return to the clinic the next day for a recheck of the blood glucose
and medication adjustment.
Utilization review can best be described as which of the following?
a system of monitoring and assessing for high-risk areas and procedures
the process of evaluating the appropriateness of inpatient hospitalization
the process used for accreditation
the process used for case management - the process of evaluating the appropriateness of
inpatient hospitalization
A utilization review is the process of evaluating the appropriateness of inpatient
hospitalization. Proof of the medical necessity for the patient's hospitalization is done mainly
through chart reviews. If the reviewer and payor do not agree, the claim can be denied,
resulting in denial of payment to the health facility.
John is a patient with acute renal failure. His inability to regulate electrolytes might be
evidenced by all but which of the following conditions?
hyperkalemia
hyperlipidemia
hypocalcemia
hypernatremia - hyperlipidemia
This patient's inability to regulate electrolytes might be evidenced by hyperkalemia,
hypernatremia, hyponatremia, hypokalemia, hypermagnesemia, hyperphosphatemia, and
hypocalcemia. Hyperlipidemia is abnormally elevated levels of any or all lipids and/or
lipoproteins in the blood.
Which of the following statements about evaluation and follow-up of a patient with IBD is
least accurate?
Most patients follow a cyclic course of remission and flare-up.
An estimated 50% to 65% of patients with Crohn's disease undergo surgery at some point in
their lives for intestinal resection or colectomy.
Overall mortality for ulcerative colitis is between 35% and 40%.
, Ulcerative colitis patients have a risk for serious complications such as hemorrhage and
perforation. - Overall mortality for ulcerative colitis is between 35% and 40%.
This is not accurate. The overall mortality for ulcerative colitis is much lower - between 12%
and 15%. This is because of risk for serious complications such as hemorrhage, perforation,
and toxic megacolon.
A patient who has been prescribed miconazole for athlete's foot asks how long he should use
the medication. Which of the following is an appropriate response to this patient?
The patient should use the medication for 3 days.
The patient should use the medication for 1 month.
The patient should use the medication until symptoms are gone.
The patient should use the medication for 2 weeks. - The patient should use the medication
for 1 month
Patients who are using miconazole for athlete's foot should apply the medication once or
twice a day for 1 month. Patients should not exceed the recommended amount or duration of
miconazole.
Mary is concerned because her 12-year-old son shows no signs of puberty. You would tell
her that the average age of onset for males is which of the following?
10 - 12 years
13 - 16 years
10.5 - 16 years
10.5- 13 years - 10.5 - 16 years
You can reassure this mother that her son is not behind schedule in reaching puberty. The
average age of onset for males is 10.5 - 16 years.
After completing a physical examination, you suspect that a 16-year old girl has acute
appendicitis. She presents with acute abdominal pain and you order a white blood cell (WBC)
count with differential and an x-ray of the abdomen. You receive the laboratory report back
first and are still waiting on the x-ray. By looking at the laboratory report, which of the
following values would you expect to see in a patient with acute appendicitis?
total WBCs 1200 mm³
neutrophils 4%
bands 1%
lymphocytes 44%
total WBCs of 500mm³
neutrophils 10%
bands 2%
lymphocytes 39%
total WBCs 16,000 mm³
neutrophils 67%
bands 8%
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