LEIK FNP Practice Questions
With Verified Answers
A 72-year-old woman has been on hydrochlorothiazide 12.5 mg for many
years to control her Stage II hypertension. Her blood pressure (BP) at this
visit is 168/96. She is currently complaining of pain on her right hip and on
both knees. She has increased her dose of ibuprofen (Motrin) from 400 mg 3
times day (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 - -B) It inhibits the effect of renal
prostaglandins and blunts the effectiveness of the diuretic.
NSAIDs and ASA inhibit the vasodilatory effects of prostaglandins, which
predisposes the kidney to ischemia. NSAIDs and diuretics can cause acute
prerenal failure by decreasing renal blood flow.
-2. All of the following are infections that affect mostly the labia and vagina
except:
A) Bacterialvaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis - -D) 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:
A) Cholecystitis
B) Acute appendicitis
C) Inguinal hernia
D) Gastriculcer - -B) Acute appendicitis.
,Signs and symptoms of an acute abdomen include invol- untary guarding,
rebound tenderness, boardlike abdomen, and a positive obtu- rator and
psoas sign. A positive obturator sign occurs when pain is elicted by internal
rotation of the right hip from 90 degrees hip/knee flexion. The psoas sign is
positive when pain occurs with passive extension of the thigh while the
patient is lying on his/her side with knees extended, or when pain occurs
with active flexion of his/her thigh at the hip.
-Treatment for mild preeclampsia includes all of the following except:
A) Bed rest except for bathroom privileges
B) Close monitoring of weight and blood pressure
C) Close follow-up of urinary protein, serum creatinine, and platelet count
D) A prescription of methyldopa (Aldomet) to control blood pressure - -D) A
prescription of methyldopa (Aldomet) to control blood pressure
Recommended care for women diagnosed with preeclampsia includes bed
rest with bath- room privileges, weight and BP monitoring, and closely
following urine protein and serum protein, creatinine, and platelet counts.
Oral medications are not used as first-line treatment.
-All of the following services are covered under Medicare Part A except:
A) Inpatienthospitalizations
B) Medicines administered to a patient while hospitalized
C) Nursing home care
D) Surgeons - -C) Nursing home care
Medicare A coverage includes inpatient hospitalization and skilled care given
in a certified skilled nursing facility. Most nursing home care is custodial care
(help with bathing, dressing, using a bathroom, and eating). This care is not
covered by Medicare A.
-A 28-year-old student is seen in the school health clinic with complaints of a
hacking cough that is productive of small amounts of sputum and a runny
nose. He does not take any medications, denies any allergies, and has no
significant medical history. Physical examination reveals a low-grade
temperature of 99.9 degrees Fahrenheit, respirations of 16/min, a pulse of 90
beats per minute, and diffuse fine crackles in the base of the lungs. A chest
radiograph (x-ray) shows diffuse infiltrates on the lower lobe of the right
lung. The total white blood cell count is 10,500/uL. What is the most likely
diagnosis?
A) Streptococcal pneumonia
B) Mycoplasma pneumonia
C) Acute bronchitis
Mycoplasma pneumonia is the organism most com- monly seen in children
and young adults. It is easily spread from droplets, from sneezing and
coughing, in close proximity. Diagnosis is based on symptoms and x-ray
results of infiltrates in lower lobes.
-A 39-year-old migrant worker presents to the clinic 2.5 days after a purified
protein derivative (PPD) test. What minimum size of induration would be
considered posi- tive for this patient?
A) 3 mm B) 5 mm C) 10 mm D) 15 mm - -C) 10 mm
The PPD is administered on the volar aspect of the lower arm and read 48
hours after the test is given. The PPD result must have induration and
measure 10 mm or greater to be positive in a low-risk patient. Induration
(firmness with palpation) must be present. If the site has erythema but no
induration, result would be negative. Color is not important.
-All of the following are correct statements regarding the role of the person
named in a durable power of attorney except:
A) The agent's decisions are legally binding
B) The agent can make decisions in other areas of the patient's life such as
financial
issues
C) The agent can decide for the patient who is on life support when that life
support
can be terminated
D) The patient's spouse has a right to override the agent's decisions - -D)
The patient's spouse has a right to override the agent's decisions
The person named in a durable power of attorney (the agent) is designated
by the patient to make all medical decisions, as well as any decisions
regarding the patient's private affairs in the event that the patient becomes
incompetent and unable to make his/her own decisions. No one has the
ability to override the agent's decision.
-All of the following are true statements regarding Munchausen syndrome
except:
A) It is considered a mental illness
B) The patient has a medical illness that causes an anxiety reaction and
denial
C) The patient fakes an illness in order to gain attention from health care
providers
, D) The patient has an inconsistent medical history along with a past history
of
frequent hospitalizations - -B) The patient has a medical illness that causes
an anxiety reaction and denial
Munchausen syndrome is a psychiatric disorder in which the patient fakes a
medical illness or disorder to gain attention from health care provid- ers.
These patients commonly use the emergency department frequently to gain
attention.
-Which of the following antihypertensive medications should the nurse
practitioner avoid when treating patients with emphysema?
A) Calcium channel blockers
B) Angiotensin-converting enzyme (ACE) inhibitors
C) Beta-blockers
D) Diuretics - -C) Beta-blockers
Beta-blockers should be avoided in patients with a history of emphysema.
Studies have shown evidence of a reduction in forced expiratory volume in 1
second (FEV1), increased airway hyperresponsiveness, and inhibition of
bronchodilator response to beta agonists in patients receiving non-selective
beta- blockers and high doses of cardioselective beta-blockers.
-A 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) Perform a complete and thorough history
B) Prescribe an oral antihistamine such as diphenhydramine 25 mg PO QID
C) Give an injection of epinephrine 1:1000 intramuscularly stat
D) Call 911 - -A) Perform a complete and thorough history
Prior to prescribing medications, a complete and thorough history must be
performed to determine possible causes of hives. The patient denied
difficulty with swallowing and breathing, so there was no medical emergency
to 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 - -B) Edema of the face and the upper extremities
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