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Leik FNP certification reviewA 30-year-old chef complains of pruritic hives over her chest and arms, but denies difficulty
swallowing or breathing. She reports a family history of allergic rhinitis and asthma. Which of the
following interventions is most appropriate?
A. Obtain a complete and thorough history
B. Recommend an oral antihistamine such as diphenhydramine 25 mg PO QID
C. Give an injection of epinephrine 1:1000 intramuscularly stat
D. Call 911 - ANSA) Obtain a complete and thorough history
Before prescribing medications, a thorough history must be obtained to determine possible
causes of hives. The patient denied difficulty with swallowing and breathing, so there was no
medical emergency that would require calling 911.
Which of the following findings is most likely in young primigravidas with pregnancy-induced
hypertension?
A. Abdominal cramping and constipation
B. Edema of the face and the upper extremities
C. Shortness of breath
D. Dysuria and frequency - ANSB) Edema of the face and the upper extremities
Common signs and symptoms of pregnancy-induced hypertension include edema of the face
and the upper extremities, weight gain, blurred vision, elevated blood pressure, proteinuria, and
headaches
Which of the following symptoms is associated with B12 deficiency anemia?
A. Spoon-shaped nails and pica
B. Abnormal neurological exam
C. Vegan diet
D. Tingling and numbness of both feet - ANSD) Tingling and numbness of both feet
Vitamin B12 deficiency anemia can cause nerve cell damage if not treated. Symptoms of B12
deficiency anemia may include tingling or numbness in fingers and toes, difficulty walking, mood
changes or depression, memory loss, disorientation, and dementia.
A second triple screen on a 35-year-old primigravida reveals abnormally low levels of alpha
fetoprotein and estriol and high levels of human chorionic gonadotropin. Which of the following
interventions is the best choice for this patient?
A. Order an ultrasound
B. Order a computed tomography (CT) scan of the abdomen
C. Order a 24-hour urine for protein clearance
D. Assess for a history of illicit drug or alcohol use - ANSA) Order an ultrasound
Abnormally low levels of alpha fetoprotein and estriol and high levels of human chorionic
gonadotropin are abnormal during pregnancy. An ultrasound should be ordered to further
evaluate the fetus for characteristics of Down syndrome and/or fetal demise.
,All of the following are true statements about diverticula except:
A. Diverticula are located in the colon
B. A low-fiber diet is associated with the condition
C. Most diverticula in the colon are infected with gram-negative bacteria
D. Supplementing with fiber, such as psyllium (Metamucil), is recommended - ANSC) Most
diverticula in the colon are infected with gram-negative bacteria
Diverticula in the colon can be infected with both gram-negative and gram-positive
Patients who are diagnosed with gonorrhea should also be treated for which of the following
infections?
A. Chancroid
B. Chlamydia trachomatis
C. Herpes genitalis
D. Pelvic inflammatory disease (PID) - ANSB) Chlamydia trachomatis
When diagnosed with gonorrhea, the patient should also be treated for Chlamydia trachomatis.
Kyphosis is a late sign of:
A. Rheumatoid arthritis
B. Osteopenia
C. Osteoporosis
D. Osteoarthritis - ANSC) Osteoporosis
Kyphosis is a curvature of the spine that causes a rounding of the back, which leads to a
slouching posture. Severe thinning of the bones (osteoporosis) contributes to this curvature in
the spine. Symptoms that may occur with severe cases of kyphosis include difficulty breathing,
fatigue, and back pain.
A 35-year-old primigravida who is at 18 weeks gestation is expecting twins. What would you
would expect her alpha fetoprotein (AFP) values to be?
A. Normal
B. Higher than normal
C. Lower than normal
D. None of the above - ANSB) Higher than normal
Alpha fetoprotein (AFP) is produced in the fetal and maternal liver. Higher levels of AFP are
commonly seen in multiple gestations due to the growing liver in each fetus, which cumulatively
lead to higher AFP levels.
Which of the following antihypertensive medications has beneficial effects for an elderly White
woman with osteoporosis?
A. Calcium channel blockers
B. Angiotensin-converting enzyme (ACE) inhibitors
C. Beta-blockers
D. Thiazide diuretics - ANSD) Thiazide diuretics
, Thiazide diuretics have a favorable effect in patients with osteopenia and osteoporosis by
slowing down the kidney's excretion of calcium and increasing distal tubule calcium
reabsorption. This results in decreased bone demineralization. Thiazide diuretics are a good
choice of therapy for this population because they treat hypertension and slow bone loss.
The Lachman maneuver is used to detect which of the following?
A. Instability of the knee
B. Nerve damage of the knee due to past knee injuries
C. Integrity of the patellar tendon
D. Tears on the meniscus of the knee - ANSA) Instability of the knee
The Lachman maneuver is a test performed to assess for knee instability (i.e., damage to the
motion of anterior translation [laxity] of the anterior cruciate ligament [ACL]). The maneuver
should be tested on both knees, comparing the injured and the opposite knee, the uninjured
knee is used as the "control." The test is positive if the injured knee slips back further (laxity).
Perform the test by bending the knee 30 degrees. Stabilize the femur with one hand. Place the
other hand under the proximal tibia at the level of the joint line and then pull forward. The laxity
is graded on a 0 (normal)-to-3 scale (1.0-1.5 cm of translation).
A 75-year-old woman has been on nifedipine (Procardia XL) 10-mg capsule for many years to
control her stage II hypertension. Her blood pressure at this visit is 165/80 mmHg. She is
currently complaining of pain at her right hip and in both knees. She has increased her dose of
ibuprofen (Motrin) from 400 mg three times daily (TID) to 800 mg TID. She is still in pain and
would like something stronger. Which of the following statements is the best explanation of the
effects of ibuprofen (Motrin) on her disease?
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 - ANSB) It inhibits the effect of renal prostaglandins and
blunts the effectiveness of the diuretic
Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetylsalicylic acid (ASA) inhibit the
vasodilatory effects of prostaglandins, which predisposes the kidney to ischemia. NSAIDs can
cause acute kidney injury by decreasing renal blood flow. Nonselective NSAIDs can adversely
affect the kidneys, GI tract, liver, cardiovascular system, and the lungs (bronchospasm).
All of the following are infections that affect mostly the labia and vagina except:
A. Bacterial vaginosis
B. Candidiasis
C. Trichomoniasis
D. Chlamydia trachomatis - ANSD) Chlamydia trachomatis
Infections that commonly affect the labia and vagina include bacterial vaginosis, candidiasis,
and trichomoniasis. Chlamydia trachomatis commonly affects the cervix, endometrial lining,
fallopian tubes, and pelvic cavity.
The nurse practitioner would test the obturator and iliopsoas muscle to evaluate for:
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