ESTUDYR
LEIK 2026/EXAM EDGE FNP REVIEW, FIRST EXAM EDGE ANCC PREP
TEST PART 1PSI FNP MOST TESTED QUESTIONS AND ANSWERS
GRADED A+ WITH RATIONALES
1. HIV Risk Reduction & Prevention Counseling (Select all that apply)
A nurse practitioner working in a community health clinic sees a sexually active adult male who
expresses concern about starting a new same-sex relationship. The patient is asymptomatic, has
no known history of HIV, and wants to reduce his risk of infection. Which interventions are
appropriate during this visit? (Select all that apply.)
A. Contact the patient’s sexual partner to schedule HIV testing
B. ⬛ Educate the patient on consistent use of barrier protection during sexual activity
C. Prescribe daily oral pre-exposure prophylaxis (PrEP) immediately
D. ⬛ Obtain a baseline combination HIV antigen/antibody test
E. ⬛ Schedule a follow-up visit in 1 month to review results and discuss PrEP options
Correct Answers: ⬛ B, ⬛ D, ⬛ E
Rationale:
Barrier protection (condoms, dental dams) is essential for HIV prevention.
PrEP is indicated only after confirming HIV-negative status.
A 4th-generation HIV antigen/antibody test is required prior to initiation.
Partner notification without consent is not ethically or legally appropriate.
2. Acute Abdominal Pain in an Older Adult
An older adult male presents with sudden onset of severe flank and back pain. He is pale,
hypotensive (BP 90/60 mmHg), and has difficulty answering questions due to pain. His abdomen
is distended on palpation. He has a 20-pack-year smoking history. Which diagnosis is most
likely?
A. Acute myocardial infarction
B. Congestive heart failure
C. Infective endocarditis
D. ⬛ Dissecting abdominal aortic aneurysm
Correct Answer: ⬛ D
,ESTUDYR
Rationale:
A dissecting AAA presents with sudden, severe tearing pain, hypotension, and abdominal
distension. Risk factors include male sex, smoking, and hypertension. This is a surgical
emergency.
3. Early Alzheimer Disease Management
A 67-year-old woman is diagnosed with mild Alzheimer-type dementia. She has memory
impairment but is still able to perform most activities of daily living independently. What is the
mainstay pharmacologic treatment at this stage?
A. NSAIDs
B. Vitamin E supplementation
C. ⬛ Cholinesterase inhibitors
D. Selegiline
Correct Answer: ⬛ C
Rationale:
Cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are first-line therapy for mild
to moderate Alzheimer disease. They provide modest cognitive benefit.
4. Cardiac Murmur Grading
While auscultating an 86-year-old patient’s heart, the nurse practitioner hears a murmur that is
audible without the stethoscope touching the chest. How should this murmur be graded?
A. I/VI
B. IV/VI
C. V/VI
D. ⬛ VI/VI
Correct Answer: ⬛ D
Rationale:
Grade VI/VI murmurs are audible with the stethoscope entirely off the chest.
Grade V/VI requires partial contact.
,ESTUDYR
5. Pneumococcal Vaccination Eligibility
Which of the following individuals would NOT be a candidate for pneumococcal vaccination?
A. A 65-year-old healthy female
B. A 35-year-old patient with HIV
C. A 58-year-old nursing home resident
D. ⬛ A 55-year-old healthy woman living alone
Correct Answer: ⬛ D
Rationale:
Pneumococcal vaccine is recommended for all adults ≥65, immunocompromised
patients, and nursing home residents.
Living alone is not an indication.
6. Chronic Pelvic Pain Etiology
Which condition is most likely to cause chronic pelvic pain rather than acute pelvic pain?
A. Ectopic pregnancy
B. Pelvic inflammatory disease
C. Ovarian torsion
D. ⬛ Interstitial cystitis
Correct Answer: ⬛ D
Rationale:
Interstitial cystitis is characterized by chronic bladder pain, urinary frequency, and urgency,
not acute inflammatory symptoms.
7. Imaging Limitations in Pancreatic Cancer
A 58-year-old man is being evaluated for suspected pancreatic cancer. Why is abdominal
ultrasound not ideal as a primary diagnostic test?
A. Tumor size limitations
B. Patient age
C. ⬛ Presence of intestinal gas
D. Prior pancreatic disease
, ESTUDYR
Correct Answer: ⬛ C
Rationale:
Intestinal gas interferes with ultrasound waves. CT scan is preferred for pancreatic pathology.
8. Newly Diagnosed Severe Type 2 Diabetes
A 58-year-old male presents with polyuria, polydipsia, and a random glucose of 309 mg/dL.
What is the most appropriate initial management?
A. Start metformin
B. Start combination oral therapy
C. Recheck glucose tomorrow
D. ⬛ Initiate insulin therapy
Correct Answer: ⬛ D
Rationale:
Severe hyperglycemia with symptoms requires insulin for rapid glucose control before
transitioning to oral agents.
9. Utilization Review Defined
Utilization review is best described as:
A. Accreditation process
B. Case management
C. ⬛ Evaluation of appropriateness of inpatient hospitalization
D. Monitoring of clinical outcomes
Correct Answer: ⬛ C
Rationale:
Utilization review ensures that hospital admissions and length of stay are medically necessary
for reimbursement.
10. Acute Renal Failure & Electrolytes
A patient with acute renal failure may demonstrate impaired electrolyte regulation. Which
condition is least likely to occur?
LEIK 2026/EXAM EDGE FNP REVIEW, FIRST EXAM EDGE ANCC PREP
TEST PART 1PSI FNP MOST TESTED QUESTIONS AND ANSWERS
GRADED A+ WITH RATIONALES
1. HIV Risk Reduction & Prevention Counseling (Select all that apply)
A nurse practitioner working in a community health clinic sees a sexually active adult male who
expresses concern about starting a new same-sex relationship. The patient is asymptomatic, has
no known history of HIV, and wants to reduce his risk of infection. Which interventions are
appropriate during this visit? (Select all that apply.)
A. Contact the patient’s sexual partner to schedule HIV testing
B. ⬛ Educate the patient on consistent use of barrier protection during sexual activity
C. Prescribe daily oral pre-exposure prophylaxis (PrEP) immediately
D. ⬛ Obtain a baseline combination HIV antigen/antibody test
E. ⬛ Schedule a follow-up visit in 1 month to review results and discuss PrEP options
Correct Answers: ⬛ B, ⬛ D, ⬛ E
Rationale:
Barrier protection (condoms, dental dams) is essential for HIV prevention.
PrEP is indicated only after confirming HIV-negative status.
A 4th-generation HIV antigen/antibody test is required prior to initiation.
Partner notification without consent is not ethically or legally appropriate.
2. Acute Abdominal Pain in an Older Adult
An older adult male presents with sudden onset of severe flank and back pain. He is pale,
hypotensive (BP 90/60 mmHg), and has difficulty answering questions due to pain. His abdomen
is distended on palpation. He has a 20-pack-year smoking history. Which diagnosis is most
likely?
A. Acute myocardial infarction
B. Congestive heart failure
C. Infective endocarditis
D. ⬛ Dissecting abdominal aortic aneurysm
Correct Answer: ⬛ D
,ESTUDYR
Rationale:
A dissecting AAA presents with sudden, severe tearing pain, hypotension, and abdominal
distension. Risk factors include male sex, smoking, and hypertension. This is a surgical
emergency.
3. Early Alzheimer Disease Management
A 67-year-old woman is diagnosed with mild Alzheimer-type dementia. She has memory
impairment but is still able to perform most activities of daily living independently. What is the
mainstay pharmacologic treatment at this stage?
A. NSAIDs
B. Vitamin E supplementation
C. ⬛ Cholinesterase inhibitors
D. Selegiline
Correct Answer: ⬛ C
Rationale:
Cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are first-line therapy for mild
to moderate Alzheimer disease. They provide modest cognitive benefit.
4. Cardiac Murmur Grading
While auscultating an 86-year-old patient’s heart, the nurse practitioner hears a murmur that is
audible without the stethoscope touching the chest. How should this murmur be graded?
A. I/VI
B. IV/VI
C. V/VI
D. ⬛ VI/VI
Correct Answer: ⬛ D
Rationale:
Grade VI/VI murmurs are audible with the stethoscope entirely off the chest.
Grade V/VI requires partial contact.
,ESTUDYR
5. Pneumococcal Vaccination Eligibility
Which of the following individuals would NOT be a candidate for pneumococcal vaccination?
A. A 65-year-old healthy female
B. A 35-year-old patient with HIV
C. A 58-year-old nursing home resident
D. ⬛ A 55-year-old healthy woman living alone
Correct Answer: ⬛ D
Rationale:
Pneumococcal vaccine is recommended for all adults ≥65, immunocompromised
patients, and nursing home residents.
Living alone is not an indication.
6. Chronic Pelvic Pain Etiology
Which condition is most likely to cause chronic pelvic pain rather than acute pelvic pain?
A. Ectopic pregnancy
B. Pelvic inflammatory disease
C. Ovarian torsion
D. ⬛ Interstitial cystitis
Correct Answer: ⬛ D
Rationale:
Interstitial cystitis is characterized by chronic bladder pain, urinary frequency, and urgency,
not acute inflammatory symptoms.
7. Imaging Limitations in Pancreatic Cancer
A 58-year-old man is being evaluated for suspected pancreatic cancer. Why is abdominal
ultrasound not ideal as a primary diagnostic test?
A. Tumor size limitations
B. Patient age
C. ⬛ Presence of intestinal gas
D. Prior pancreatic disease
, ESTUDYR
Correct Answer: ⬛ C
Rationale:
Intestinal gas interferes with ultrasound waves. CT scan is preferred for pancreatic pathology.
8. Newly Diagnosed Severe Type 2 Diabetes
A 58-year-old male presents with polyuria, polydipsia, and a random glucose of 309 mg/dL.
What is the most appropriate initial management?
A. Start metformin
B. Start combination oral therapy
C. Recheck glucose tomorrow
D. ⬛ Initiate insulin therapy
Correct Answer: ⬛ D
Rationale:
Severe hyperglycemia with symptoms requires insulin for rapid glucose control before
transitioning to oral agents.
9. Utilization Review Defined
Utilization review is best described as:
A. Accreditation process
B. Case management
C. ⬛ Evaluation of appropriateness of inpatient hospitalization
D. Monitoring of clinical outcomes
Correct Answer: ⬛ C
Rationale:
Utilization review ensures that hospital admissions and length of stay are medically necessary
for reimbursement.
10. Acute Renal Failure & Electrolytes
A patient with acute renal failure may demonstrate impaired electrolyte regulation. Which
condition is least likely to occur?
