LEIK FAMILY NURSE PRACTITIONER (FNP)
PRACTICE EXAMINATION 2026
Advanced Clinical Review, Diagnosis, Pharmacology, and Board
Certification Readiness Assessment
Examination Level: Family Nurse Practitioner Certification Preparation
SPRING SEMESTER EXAM 2026
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
D) Legionnaires disease
B) Mycoplasma pneumonia
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
1
based on symptoms and x-ray results of infiltrates in lower lobes.
Page
, 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
2
Page
, 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
3
Page
, 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
4
D) Dysuria and frequency
Page
PRACTICE EXAMINATION 2026
Advanced Clinical Review, Diagnosis, Pharmacology, and Board
Certification Readiness Assessment
Examination Level: Family Nurse Practitioner Certification Preparation
SPRING SEMESTER EXAM 2026
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
D) Legionnaires disease
B) Mycoplasma pneumonia
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
1
based on symptoms and x-ray results of infiltrates in lower lobes.
Page
, 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
2
Page
, 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
3
Page
, 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
4
D) Dysuria and frequency
Page
