FNP Leik Practice test 2
Study online at https://quizlet.com/_cgidgk
1. A 75 year old female presents in the office complaining that her heart "keeps
skipping beats and goes very fast". The patient also reports dizziness and
shortness of breath, especially with activity. Her pulse is 120 beats/minute and
irregular. The NP orders a 12-lead EKG and considers an echocardiogram. The
NP will likely prescribe:
a. chlorthalidone 12.mg daily
b. warfarin (Coumadin) 5 mg daily
c. warfarin (Coumadin) 2.5 mg daily
d. chlorthalidone 25 mg daily: c. warfarin (Coumadin) 2.5 mg daily
2. A young adult male visits the urgent care clinic after falling and landing on
his buttock. He complaints of feeling electrical impulses traveling down both
legs and inability to urinate. Upon physical exam, the NP notes decreased
lower extremity strength and reflexes. Which diagnosis is most likely?
A. cauda equina syndrome
B. lumbar stenosis
C. fibromyalgia
D. Paget's disease: A. cauda equina syndrome
3. A 35 y/o patient is being worked up for microscopic hematuria. All of the
following are differentials for microscopy hematuria except:
A. kidney stones
B. bladder cancer
C. acute pyelonephritis
D. renal artery stenosis: D. renal artery stenosis
4. A 22 y/o female presents to urgent care with signs of a broken arm, stating
that she fell at home. Upon assessment, the NP observes numerous bruises
in various stages of healing, and the patients live-in boyfriend response
aggressively to all questions posed to the patient. which of the following
intervention is most appropriate?
A. call security and have the boyfriend removed from the exam room
B. ask the boyfriend why he will not let the patient answer the questions
C. inform the boyfriend that the rest of the exam must be private, show him to
the waiting room, and tell him you will retrieve him as soon as you finish.
D. state your suspicions to the couple and ask them to provide a truthful
answer to the injuries: C. inform the boyfriend that the rest of the exam must be
private, show him to the waiting room, and tell him you will retrieve him as soon as
you finish.
5. The NP is assessing a 13 y/o male who presents with back pain and nau-
sea/vomiting x 24 hours. He reports feeling dull pain and muscle spasm in his
back after a direct hit to the side during football practice. BP 140/84, tempe
, FNP Leik Practice test 2
Study online at https://quizlet.com/_cgidgk
99.1, HR 98, RR 26. What is most likely diagnosis?
A. appendicitis
B. bruised kidney
C. cholecystitis
D. ruptured vertebral disk: B. bruised kidney
6. Which of the following is a first-line medication for tinea unguium?
A. oral terbinafine (lamisil)
B. efinaconazole 10% solution
C. azeliac acid
D. metronidazole topical get: A. oral terbinafine (lamisil)
7. An elderly patient was burned when a large pot of boiling water fell off the
stove. According to Lund-Browder chart, the patient has reddened skin and
several bullae on approx 4% of the abdominal area. The patient is allergic to
sulfa products. Which of the following intervention is most appropriate?
A. treat with benzocaine spray
B. gentle rupture blisters
C. treat with silver sulfadiazine
D. treat with bacitracin zinc: D. treat with bacitracin zinc
8. An asian mother presents with her newborn. Upon exam, the NP notes
black-colored patches on the newborns lumboscaral area. How will the NP
document these findings?
A. milia
B. erythema toxic neonatorum
C. Mongolian spots
D. port wine stain: C. Mongolian spots
9. Which antipsychotic medication is most likely to produce extrapyramidal
effects?
A. Sertraline
B. Citalopram
C. Aripiprazole
D. Haloperidol: D. Haloperidol
10. A toddler with congenital heart disease is seen for a 1-week history of facial
and lower-extremity edema accompanied by shortness of breath. The child's
mother reports that the child's appetite has been poor. The chest x-ray reveals
that the child has congestive heart failure (CHF). Which of the following heart
sounds are found in these patients?
A) S1 and S2
B) S1, S2, and S3
, FNP Leik Practice test 2
Study online at https://quizlet.com/_cgidgk
C) S1, S2, and S4
D) Still's murmur and S4: B) S1, S2, and S3
11. A 14 year old male patient presents with acute pain in his left testicle
radiating to the lower abdomen lasting 2 hours. Which of the following if the
best intervention?
A. manual detorsion
B. radioisotope scrotal scanning
C. referral for immediate surgery
D. color Doppler US: D. color Doppler US
12. A 67 y/o female complains of progressive dyspnea, minimal cough, and
a 10# weight loss over the last 3 months. The NP notes decreased posterior
breath sounds, the use of accessory muscles to breathe, temp of 98.8, and RR
24. the NP suspects?
A. emphysema
B. chronic bronchitis
C. respiratory infection
D. pneumonia: A. emphysema
13. A middle-aged male with a history of cluster headaches arrives that the
primary care office for treatment. Which of the following interventions is
included in the acute treatment plan?
A. ice pack on forehead
B. acetaminophen
C. intranasal 4% lidocaine
D. phenytoin: C. intranasal 4% lidocaine
ice pack good for migraine
Tylenol good for tension HA
Dilantin for trigeminal neuralgia
14. A middle aged female presents with complaints of weight gain, constipa-
tion, and alopecia of the eyebrows. Cholesterol 247, thyroid peroxidase (TPO)
is 161. What is the likely diagnosis?
A. Thyroid cancer
B. Hyperprolactinemia
C. Pheochromocytoma
D. Hashimotos thyroiditis: D. Hashimotos thyroiditis
TPO is gold standard for dx. Normal TPO <35
, FNP Leik Practice test 2
Study online at https://quizlet.com/_cgidgk
15. An overweight male teenager presents with complaints of fatigue and
lethargy. His mother states that he has been falling asleep in school. Upon
examination, he is found to be hypertensive with an average blood pressure
of 164/92. The NP suspects secondary hypertension, which can be caused by
disorders of all of the following systems, except:
a. renal
b. endocrine
c. musculoskeletal
d. respiratory: c. musculoskeletal
16. An adult patient stepped on a nail while walking on the beach. The nail
punctured through the sneaker, and she has a swollen, diffuse pinkish-red,
warm foot. Which gram negative photogenic is most likely the cause of this
infection?
A. pseudomonas
B. vibrio vulificus
C. pasteurella
D. Staph A: A. pseudomonas
vibrio - raw oysters
pasteurella - cat and dog bites
17. A patient with Pick's disease fell out of bed and hit her head on the table.
The patient is not on anticoags and is alert and oriented upon arrival to the
clinic. The patient VS are BP 188/90, HR 43, RR 7. Which diagnosis is most
likely?
A. hypovolemic shock
B. increase ICP
C. CVA
D. subdural hematoma: B. increase ICP
VS representative of Cushing's triad (increase BP, low HR and RR)
18. Pioglitazone (Actos) is contraindicated in patients with which of the follow-
ing conditions?
A. renal disease
B. liver disease
C. asthma
D. class III or IV heart disease: D. class III or IV heart disease
19. An 82-year-old patients sees the NP for an annual exam. The patient re-
quests a colonoscopy to screen for colon cancer. Which is the most thera-
peutic response by the NP?
Study online at https://quizlet.com/_cgidgk
1. A 75 year old female presents in the office complaining that her heart "keeps
skipping beats and goes very fast". The patient also reports dizziness and
shortness of breath, especially with activity. Her pulse is 120 beats/minute and
irregular. The NP orders a 12-lead EKG and considers an echocardiogram. The
NP will likely prescribe:
a. chlorthalidone 12.mg daily
b. warfarin (Coumadin) 5 mg daily
c. warfarin (Coumadin) 2.5 mg daily
d. chlorthalidone 25 mg daily: c. warfarin (Coumadin) 2.5 mg daily
2. A young adult male visits the urgent care clinic after falling and landing on
his buttock. He complaints of feeling electrical impulses traveling down both
legs and inability to urinate. Upon physical exam, the NP notes decreased
lower extremity strength and reflexes. Which diagnosis is most likely?
A. cauda equina syndrome
B. lumbar stenosis
C. fibromyalgia
D. Paget's disease: A. cauda equina syndrome
3. A 35 y/o patient is being worked up for microscopic hematuria. All of the
following are differentials for microscopy hematuria except:
A. kidney stones
B. bladder cancer
C. acute pyelonephritis
D. renal artery stenosis: D. renal artery stenosis
4. A 22 y/o female presents to urgent care with signs of a broken arm, stating
that she fell at home. Upon assessment, the NP observes numerous bruises
in various stages of healing, and the patients live-in boyfriend response
aggressively to all questions posed to the patient. which of the following
intervention is most appropriate?
A. call security and have the boyfriend removed from the exam room
B. ask the boyfriend why he will not let the patient answer the questions
C. inform the boyfriend that the rest of the exam must be private, show him to
the waiting room, and tell him you will retrieve him as soon as you finish.
D. state your suspicions to the couple and ask them to provide a truthful
answer to the injuries: C. inform the boyfriend that the rest of the exam must be
private, show him to the waiting room, and tell him you will retrieve him as soon as
you finish.
5. The NP is assessing a 13 y/o male who presents with back pain and nau-
sea/vomiting x 24 hours. He reports feeling dull pain and muscle spasm in his
back after a direct hit to the side during football practice. BP 140/84, tempe
, FNP Leik Practice test 2
Study online at https://quizlet.com/_cgidgk
99.1, HR 98, RR 26. What is most likely diagnosis?
A. appendicitis
B. bruised kidney
C. cholecystitis
D. ruptured vertebral disk: B. bruised kidney
6. Which of the following is a first-line medication for tinea unguium?
A. oral terbinafine (lamisil)
B. efinaconazole 10% solution
C. azeliac acid
D. metronidazole topical get: A. oral terbinafine (lamisil)
7. An elderly patient was burned when a large pot of boiling water fell off the
stove. According to Lund-Browder chart, the patient has reddened skin and
several bullae on approx 4% of the abdominal area. The patient is allergic to
sulfa products. Which of the following intervention is most appropriate?
A. treat with benzocaine spray
B. gentle rupture blisters
C. treat with silver sulfadiazine
D. treat with bacitracin zinc: D. treat with bacitracin zinc
8. An asian mother presents with her newborn. Upon exam, the NP notes
black-colored patches on the newborns lumboscaral area. How will the NP
document these findings?
A. milia
B. erythema toxic neonatorum
C. Mongolian spots
D. port wine stain: C. Mongolian spots
9. Which antipsychotic medication is most likely to produce extrapyramidal
effects?
A. Sertraline
B. Citalopram
C. Aripiprazole
D. Haloperidol: D. Haloperidol
10. A toddler with congenital heart disease is seen for a 1-week history of facial
and lower-extremity edema accompanied by shortness of breath. The child's
mother reports that the child's appetite has been poor. The chest x-ray reveals
that the child has congestive heart failure (CHF). Which of the following heart
sounds are found in these patients?
A) S1 and S2
B) S1, S2, and S3
, FNP Leik Practice test 2
Study online at https://quizlet.com/_cgidgk
C) S1, S2, and S4
D) Still's murmur and S4: B) S1, S2, and S3
11. A 14 year old male patient presents with acute pain in his left testicle
radiating to the lower abdomen lasting 2 hours. Which of the following if the
best intervention?
A. manual detorsion
B. radioisotope scrotal scanning
C. referral for immediate surgery
D. color Doppler US: D. color Doppler US
12. A 67 y/o female complains of progressive dyspnea, minimal cough, and
a 10# weight loss over the last 3 months. The NP notes decreased posterior
breath sounds, the use of accessory muscles to breathe, temp of 98.8, and RR
24. the NP suspects?
A. emphysema
B. chronic bronchitis
C. respiratory infection
D. pneumonia: A. emphysema
13. A middle-aged male with a history of cluster headaches arrives that the
primary care office for treatment. Which of the following interventions is
included in the acute treatment plan?
A. ice pack on forehead
B. acetaminophen
C. intranasal 4% lidocaine
D. phenytoin: C. intranasal 4% lidocaine
ice pack good for migraine
Tylenol good for tension HA
Dilantin for trigeminal neuralgia
14. A middle aged female presents with complaints of weight gain, constipa-
tion, and alopecia of the eyebrows. Cholesterol 247, thyroid peroxidase (TPO)
is 161. What is the likely diagnosis?
A. Thyroid cancer
B. Hyperprolactinemia
C. Pheochromocytoma
D. Hashimotos thyroiditis: D. Hashimotos thyroiditis
TPO is gold standard for dx. Normal TPO <35
, FNP Leik Practice test 2
Study online at https://quizlet.com/_cgidgk
15. An overweight male teenager presents with complaints of fatigue and
lethargy. His mother states that he has been falling asleep in school. Upon
examination, he is found to be hypertensive with an average blood pressure
of 164/92. The NP suspects secondary hypertension, which can be caused by
disorders of all of the following systems, except:
a. renal
b. endocrine
c. musculoskeletal
d. respiratory: c. musculoskeletal
16. An adult patient stepped on a nail while walking on the beach. The nail
punctured through the sneaker, and she has a swollen, diffuse pinkish-red,
warm foot. Which gram negative photogenic is most likely the cause of this
infection?
A. pseudomonas
B. vibrio vulificus
C. pasteurella
D. Staph A: A. pseudomonas
vibrio - raw oysters
pasteurella - cat and dog bites
17. A patient with Pick's disease fell out of bed and hit her head on the table.
The patient is not on anticoags and is alert and oriented upon arrival to the
clinic. The patient VS are BP 188/90, HR 43, RR 7. Which diagnosis is most
likely?
A. hypovolemic shock
B. increase ICP
C. CVA
D. subdural hematoma: B. increase ICP
VS representative of Cushing's triad (increase BP, low HR and RR)
18. Pioglitazone (Actos) is contraindicated in patients with which of the follow-
ing conditions?
A. renal disease
B. liver disease
C. asthma
D. class III or IV heart disease: D. class III or IV heart disease
19. An 82-year-old patients sees the NP for an annual exam. The patient re-
quests a colonoscopy to screen for colon cancer. Which is the most thera-
peutic response by the NP?
