LEIK FNP Practice Questions & Answers (Test Bank)
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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 – 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.
- All of the following are infections that affect mostly the labia and vagina except:
A) Bacterialvaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis – 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 – 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
C) Close follow-up of urinary protein, serum creatinine, and platelet count
D) A prescription of methyldopa (Aldomet) to control blood pressure – 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 – 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 – 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 – 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 lowrisk 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 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