LEIK FNP Practice Questions With Complete Solutions.
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LEIK FNP
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LEIK FNP
A 72-year-old woman has been on hydrochlorothiazide 12.5 mg for many years to control her Stage II hypertension. Her blood pressure (BP) at this visit is 168/96. She is currently complaining of pain on her right hip and on both knees. She has increased her dose of ibuprofen (Motrin) from 400 mg 3 t...
a 72 year old woman has been on hydrochlorothiazid
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LEIK FNP Practice Questions With
Complete Solutions.
A 72-year-old woman has been on hydrochlorothiazide 12.5 mg for many years to
control her Stage II hypertension. Her blood pressure (BP) at this visit is 168/96. She
is currently complaining of pain on her right hip and on both knees. She has
increased her dose of ibuprofen (Motrin) from 400 mg 3 times day (TID) to 800 mg
TID. She is still in pain and would like something stronger. Which of the following
statements is the best explanation of the effects of ibuprofen (Motrin) on her
disease?
A) It increases the chances of adverse effects to her health
B) It inhibits the effect of renal prostaglandins and blunts the effectiveness of the
diuretic
C) It prolongs the therapeutic effects of hydrochlorothiazide and other diuretics
D) None of the statements are true - Answer B) It inhibits the effect of renal
prostaglandins and blunts the effectiveness of the diuretic.
NSAIDs and ASA inhibit the vasodilatory effects of prostaglandins, which
predisposes the kidney to ischemia. NSAIDs and diuretics can cause acute prerenal
failure by decreasing renal blood flow.
2. All of the following are infections that affect mostly the labia and vagina except:
A) Bacterialvaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis - Answer D) Chlamydia trachomatis
Infections that commonly affect the labia and vagina include bacterial vaginosis,
candidiasis, and trichomoniasis. Chlamydia trachomatis commonly affects the cervix,
endometrial lining , fallopian tubes, and pelvic cavity.
The nurse practitioner would test the obturator and iliopsoas muscle to evaluate for:
A) Cholecystitis
B) Acute appendicitis
C) Inguinal hernia
D) Gastriculcer - Answer B) Acute appendicitis.
Signs and symptoms of an acute abdomen include invol- untary guarding, rebound
tenderness, boardlike abdomen, and a positive obtu- rator and psoas sign. A positive
obturator sign occurs when pain is elicted by internal rotation of the right hip from 90
degrees hip/knee flexion. The psoas sign is positive when pain occurs with passive
extension of the thigh while the patient is lying on his/her side with knees extended,
or when pain occurs with active flexion of his/her thigh at the hip.
Treatment for mild preeclampsia includes all of the following except:
A) Bed rest except for bathroom privileges
B) Close monitoring of weight and blood pressure
,LEIK FNP Practice Questions With
Complete Solutions.
C) Close follow-up of urinary protein, serum creatinine, and platelet count
D) A prescription of methyldopa (Aldomet) to control blood pressure - Answer D) A
prescription of methyldopa (Aldomet) to control blood pressure
Recommended care for women diagnosed with preeclampsia includes bed rest with
bath- room privileges, weight and BP monitoring, and closely following urine protein
and serum protein, creatinine, and platelet counts. Oral medications are not used as
first-line treatment.
All of the following services are covered under Medicare Part A except:
A) Inpatienthospitalizations
B) Medicines administered to a patient while hospitalized
C) Nursing home care
D) Surgeons - Answer C) Nursing home care
Medicare A coverage includes inpatient hospitalization and skilled care given in a
certified skilled nursing facility. Most nursing home care is custodial care (help with
bathing, dressing, using a bathroom, and eating). This care is not covered by
Medicare A.
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 - Answer 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 based on symptoms and x-ray results of infiltrates in lower
lobes.
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 - Answer 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
,LEIK FNP Practice Questions With
Complete Solutions.
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 - Answer 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 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 - Answer 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 - Answer C) Beta-blockers
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.
, LEIK FNP Practice Questions With
Complete Solutions.
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 - Answer 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
D) Dysuria and frequency - Answer B) Edema of the face and the upper extremities
Common signs and symptoms of pregnancy-induced hypertension include edema of
the face and the upper extremities, weight gain, blurred vision, elevated BP,
proteinuria, and headaches.
Which of the following symptoms is associated with B12 deficiency anemia?
A) Spoon-shaped nails and pica
B) An abnormal neurological exam
C) A vegan diet
D) Tingling and numbness of both feet - Answer D) Tingling and numbness of both
feet
Vitamin B12 deficiency anemia can cause nerve cell damage if not treated.
Symptoms of B12 deficiency anemia may include tingling or numbness in fingers and
toes, difficulty walking, mood changes or depression, memory loss, disorientation,
and dementia.
A second triple screen on a 35-year-old primigravida reveals abnormally low lev- els
of the alpha fetoprotein and estriol and high levels of human chorionic gonad-
otropin. Which of the following interventions is the best choice for this patient?
A) Order an ultrasound
B) Order a computed tomography (CT) scan of the abdomen
C) Order a 24-hour urine for protein clearance
D) Assess for a history of illicit drug or alcohol use - Answer A) Order an ultrasound
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