BARKLEY FNP / LEIK FNP PRACTICE
QUESTIONS EXAM 2026/2027 LATEST
UPDATE
SECTION 1: ADVANCED HEALTH ASSESSMENT (Questions 1-20)
Q1. The nurse practitioner would test the obturator and iliopsoas muscles to
evaluate for:
• A) Cholecystitis
• B) Acute appendicitis
• C) Inguinal hernia
• D) Gastric ulcer
Correct ,,,,ANSWER,,,: B) Acute appendicitis
Rationale: Signs and symptoms of an acute abdomen include involuntary guarding,
rebound tenderness, boardlike abdomen, and positive obturator and psoas signs. A
positive obturator sign occurs when pain is elicited by internal rotation of the right
hip from 90 degrees of hip/knee flexion. The psoas sign is positive when pain
occurs with passive extension of the thigh while the patient is lying on the side with
knees extended, or with active flexion of the thigh at the hip .
,Q2. While performing a fundoscopic exam on a 35-year-old female during a
routine physical exam, you notice sharp disc margins and a yellowish-orange
color in the macular area. The ratio of veins to arteries is 3:2. What is the most
appropriate action?
• A) Refer for immediate ophthalmologic evaluation
• B) Advise the patient that she has a normal exam
• C) Order a CT scan of the head
• D) Schedule a follow-up exam in 6 months
Correct ,,,,ANSWER,,,: B) Advise the patient that she has a normal exam
Rationale: Sharp disc margins are normal. The yellowish-orange color in the
macular area represents the normal macula lutea (yellow spot). A normal artery-to-
vein ratio is 2:3 (veins slightly larger than arteries). The finding of 3:2 (veins to
arteries) is essentially normal and indicates no arteriovenous nicking .
Q3. During a sports physical, you note that the vision of an 18-year-old male
athlete is 20/30 in both eyes. What does this mean?
• A) The patient can see at 30 feet what a person with normal vision can see at
20 feet
• B) The patient has 20/30 vision, which is better than normal
• C) The patient can see at 20 feet what a person with normal vision can see at
30 feet
• D) The patient has normal vision
Correct ,,,,ANSWER,,,: C) The patient can see at 20 feet what a person with
normal vision can see at 30 feet
,Rationale: Visual acuity of 20/30 means the patient can see at 20 feet what a
person with normal vision can see at 30 feet, indicating mild myopia
(nearsightedness). The larger the second number, the worse the vision .
Q4. The cover/uncover test is a screening tool for what condition?
• A) Glaucoma
• B) Strabismus
• C) Color blindness
• D) Macular degeneration
Correct ,,,,ANSWER,,,: B) Strabismus
Rationale: The cover/uncover test detects misalignment of the eyes (strabismus)
by observing movement of the uncovered eye as it refixates on a target. It can
detect both manifest and latent deviations .
Q5. The Ishihara tool is a screening tool for what condition?
• A) Strabismus
• B) Visual acuity
• C) Color blindness
• D) Glaucoma
Correct ,,,,ANSWER,,,: C) Color blindness
, Rationale: The Ishihara color plates are the standard screening tool for red-green
color vision deficiencies, which are X-linked recessive and more common in
males .
Q6. A 68-year-old woman with hypertension and diabetes is seen for a dry
cough that worsens at night when she lies in bed. She has SOB which worsens
with exertion. Her pulse is 90/min and regular. The patient has gained 6 lbs
over the past 2 months. She is on a nitroglycerin patch and furosemide daily.
The best explanation for her symptoms is:
• A) Uncontrolled diabetes
• B) Congestive heart failure
• C) Medication side effect
• D) Pneumonia
Correct ,,,,ANSWER,,,: B) Congestive heart failure
Rationale: The symptoms of orthopnea (cough worse when lying down), dyspnea
on exertion, weight gain (fluid retention), and underlying risk factors (hypertension,
diabetes) are classic for congestive heart failure. The weight gain suggests fluid
accumulation despite furosemide .
Q7. A 30-year-old type 2 diabetic is on regular insulin and lente insulin in the
morning and evening. She denies changes in her diet or any illness but recently
started attending aerobic classes in the afternoon. Because of her workouts,
her blood sugars have dipped below 50 mg/dL very early in the morning. Her
QUESTIONS EXAM 2026/2027 LATEST
UPDATE
SECTION 1: ADVANCED HEALTH ASSESSMENT (Questions 1-20)
Q1. The nurse practitioner would test the obturator and iliopsoas muscles to
evaluate for:
• A) Cholecystitis
• B) Acute appendicitis
• C) Inguinal hernia
• D) Gastric ulcer
Correct ,,,,ANSWER,,,: B) Acute appendicitis
Rationale: Signs and symptoms of an acute abdomen include involuntary guarding,
rebound tenderness, boardlike abdomen, and positive obturator and psoas signs. A
positive obturator sign occurs when pain is elicited by internal rotation of the right
hip from 90 degrees of hip/knee flexion. The psoas sign is positive when pain
occurs with passive extension of the thigh while the patient is lying on the side with
knees extended, or with active flexion of the thigh at the hip .
,Q2. While performing a fundoscopic exam on a 35-year-old female during a
routine physical exam, you notice sharp disc margins and a yellowish-orange
color in the macular area. The ratio of veins to arteries is 3:2. What is the most
appropriate action?
• A) Refer for immediate ophthalmologic evaluation
• B) Advise the patient that she has a normal exam
• C) Order a CT scan of the head
• D) Schedule a follow-up exam in 6 months
Correct ,,,,ANSWER,,,: B) Advise the patient that she has a normal exam
Rationale: Sharp disc margins are normal. The yellowish-orange color in the
macular area represents the normal macula lutea (yellow spot). A normal artery-to-
vein ratio is 2:3 (veins slightly larger than arteries). The finding of 3:2 (veins to
arteries) is essentially normal and indicates no arteriovenous nicking .
Q3. During a sports physical, you note that the vision of an 18-year-old male
athlete is 20/30 in both eyes. What does this mean?
• A) The patient can see at 30 feet what a person with normal vision can see at
20 feet
• B) The patient has 20/30 vision, which is better than normal
• C) The patient can see at 20 feet what a person with normal vision can see at
30 feet
• D) The patient has normal vision
Correct ,,,,ANSWER,,,: C) The patient can see at 20 feet what a person with
normal vision can see at 30 feet
,Rationale: Visual acuity of 20/30 means the patient can see at 20 feet what a
person with normal vision can see at 30 feet, indicating mild myopia
(nearsightedness). The larger the second number, the worse the vision .
Q4. The cover/uncover test is a screening tool for what condition?
• A) Glaucoma
• B) Strabismus
• C) Color blindness
• D) Macular degeneration
Correct ,,,,ANSWER,,,: B) Strabismus
Rationale: The cover/uncover test detects misalignment of the eyes (strabismus)
by observing movement of the uncovered eye as it refixates on a target. It can
detect both manifest and latent deviations .
Q5. The Ishihara tool is a screening tool for what condition?
• A) Strabismus
• B) Visual acuity
• C) Color blindness
• D) Glaucoma
Correct ,,,,ANSWER,,,: C) Color blindness
, Rationale: The Ishihara color plates are the standard screening tool for red-green
color vision deficiencies, which are X-linked recessive and more common in
males .
Q6. A 68-year-old woman with hypertension and diabetes is seen for a dry
cough that worsens at night when she lies in bed. She has SOB which worsens
with exertion. Her pulse is 90/min and regular. The patient has gained 6 lbs
over the past 2 months. She is on a nitroglycerin patch and furosemide daily.
The best explanation for her symptoms is:
• A) Uncontrolled diabetes
• B) Congestive heart failure
• C) Medication side effect
• D) Pneumonia
Correct ,,,,ANSWER,,,: B) Congestive heart failure
Rationale: The symptoms of orthopnea (cough worse when lying down), dyspnea
on exertion, weight gain (fluid retention), and underlying risk factors (hypertension,
diabetes) are classic for congestive heart failure. The weight gain suggests fluid
accumulation despite furosemide .
Q7. A 30-year-old type 2 diabetic is on regular insulin and lente insulin in the
morning and evening. She denies changes in her diet or any illness but recently
started attending aerobic classes in the afternoon. Because of her workouts,
her blood sugars have dipped below 50 mg/dL very early in the morning. Her
