AANP FNP LEIK Practice Exam 2025/2026:
800+ Verified Questions & Answers |
Guaranteed Pass, Exams of Clinical Medicine
A 53 year old male patient comes to the clinic with pain in her lower right calf. He states that he
just returned from travel form Europe. The nurse practitioner dorsiflexes his foot, which elicits
lower leg pain. This is known as:
a. Murphey's sign
b. McBurney's sign
c. Babinski's sign
d. Homan's sign d
Homan's sign is lower leg pain on dorsiflexion of the foot. Often found in DVT. Murphey's sign is
for cholecystitis, McBurney's sign is appendix, Babinski's sign is neurological exam of big toe and
reflex.
A 58 year old male patient comes to the clinic with complaints of fatigue and exertional
dyspnea. He states that he has been running 5 miles daily for the past 10 years but he can
barely run 2 without needing to stop. According to the New York Heart Association (NYHA)
system, which classification does the patient fall into?
a. Class I
b. Class II
c. Class III
d. Class IV b
Class II. Class I = no limitations on physical activity. Class III = marked limitation on physical
activity. Class IV = symptoms are present at rest, with or without activity.
What is the first line medication for a patient with stable heart failure?
a. Losartan
1|Page
,b. Metoprolol
c. Terazosin
d. Indapamide a
ACE1 or ARB are first line treatment for stable HF.
A 44 year old patient comes to the clinic with discomfort in his legs. He has a history of smoking
and hyperlipidemia. He states that the pain in his legs worsen when walking but resolves with
rest. Upon assessment the nurse practitioner notes gangrenous toes. The patients ankle-
brachial index score is 0.8. What does this score indicate?
a. Score of 0.8 is diagnostic for peripheral arterial disease
b. Score of 0.8 is non-diagnostic for peripheral arterial disease
c. Score of 0.8 is diagnostic for peripheral venous disease
d. Score of 0.8 is non-diagnostic for peripheral venous disease a
ABI score equal or less than 0.9 is diagnostic for PAD. ABI score 0.91 to 1.3 is normal.
A patient is diagnosed with peripheral arterial disease. Which of the following medications is
best used for the management of this patient?
a. Pentoxifylline (Trental)
b. Cilostazol (Pletal)
c. Warfarin (Coumadin)
d. Dabigatran (Pradaxa) b
Cilostazol (Pletal) is more effective than pentoxifylline (trental). Patient should also avoid
grapefruit juice, diltiazem, and meprazole, which can increase serum concentration if taken
together.
A patient comes to the clinic with complaints that her fingers have begun to turn white to bluish
on very cold days. She states that it does not resolve immediately when returning into a warmer
setting. After two hours, her fingers tips become red and warm and numbness subsides. Which
of the following medications may help this patient?
2|Page
,a. ACE
b. ARB
c. CCB
d. BB c
This patient is displaying symptoms of Raynauds phenomenon. Medications that are used to
treat this include CCB (nifedipine, amlodipine).
A 61 year old male patient comes to the clinic with cough, shortness of breath, heavy sputum,
fever and chills. His past medical history include hypercholesterolemia and hypertension.
Medications are simvastatin (Zocor) 40. mg/d and Lostartan (Cozaar). He has no known
allergies. The nurse practitioner orders a chest x-ray, which shows consolidation. The patient is
diagnosed with community-acquired pneumonia. Which of the following antibiotics should the
nurse practitioner not order for this patient?
a. Erythromycin
b. Doxycycline (Vibramycin)
c. Ceftriaxone (Rocephin)
d. Penicillin a
Patients taking simvastatin or lovastatin should not mix with any macrolide. The best treatment
choice for this patient then is doxycycline.
Which of the following are associated with the criteria for metabolic syndrome?
a. Obesity, HTN, fasting glucose >200
b. Obesity, fasting glucose >100, hyperlipidemia
c. Obesity, decreased triglycerides, and elevated HDLs
d. Obesity, fasting glucose >150, and elevated HDLs b
Criteria for metabolic syndrome include abdominal obesity, HTN, hyperlipidemia or elevated
triglycerides and low HADL, elevated fasting glucose >100 mg/dL.
3|Page
, A patient wants to know their BMI. How does the nurse practitioner calculate the BMI?
a. Age divided by height plus weight
b. Height divided by weight
c. Weight divided by height
d. Weight divided by age c
weight (kgs) / height (meters)
Expected findings in a patient with COPD include all of the following except:
a. Increased anterior-posterior diameter
b. Hyporesonance
c. Decreased tactile fremitus
d. Flattened diaphram b
COPD would should increased anterior-posterior diameter, decreased breath and heart sounds,
use of accessory. muscles, pursed-lip breathing, and weight loss. Percussion would produce
HYPERresonance. Tactile fremitus and egophony would decrease. Cxr would show flattened
diaphragms with hyperinflation.
Anticholinergics should be avoided in all of the following patients except:
a. Patient diagnosed with narrow-angle glaucoma
b. Patient with benign prostatic hyperplasia
c. Patient with hyperthyroidism
d. Patient with bladder neck obstruction c
Patients with hyperthyroidism should avoid using SABAs if possible. Anticholinergics should be
avoided in patients with narrow-angle glaucoma, BPH, and bladder neck obstruction.
What is the first line treatment for a patient that is considered a category C (GOLD 3-4) with
COPD?
4|Page
800+ Verified Questions & Answers |
Guaranteed Pass, Exams of Clinical Medicine
A 53 year old male patient comes to the clinic with pain in her lower right calf. He states that he
just returned from travel form Europe. The nurse practitioner dorsiflexes his foot, which elicits
lower leg pain. This is known as:
a. Murphey's sign
b. McBurney's sign
c. Babinski's sign
d. Homan's sign d
Homan's sign is lower leg pain on dorsiflexion of the foot. Often found in DVT. Murphey's sign is
for cholecystitis, McBurney's sign is appendix, Babinski's sign is neurological exam of big toe and
reflex.
A 58 year old male patient comes to the clinic with complaints of fatigue and exertional
dyspnea. He states that he has been running 5 miles daily for the past 10 years but he can
barely run 2 without needing to stop. According to the New York Heart Association (NYHA)
system, which classification does the patient fall into?
a. Class I
b. Class II
c. Class III
d. Class IV b
Class II. Class I = no limitations on physical activity. Class III = marked limitation on physical
activity. Class IV = symptoms are present at rest, with or without activity.
What is the first line medication for a patient with stable heart failure?
a. Losartan
1|Page
,b. Metoprolol
c. Terazosin
d. Indapamide a
ACE1 or ARB are first line treatment for stable HF.
A 44 year old patient comes to the clinic with discomfort in his legs. He has a history of smoking
and hyperlipidemia. He states that the pain in his legs worsen when walking but resolves with
rest. Upon assessment the nurse practitioner notes gangrenous toes. The patients ankle-
brachial index score is 0.8. What does this score indicate?
a. Score of 0.8 is diagnostic for peripheral arterial disease
b. Score of 0.8 is non-diagnostic for peripheral arterial disease
c. Score of 0.8 is diagnostic for peripheral venous disease
d. Score of 0.8 is non-diagnostic for peripheral venous disease a
ABI score equal or less than 0.9 is diagnostic for PAD. ABI score 0.91 to 1.3 is normal.
A patient is diagnosed with peripheral arterial disease. Which of the following medications is
best used for the management of this patient?
a. Pentoxifylline (Trental)
b. Cilostazol (Pletal)
c. Warfarin (Coumadin)
d. Dabigatran (Pradaxa) b
Cilostazol (Pletal) is more effective than pentoxifylline (trental). Patient should also avoid
grapefruit juice, diltiazem, and meprazole, which can increase serum concentration if taken
together.
A patient comes to the clinic with complaints that her fingers have begun to turn white to bluish
on very cold days. She states that it does not resolve immediately when returning into a warmer
setting. After two hours, her fingers tips become red and warm and numbness subsides. Which
of the following medications may help this patient?
2|Page
,a. ACE
b. ARB
c. CCB
d. BB c
This patient is displaying symptoms of Raynauds phenomenon. Medications that are used to
treat this include CCB (nifedipine, amlodipine).
A 61 year old male patient comes to the clinic with cough, shortness of breath, heavy sputum,
fever and chills. His past medical history include hypercholesterolemia and hypertension.
Medications are simvastatin (Zocor) 40. mg/d and Lostartan (Cozaar). He has no known
allergies. The nurse practitioner orders a chest x-ray, which shows consolidation. The patient is
diagnosed with community-acquired pneumonia. Which of the following antibiotics should the
nurse practitioner not order for this patient?
a. Erythromycin
b. Doxycycline (Vibramycin)
c. Ceftriaxone (Rocephin)
d. Penicillin a
Patients taking simvastatin or lovastatin should not mix with any macrolide. The best treatment
choice for this patient then is doxycycline.
Which of the following are associated with the criteria for metabolic syndrome?
a. Obesity, HTN, fasting glucose >200
b. Obesity, fasting glucose >100, hyperlipidemia
c. Obesity, decreased triglycerides, and elevated HDLs
d. Obesity, fasting glucose >150, and elevated HDLs b
Criteria for metabolic syndrome include abdominal obesity, HTN, hyperlipidemia or elevated
triglycerides and low HADL, elevated fasting glucose >100 mg/dL.
3|Page
, A patient wants to know their BMI. How does the nurse practitioner calculate the BMI?
a. Age divided by height plus weight
b. Height divided by weight
c. Weight divided by height
d. Weight divided by age c
weight (kgs) / height (meters)
Expected findings in a patient with COPD include all of the following except:
a. Increased anterior-posterior diameter
b. Hyporesonance
c. Decreased tactile fremitus
d. Flattened diaphram b
COPD would should increased anterior-posterior diameter, decreased breath and heart sounds,
use of accessory. muscles, pursed-lip breathing, and weight loss. Percussion would produce
HYPERresonance. Tactile fremitus and egophony would decrease. Cxr would show flattened
diaphragms with hyperinflation.
Anticholinergics should be avoided in all of the following patients except:
a. Patient diagnosed with narrow-angle glaucoma
b. Patient with benign prostatic hyperplasia
c. Patient with hyperthyroidism
d. Patient with bladder neck obstruction c
Patients with hyperthyroidism should avoid using SABAs if possible. Anticholinergics should be
avoided in patients with narrow-angle glaucoma, BPH, and bladder neck obstruction.
What is the first line treatment for a patient that is considered a category C (GOLD 3-4) with
COPD?
4|Page
