ANCC exam 3
A nurse practitioner is using motivational interviewing techniques with a patient who has recently been diagnosed with hypertension. The patient expresses concerns about making lifestyle changes. Which of the following responses is the most appropriate to facilitate further discussion? A. "Do you take your medications regularly?" Incorrect B. "How do you feel about the changes you need to make?" Correct C. "Is there a specific diet you're considering?" Incorrect D. "You should reduce your salt intake, right?"
"How do you feel about the changes you need to make?"
A 24-day-old female infant presents to the clinic with a 1-day history of fever and decreased appetite. Her parents report that she has been sleeping more than usual and has shown little interest in breastfeeding. The physical exam reveals a well-appearing infant in no acute distress. The vital signs are as follows: rectal temperature of 100.5°F, HR of 175 bpm, respiratory rate of 35 breaths/min, and oxygen saturation of 99%. What guidance should the nurse practitioner provide to the infant's parents? A. "I am concerned about possible sepsis" Correct B. "Since it has only been 1 day, it is likely viral" Incorrect C. "She needs a 10-day course of antibiotics" Incorrect D. "You can give her ibuprofen (Motrin) every 6-8 hours"
"I am concerned about possible sepsis"
Which of the following patients with a 30 pack-year smoking history should undergo screening for lung cancer with low-dose CT of the chest, according to the USPSTF? A. A 45-year-old patient who currently smokes Incorrect B. A 60-year-old patient who quit smoking 10 years ago Correct C. A 75-year-old patient who quit smoking 20 years ago Incorrect D. An 85-year-old patient who currently smokes
A 60-year-old patient who quit smoking 10 years ago
A 22-year-old man presents to the clinic after sustaining a dog bite injury. He has multiple bite wounds. After his wounds have been thoroughly cleaned and irrigated, he asks whether he will need to have stitches. Which of the following bite wounds would it be acceptable to offer primary wound closure for? A. A deep wound over the elbow joint Incorrect B. A lip laceration that crosses the vermillion border Correct C. A puncture wound on his hand Incorrect D. A wound to his foot
A lip laceration that crosses the vermillion border
A 13-year-old girl presents to the clinic with poor school performance. The patient has had multiple runaway attempts in the past year. Which of the following would raise concern for sexual abuse and indicate the need for sexually transmitted infection screening? A. A sibling with a sexually transmitted infection Correct B. Irregular periods Incorrect C. Multiple boyfriends Incorrect D. Poor hygiene
A sibling with a sexually transmitted infection
A 44-year-old woman presents to the clinic with reports of gradual hearing loss in her right ear and intermittent episodes of dizziness and imbalance for 1 year. The otoscopic examination reveals no abnormal findings. The Rinne, Weber, and audiometry tests reveal significant sensorineural hearing loss on the right side. The Romberg test is normal. Which of the following is the most likely diagnosis? A. Acoustic neuroma Correct B. Cholesteatoma Incorrect C. Ménière disease Incorrect D. Presbycusis
Acoustic neuroma
A 26-year-old man presents to the clinic with a report of a human bite wound to his right thumb, sustained while working as a nurse. Records indicate that a primary childhood DTaP vaccination series was completed, and he received a Tdap booster at age 19. The wound was cleaned and bandaged. Which additional step is most appropriate at this time? A. Administer a Td booster Correct B. Administer a Tdap booster Incorrect C. Administer human tetanus immune globulin Incorrect D. No additional treatment is recommended
Administer a Td booster
A 58-year-old man is on a multidrug regimen for essential hypertension. His blood pressure is at goal, but he notes persistent bilateral pedal edema. Which of the following medications is the most likely cause of this side effect? A. Amlodipine (Norvasc) Correct B. Enalapril (Vasotec) Incorrect C. Losartan (Cozaar) Incorrect D. Metoprolol tartrate (Lopressor)
Amlodipine (Norvasc)
A newly licensed nurse practitioner is preparing to start their first position at a primary care clinic. During the onboarding process, the clinic's medical director requests that the nurse practitioner sign a collaborative agreement document. Which of the following best describes a collaborative agreement? A. A contract between the nurse practitioner and the clinic for employment terms and salary Incorrect B. A document formalizing the responsibilities in the clinic regarding patient load, billing, and documentation Incorrect C. An agreement between the nurse practitioner and a physician outlining the scope of practice and consultation requirements Correct D. An arrangement between the nurse practitioner and the clinic's insurance provider regarding patient billing procedures
An agreement between the nurse practitioner and a physician outlining the scope of practice and consultation requirements
A 70-year-old man presents to the clinic with urinary hesitancy, frequency, a slow stream, and straining to void. The symptoms have been present and progressively worsening over the past 2 years. Which of the following physical exam findings is most consistent with the suspected diagnosis? A. A prostate of normal size and proteinuria on urine dipstick Incorrect B. A small, firm, irregular prostate Incorrect C. An enlarged, boggy, exquisitely tender prostate Incorrect D. An enlarged, rubbery, symmetrical prostate
An enlarged, rubbery, symmetrical prostate
A 45-year-old patient presents to the clinic for an annual physical exam. He inquires about hepatitis C virus screening, as he has not had screening for this virus in the past. He has no identifiable risk factors for hepatitis C virus and reports no current associated symptoms. Which of the following screening tests for hepatitis C virus should the nurse practitioner order first? A. Anti-hepatitis C virus antibody test Correct B. Qualitative hepatitis C virus RNA test Incorrect C. Quantitative hepatitis C virus RNA test Incorrect D. Screening for hepatitis C virus is not indicated
Anti-hepatitis C virus antibody test
A 12-year-old girl presents to the clinic with redness in and watery discharge from her right eye that began 2 days ago. It now involves the left eye as well. She woke up this morning unable to open her eyes and had to wash her face with a warm washcloth to do so. She recovered from a cold 2 weeks ago and has otherwise been healthy. The physical examination reveals bilateral conjunctival injection and tearing. What is the best treatment for this condition? A. Artificial tears and cold compresses Correct B. Erythromycin ophthalmic ointment Incorrect C. Ketorolac ophthalmic solution (Acular) Incorrect D. Trimethoprim-polymyxin B ophthalmic solution (Polytrim)
Artificial tears and cold compresses
A 53-year-old man presents to the clinic with a 3-month history of palpitations, fatigue, and weakness that he experiences shortly after starting yard work. He has a medical history of diabetes mellitus and hypertension. An ECG shows an irregularly irregular rhythm. Which of the following is the most likely diagnosis? A. Atrial fibrillation Correct B. Atrial flutter Incorrect C. First-degree atrioventricular block Incorrect D. Ventricular tachycardia
Atrial fibrillation
Which of the following dietary guidelines is currently recommended for children 1-2 years of age? A. Avoid added sugars Correct B. Avoid dietary fat and carbohydrates Incorrect C. Be limited to 8 ounces of juice per day Incorrect D. Consume at least 2 cups of skim milk daily
Avoid added sugars
A 2-month-old Black infant presents to the clinic for a routine visit. On the physical exam, the nurse practitioner notes 2 light-brown macules with uniform borders on the infant's torso. Which of the following is the most likely diagnosis? A. Café-au-lait spots Correct B. Congenital dermal melanocytosis Incorrect C. Milia Incorrect D. Salmon patch
Café-au-lait spots
A 27-year-old nullipara woman who is sexually active presents to the clinic for her routine women's health visit. Which of the following clinical manifestations should prompt the nurse practitioner to offer the patient a serum pregnancy test? A. Chadwick sign Correct B. Effacement Incorrect C. Lichen planus Incorrect D. Vasa previa
Chadwick sign
A 43-year-old woman presents to the clinic to establish care. She has no significant medical history, but she has not seen a primary care clinician since childhood. She feels well and has no health concerns at this time. She reports no family history of cancer, but her mother has dense breasts, and she is concerned that her breasts might also be dense. A physical exam, including a pelvic exam and breast exam, reveals no abnormal findings. Which of the following is recommended by the USPSTF for breast cancer screening for this patient? A. Annual screening with breast MRI for women 40-74 years of age with dense breasts Incorrect B. Annual screening with mammography for women 40-74 years of age Incorrect C. Biennial screening with mammography for women 40-74 years of age Incorrect D. Biennial screening with mammography for women 50-74 years of age
Biennial screening with mammography for women 50-74 years of age
A 20-year-old man with a history of asthma presents to the clinic for an annual physical. He states that he currently has asthma symptoms every day that impact his daily activities. He states that he needs to take his albuterol (ProAir HFA) inhaler at least once per day for symptom relief. His most recent pulmonary function test revealed FEV₁ of 70% of predicted. What would be the best option for daily symptom control? A. Budesonide-formoterol (Symbicort) Correct B. Prednisone Incorrect C. Scheduled albuterol (ProAir HFA) Incorrect D. Theophylline (Elixophyllin)
Budesonide-formoterol (Symbicort)
A 67-year-old man presents to the clinic for his annual wellness visit. He explains to the nurse practitioner that he is having difficulty seeing things directly in front of him. However, his peripheral vision is at his baseline. Which of the following is the most common risk factor for this condition? A. Cigarette smoking Correct B. Diabetes Incorrect C. Elevated intraocular pressure Incorrect D. Hyperthyroidism
Cigarette smoking
A 12-year-old afebrile patient presents to the clinic with right ear pain for the past 2 days after swimming. On examination, there is erythema and edema of the external auditory canal, with debris and crusted material visible in the external canal. The tympanic membrane is intact and nonerythematous. She reports pain when the auricle is gently pressed. Which of the following is the best therapy? A. Acetic acid 2% otic solution Incorrect B. Ciprofloxacin 0.3% and dexamethasone 0.1% otic solution (Ciprodex) Correct C. Oral amoxicillin Incorrect D. Oral cefdinir
Ciprofloxacin 0.3% and dexamethasone 0.1% otic solution (Ciprodex)
A 5-year-old boy presents to the clinic with a sore throat and fever. On physical examination, he has pharyngeal erythema, tender cervical adenopathy, and bilateral tonsillar exudates. His rapid Streptococcus screen is positive. His mother reports the child has a history of a severe penicillin allergy. Which of the following medications is the most appropriate therapy at this time? A. Cephalexin (Keflex) Incorrect B. Clarithromycin Correct C. Trimethoprim-sulfamethoxazole (Bactrim DS) Incorrect D. Vancomycin (Vancocin)
Clarithromycin
A 12-month-old female infant presents to the clinic for a routine well-child visit. Her mother reports they recently immigrated to the United States from Guatemala. The patient is exclusively breastfed, and her weight for age is in the 65th percentile. The lab results are hemoglobin of 10.5 g/dL and a lead level of 2.3 mcg/dL. Which of the following is the best next step? A. Complete a focused history and dietary assessment Correct B. Order a serum ferritin Incorrect C. Prescribe oral iron supplementation Incorrect D. Refer for lead chelation therapy Incorrect Review Previous QuestionReview Next Question
Complete a focused history and dietary assessment
A 4-year-old boy with a history of cystic fibrosis presents to the clinic for a routine follow-up visit. His mother states he recently began playing soccer. She reports no fevers, increased sputum production, abdominal pain, or diarrhea. At his last visit, he was prescribed albuterol (ProAir HFA) PRN. Other medications include pancrelipase (Pancreaze) with meals and a multivitamin daily. His height and weight are measured at 39.5 inches and 30 lbs, respectively, with a BMI of 13.5 kg/m2, placing him in the fifth percentile for weight for age and the first percentile for BMI. His FEV₁ in the office today is 85% of the predicted value. Which of the following is the most appropriate next step in management? A. Complete a nutritional assessment Correct B. Discourage aerobic exercise Incorrect C. Increase pancreatic enzymes Incorrect D. Prescribe formoterol-budesonide (Symbicort) daily
Complete a nutritional assessment
A nurse practitioner is considering introducing telehealth into their practice. Which of the following is true regarding telehealth? A. Compliance with HIPAA privacy and security rules is mandatory Correct B. Health outcomes are inferior to traditional in-person visits Incorrect C. Liability insurance is not available Incorrect D. Only physicians are permitted to bill for telehealth services
Compliance with HIPAA privacy and security rules is mandatory
A 69-year-old man presents to the clinic with reports of redness, pain, and tearing of his left eye for the past week. He wears glasses but reports no history of recent trauma or contact lens use. The physical examination reveals conjunctival injection, dendritic corneal ulcers, and decreased visual acuity in the left eye. Which of the following is the most likely diagnosis? A. Acute angle-closure glaucoma Incorrect B. Bacterial conjunctivitis Incorrect C. Dry eye syndrome Incorrect D. Herpes keratitis
Herpes keratitis
A 62-year-old woman presents with a report of dysuria and a fever of 100.1°F for 2 days. Which additional finding would suggest a complicated UTI rather than an uncomplicated UTI? A. Bacteriuria Incorrect B. Costovertebral angle tenderness Correct C. Suprapubic pain Incorrect D. Urinary frequency
Costovertebral angle tenderness
A 41-year-old woman presents to the clinic with concerns about changes in weight, unusual bruising, depression, irregular menses, and a decreased libido. She has a history of asthma. On exam, you note a buffalo hump, hirsutism, striae and bruising on the abdomen and upper arms, and hyperhidrosis. Her BP is found to be elevated at 171/96 mm Hg. Which of the following is the most likely diagnosis? A. Adrenal insufficiency Incorrect B. Cushing syndrome Correct C. Hypothyroidism Incorrect D. Polycystic ovary syndrome
Cushing syndrome
A nurse practitioner is assisting with the implementation of a new electronic medical record system in the clinic. The nurse practitioner would like to remain in compliance with legal and ethical principles for managing health-care information. Which of the following system features should be prioritized? A. Access restricted to licensed health-care clinicians only Incorrect B. Advertisements direct to patients based on their health data Incorrect C. Data protection with accessibility for authorized staff Correct D. Display of the latest medical research on the homepage
Data protection with accessibility for authorized staff
A 9-year-old boy presents to the clinic for a follow-up visit. His mother reports that the patient has been experiencing difficulty falling and staying asleep since his last visit. There is no report of mood changes or issues with school performance. His vital signs are normal. Current medications include polyethylene glycol 3350 (Miralax) 17g once daily, methylphenidate (Ritalin) 5 mg twice daily, and a children's multivitamin once daily. Which of the following is the most appropriate next step in management? A. Decrease second dose of methylphenidate (Ritalin) to 2.5 mg Correct B. Discontinue methylphenidate (Ritalin) and begin atomoxetine (Strattera) 40 mg once daily Incorrect C. Prescribe extended-release methylphenidate (Ritalin) Incorrect D. Recommend a drug holiday from methylphenidate (Ritalin)
Decrease second dose of methylphenidate (Ritalin) to 2.5 mg
A 36-year-old G4P3 woman presents for a routine prenatal visit at 30 weeks gestation. She was diagnosed with gestational diabetes mellitus at 26 weeks gestation. The nurse practitioner reviews the patient's vital signs and blood glucose log and orders lab work. Which of the following findings indicates effective management of this condition? A. 1-hour postprandial blood glucose levels < 200 mg/dL Incorrect B. 2-hour postprandial glucose levels < 100 mg/dL Incorrect C. Daily fasting glucose levels of < 95 mg/dL Correct D. Weight loss of 2 pounds since the last visit
Daily fasting glucose levels of < 95 mg/dL
A 9-month-old female infant presents to the clinic for a routine well-child visit. Six months ago, she was prescribed omeprazole (Prilosec) due to gastroesophageal reflux and poor weight gain. At the present visit, her parents report that she is drinking approximately 24 ounces of formula daily and eating some solid foods. They report no current issues with reflux. While reviewing the patient's growth chart, the nurse practitioner notes steady and appropriate weight gain over the past 6 months. Which of the following is the next best step in management? A. Continue omeprazole (Prilosec) as prescribed Incorrect B. Decrease the dose of omeprazole (Prilosec) and reevaluate in 3 weeks Correct C. Discontinue omeprazole (Prilosec) and prescribe metoclopramide (Reglan) Incorrect D. Discontinue omeprazole (Prilosec) and reevaluate in 3 months
Decrease the dose of omeprazole (Prilosec) and reevaluate in 3 weeks
A 75-year-old man presents for a hospital follow-up after having a myocardial infarction. Since returning home from the hospital, he has had dyspnea on exertion and orthopnea. The physical examination reveals an S3 gallop on cardiac auscultation and trace bilateral pedal edema. Which of the following best describes the cause of his current presentation? A. Bronchospasm and inflammation resulting in airway constriction Incorrect B. Depression of cardiac contractility secondary to loss of functional muscle Correct C. Heart valve regurgitation leading to increased preload Incorrect D. Supranormal cardiac function that is not able to meet increased metabolic demands
Depression of cardiac contractility secondary to loss of functional muscle
Which of the following should the nurse practitioner do to help prevent the leading cause of death in adolescents 13-18 years old? A. Administer immunizations Incorrect B. Educate on safe sex practices Incorrect C. Encourage seat belt use Correct D. Recommend stress-reduction techniques
Encourage seat belt use
A 62-year-old man is interested in taking saw palmetto for his benign prostatic hyperplasia. The man currently takes amlodipine (Norvasc) for hypertension. Which of the following instructions should the nurse practitioner give regarding saw palmetto? A. A decrease in blood pressure is a side effect Incorrect B. Discontinue 2 weeks before surgical procedures due to concern for bleeding Correct C. Interactions with the cytochrome P450 isoforms are common Incorrect D. It is a significantly effective treatment for benign prostatic hyperplasia
Discontinue 2 weeks before surgical procedures due to concern for bleeding
A 47-year-old woman presents with 4 days of high fever, headache, and myalgias. She developed a blanching erythematous rash with macules on her wrists and ankles that spread to her trunk 2 days ago. She reports no history of overseas travel but was camping in Arkansas last weekend. Which of the following is the most appropriate treatment for the suspected diagnosis? A. Ceftriaxone Incorrect B. Doxycycline (Vibramycin) Correct C. Erythromycin (Erythrocin) Incorrect D. Vancomycin (Vancocin)
Doxycycline (Vibramycin)
You are examining a 2-week-old female infant at a routine visit. Her mother states that her child's eyes seemed to be tearing up frequently over the past several days. The examination shows excessive tearing and some slight discharge in the medial canthus bilaterally. There is no conjunctival injection or discharge detected. Which of the following is the most appropriate next step in management? A. Educate the mother on how to massage the lacrimal sac Correct B. Order ofloxacin ophthalmic (Ocuflox) eye drops to apply to both eyes Incorrect C. Order oral amoxicillin twice daily Incorrect D. Refer the patient to ophthalmology
Educate the mother on how to massage the lacrimal sac
A 63-year-old woman presents to your office to review her recent DXA results. The T-score of her spine is −1.5. She has no history of fractures. Her fracture risk assessment score for the hip is 2%, and her overall risk of a major osteoporotic fracture is 17%. Which of the following is the best initial step in management? A. Encourage weight-bearing exercise and discuss vitamin D and calcium supplements Correct B. No interventions are needed, as this bone density scan is normal Incorrect C. Prescribe alendronate (Fosamax) Incorrect D. Prescribe denosumab (Prolia)
Encourage weight-bearing exercise and discuss vitamin D and calcium supplements
A 62-year-old woman presents to the clinic with spotting for 2 weeks. Her last menstrual cycle was 8 years ago. She reports that she is sexually active with one partner. A pelvic examination reveals atrophic vaginal mucosa without evidence of bleeding, and adnexal masses are not palpable. The vulvar and urethral examination is unremarkable. Stool guaiac testing is negative. Which of the following is the most likely diagnosis? A. Bladder cancer Incorrect B. Endometrial carcinoma Correct C. Ovarian fibroma Incorrect D. Rectal adenocarcinoma
Endometrial carcinoma
A 20-year-old woman presents with a swollen, red, locally tender lump on her upper eyelid margin that developed 2 days ago without a known injury. She recently started wearing eye makeup and reports frequently falling asleep without removing the eye makeup. She reports no change in vision, and her ocular movements are intact. Which of the following is the most likely diagnosis? A. Blepharitis Incorrect B. Chalazion Incorrect C. Dacryocystitis Incorrect D. External hordeolum
External hordeolum
An 82-year-old woman presents to the clinic with reports of increased fatigue, slower walking speed, and decreased strength over the past 6 months. She also reports an unintentional 10-lb weight loss over the past year. Laboratory tests, including CBC, kidney function, thyroid function, and vitamin D levels, are unremarkable. Which of the following is the most likely diagnosis? A. Depression Incorrect B. Frailty Correct C. Malnutrition Incorrect D. Parkinson disease
Frailty
A 67-year-old woman presents to the clinic with reports of left-sided facial pain. She reports the pain as severe, burning, and sharp. She was evaluated in the clinic 4 months ago for herpes zoster located over her left jaw, and she completed treatment with valacyclovir (Valtrex). Despite using capsaicin cream and ibuprofen (Motrin), she has not experienced any relief. The physical examination reveals no abnormalities or skin findings. Which of the following is the best next treatment option for the suspected diagnosis? A. Duloxetine (Cymbalta) Incorrect B. Gabapentin (Neurontin) Correct C. Nortriptyline (Pamelor) Incorrect D. Tramadol (Ultram)
Gabapentin (Neurontin)
Which of the following medications carries a higher risk of severe prolonged hypoglycemia in older adults, according to the Beers criteria? A. Empagliflozin (Jardiance) Incorrect B. Glyburide (Glynase) Correct C. Metformin (Glumetza) Incorrect D. Pioglitazone (Actos)
Glyburide (Glynase)
A 30-year-old woman presents to the clinic with a report of skin discoloration on her neck and bilateral axilla for several months. She reports no other symptoms. The physical examination reveals BP of 138/84 mm Hg, BMI of 32 kg/m2, and large areas of dark brown, velvety textured hyperpigmentation on the right neck and bilateral axillae. Which of the following is the most appropriate diagnostic test? A. HbA1C level Correct B. Skin biopsy Incorrect C. Testosterone level Incorrect D. Vitamin A level
HbA1C level
A 31-year-old patient presents with a history of anemia initially diagnosed approximately 10 years ago, but the patient did not start treatment at that time due to cost. The patient's mother is reported to be positive for the beta-thalassemia trait, but the father's history is unknown. Currently, she reports no symptoms but is concerned that she should be tested for thalassemia before having children. Which of the following laboratory studies is often used to confirm the diagnosis of beta-thalassemia? A. Bone marrow biopsy Incorrect B. Hemoglobin electrophoresis Correct C. Iron studies Incorrect D. Peripheral smear
Hemoglobin electrophoresis
A 55-year-old woman presents to the clinic with hot flashes and night sweats for several months. She has not had a menstrual cycle in 2 years. She states that she has tried to treat these symptoms on her own with black cohosh, but it does not seem to help anymore. She asks whether she can be prescribed hormones. Which of the following should the nurse practitioner rule out before prescribing hormone replacement therapy? A. Family history of breast cancer Incorrect B. History of a transient ischemic attack Correct C. History of melanoma Incorrect D. Hypertension
History of a transient ischemic attack
A 61-year-old man presents to the clinic with reports of dysuria, fever, and pelvic pain. A digital rectal exam reveals an edematous and tender prostate. The nurse practitioner plans to prescribe ciprofloxacin (Cipro) for treatment of suspected acute bacterial prostatitis. Which of the following, if included in the patient's medical history, should indicate to the nurse practitioner to avoid prescribing this medication? A. History of hyperkalemia Incorrect B. History of lymphoma Incorrect C. History of myasthenia gravis Correct D. History of myocardial infarction
History of myasthenia gravis
A 46-year-old woman presents with perioral numbness and muscle twitching in her hands for 1 week. She has a history of parathyroidectomy. On exam, she has positive Chvostek and Trousseau signs. Which of the following is the most likely diagnosis? A. Hypercalcemia Incorrect B. Hyperkalemia Incorrect C. Hypocalcemia Correct D. Hypokalemia
Hypocalcemia
An 81-year-old woman presents to the clinic to establish care. The patient is Mexican American. Which of the following is a health-related belief that is distinctive of Mexican culture? A. Illness may be attributed to a hot-cold imbalance Correct B. Illness may be attributed to an imbalance between yin and yang Incorrect C. Illness may be attributed to living out of balance with nature and social environments Incorrect D. Illness may be attributed to sins committed in a prior life
Illness may be attributed to a hot-cold imbalance
Which of the following of Erikson's stages of development is consistent with a sense of pride in academic achievements? A. Autonomy vs shame and doubt Incorrect B. Industry vs inferiority Correct C. Initiative vs guilt Incorrect D. Trust vs mistrust
Industry vs inferiority
A nurse practitioner is presenting at a primary care conference. The topic of the presentation is the initiation of end-of-life discussions with patients with end-stage organ failure. When would be the appropriate time to have an end-of-life discussion with this patient population? A. After all treatment options have failed Incorrect B. In the hospital Incorrect C. Initial encounter Correct D. Over the phone
Initial encounter
A 27-year-old man presents with a 2-day history of persistent nausea, tremors, and difficulty concentrating. His medical history is significant for bipolar disorder treated with lithium (Lithobid) and hypertension. He reports he was recently started on hydrochlorothiazide 5 days ago. The physical exam demonstrates coarse hand tremors, nystagmus, and hyperreflexia. Vital signs reveal BP of 135/90 mm Hg, a heart rate of 98 bpm, a respiratory rate of 18 breaths/min, and a temperature of 98.6°F. Which of the following is the most likely diagnosis? A. Hyperkalemia Incorrect B. Ischemic stroke Incorrect C. Lithium toxicity Correct D. Serotonin syndrome
Lithium toxicity
A 72-year-old man presents to the outpatient clinic to establish care. The patient provides the office staff with a document that outlines his wishes regarding medical interventions and end-of-life care, specifically if he becomes terminally ill or unable to speak for himself. Which of the following best describes this document? A. Do not resuscitate order Incorrect B. Durable power of attorney for health care Incorrect C. Living will Correct D. Medical release form
Living will
Which of the following findings are the most consistent with iron deficiency anemia? A. Elevated mean corpuscular volume and normal mean corpuscular hemoglobin Incorrect B. Low mean corpuscular volume and low mean corpuscular hemoglobin Correct C. Low mean corpuscular volume and normal red blood cell distribution width Incorrect D. Normal mean corpuscular volume and normal mean corpuscular hemoglobin
Low mean corpuscular volume and low mean corpuscular hemoglobin
A 3-year-old boy presents to the office for an annual exam. The nurse practitioner notices that the caregiver has an inappropriate affect, and the boy has multiple bruises at varying stages of healing. When asked about the injuries, the caregiver gives an explanation that does not match the exam findings. The nurse practitioner suspects physical abuse. Which of the following is a risk factor for physical child abuse? A. Age of 5-10 years old Incorrect B. Living in a densely populated area Incorrect C. Low socioeconomic status Correct D. Parent with a family history of substance abuse
Low socioeconomic status
Which of the following is the most important first step when evaluating a 15-year-old girl with a 4-month history of secondary amenorrhea? A. Checking weight Incorrect B. Measuring FSH Incorrect C. Measuring human chorionic gonadotropin levels Correct D. Measuring TSH
Measuring human chorionic gonadotropin levels
A 25-year-old woman presents with a report of gray-white vaginal discharge for 1 week. A fishy odor is noted after application of 10% potassium hydroxide. Wet prep reveals vaginal squamous epithelial cells covered in bacteria, giving the cells a distinctive stippled appearance. Which of the following is the appropriate treatment for this patient? A. Azithromycin (Zithromax) Incorrect B. Ceftriaxone Incorrect C. Metronidazole (Flagyl) Correct D. Miconazole
Metronidazole (Flagyl)
A 70-year-old man presents to the office with his daughter. She has noticed that he is having more difficulty performing complex tasks. He has problems with orientation and has become lost in familiar locations. These issues have progressively worsened over the past year. Which of the following is the most appropriate next step in diagnosing dementia? A. Brain biopsy Incorrect B. CMP Incorrect C. Mini-Mental State Exam Correct D. Neuroimaging of the head
Mini-Mental State Exam
A 78-year-old man presents to the clinic for a rash. The patient is frail with multiple comorbidities, including multiple strokes. He is accompanied by a grandchild, who is his caregiver. The nurse practitioner determines the rash is likely incontinence dermatitis. The nurse practitioner also notes a 10-pound weight loss since his last visit 3 months ago. Which of the following would heighten the suspicion of neglect? A. Bruising of various ages Incorrect B. Multiple missed appointments Correct C. Sexually transmitted infections Incorrect D. Sudden change in financial situation
Multiple missed appointments
A 35-year-old woman presents to her primary care nurse practitioner with two episodes in the last month of feeling like the room is spinning. The episodes lasted 30 minutes and resolved without intervention. She also reports buzzing in her left ear and difficulty hearing. On exam, transient nystagmus unrelated to position is noted. The Rinne test demonstrates bilateral air conduction greater than bone conduction, and the Weber test reveals lateralization to the right ear. An MRI of the brain is performed with no significant results. Which of the following is the most likely diagnosis? A. Benign paroxysmal positional vertigo Incorrect B. Ménière disease Correct C. Vestibular neuritis Incorrect D. Vestibular schwannoma
Ménière disease
A 40-year-old man was diagnosed with depression and prescribed a selective serotonin reuptake inhibitor for the first time. Which of the following side effects should the nurse practitioner discuss with the patient? A. Insomnia can be improved by taking the medication at bedtime Incorrect B. Nausea typically resolves in 1-3 weeks Correct C. Sexual dysfunction is typically irreversible Incorrect D. Weight loss should be expected
Nausea typically resolves in 1-3 weeks
Nurse practitioners should be aware that they are mandated to report certain infectious disease diagnoses to the US Department of Health and Human Services. Which of the following diagnoses needs to be reported, according to the CDC? A. Coxsackievirus Incorrect B. Enterovirus Incorrect C. Neisseria gonorrhoeae Correct D. Parvovirus
Neisseria gonorrhoeae
A 26-year-old patient who is pregnant and plans to breastfeed comes to the clinic to discuss postpartum contraception options. She would like to begin contraception as soon as possible after delivery. Which of the following is the most appropriate contraception method for this patient? A. Diaphragm Incorrect B. Ethinyl estradiol and norelgestromin transdermal patch (Xulane) Incorrect C. Medroxyprogesterone acetate (Depo-Provera) Incorrect D. Norethindrone (Aygestin)
Norethindrone (Aygestin)
A nurse practitioner partners with a local university to study the effects of a novel dietary supplement on blood pressure regulation in young adults. Eager to begin, the nurse practitioner has already drafted the research protocol, identified potential participants, and secured the necessary supplements for the study. However, the university's research coordinator advises the nurse practitioner to first address a critical step before proceeding. Which of the following is essential before initiating the study? A. Design a marketing strategy for the dietary supplement Incorrect B. Ensure the study results will be published in a top-tier journal Incorrect C. Obtain approval from the institutional review board Correct D. Secure additional funding from pharmaceutical companies
Obtain approval from the institutional review board
Which of the following cases of bruising would raise concern for child abuse? A. Multiple bruises on a toddler's shins Incorrect B. One bruise on a 3-month-old infant Correct C. One bruise on a crawling child Incorrect D. One bruise on a toddler's forehead
One bruise on a 3-month-old infant
A 70-year-old man presents to the clinic for a routine checkup. He has a history of smoking one pack of cigarettes per day for the past 40 years. He reports no discomfort today. Which of the following is the most appropriate recommendation regarding abdominal aortic aneurysm screening for this patient? A. Advise him to quit smoking but defer screening since he is asymptomatic Incorrect B. No screening necessary, as he is beyond the recommended age Incorrect C. Order an abdominal U/S for screening today Correct D. Perform a physical examination of the abdomen to assess for a pulsatile mass
Order an abdominal U/S for screening today
A nurse practitioner-owned and -run outpatient facility recently implemented an electronic medical record and electronic prescribing program. The nurse practitioner knows that the Medicare Modernization Act of 2003 supports this technology and encourages more utilization within America's health-care system. Which Medicare plan supports the use of electronic prescribing? A. Part A Incorrect B. Part B Incorrect C. Part C Incorrect D. Part D
Part D
A nurse practitioner is educating a group of nursing students about the levels of prevention in public health. Which of the following is an example of secondary prevention? A. Administering vaccines to children Incorrect B. Encouraging regular exercise and a balanced diet Incorrect C. Organizing support groups for individuals with major depression Incorrect D. Performing mammograms to detect early-stage breast cancer
Performing mammograms to detect early-stage breast cancer
A 49-year-old woman presents to the clinic with reports of progressive neurological symptoms. The nurse practitioner orders an MRI of the brain, which reveals multiple demyelinated lesions. Which clinical manifestations are most consistent with multiple sclerosis? A. Cogwheel rigidity and resting tremor Incorrect B. Dysphagia, ptosis, and diplopia Incorrect C. Hyporeflexia and gait imbalance Incorrect D. Peripheral motor weakness and sensory loss
Peripheral motor weakness and sensory loss
A 68-year-old woman presents to the office with reports of aching pain and stiffness in her neck, shoulders, and hips, which started 2 weeks ago. The symptoms are worse in the morning and make daily activities, such as putting on a shirt or standing up from a seated position, difficult to perform. Her labs reveal an elevated erythrocyte sedimentation rate and C-reactive protein, but a negative rheumatoid factor. Which of the following is the most appropriate treatment for the suspected diagnosis? A. Acetaminophen (Tylenol) Incorrect B. Ibuprofen (Motrin) Incorrect C. Methotrexate (Trexall) Incorrect D. Prednisone
Prednisone
A patient presents to the office for follow-up on acid reflux. The nurse practitioner reviews their recent esophagogastroduodenoscopy, which demonstrates Barrett esophagus. Which of the following is the best next step in management? A. Give the patient reassurance that this condition is benign and no further management is needed Incorrect B. Prescribe metronidazole (Flagyl) Incorrect C. Prescribe omeprazole (Prilosec) Correct D. Refer the patient to oncology
Prescribe omeprazole (Prilosec)
A 44-year-old woman presents to the office with a report of persistent generalized fatigue, weight loss, muscle aches, nausea, and vomiting for several months. More recently, she reports hyperpigmentation on her neck, near syncope when standing too quickly, and an increased craving for salty foods. Laboratory results reveal an elevated adrenocorticotropic hormone level and a decreased morning serum cortisol level. Which of the following is the most likely diagnosis? A. Adrenal adenoma Incorrect B. Cushing syndrome Incorrect C. Pheochromocytoma Incorrect D. Primary adrenal insufficiency
Primary adrenal insufficiency
An active 86-year-old man presents for evaluation of a new tremor that he has noticed intermittently over the past several years. He is concerned because the tremor was initially mild and localized to his hands, but lately, it is more pronounced and affecting his arms. He has noticed that the tremor is worse when his arms are extended and when he uses his hands, specifically handling eating utensils and drinking from a glass. He usually enjoys weekly cocktail parties but has lately been having a glass of wine at home to avoid social embarrassment. He does notice that alcohol seems to provide some relief. He is concerned that the tremor may have to do with his age. Which of the following medications is the best initial choice to manage this patient's condition? A. Botulinum toxin A (Botox) Incorrect B. Donepezil (Aricept) Incorrect C. Propranolol (Hemangeol) Correct D. Rasagiline (Azilect)
Propranolol (Hemangeol)
A 5-month-old female infant presents to the clinic for a well-child check. She was born at 39 weeks gestation via uncomplicated vaginal delivery and has had no past medical conditions. She is exclusively breastfeeding and is appropriately gaining weight. Which of the following milestones is appropriate for this patient? A. Pushes up on the elbows when on the stomach Correct B. Says "mama" nonspecifically Incorrect C. Sits without support Incorrect D. Transfers toys from hand to hand
Pushes up on the elbows when on the stomach
The nurse practitioner is tasked with conducting research in the clinic to determine the best course of action to improve compliance with prescribed treatment plans in adult patients with diabetes. Which of the following studies would offer the highest quality of evidence? A. Case study on follow-up phone calls Incorrect B. Cohort study on using a pill box Incorrect C. Qualitative study of telemedicine visits with primary care clinician Incorrect D. Randomized controlled trial of using smartphones to remind patients to check blood glucose
Randomized controlled trial of using smartphones to remind patients to check blood glucose
A 4-year-old girl presents to the office for an annual well-child check with her parent. Her physical exam is within normal limits. Her mother asks whether children her age have a sense of spirituality. Which of the following behaviors demonstrates new, age-appropriate spiritual development for a 4-year-old child? A. Demonstrates moral thinking Incorrect B. Exhibits love and trust toward a caregiver Incorrect C. Has an imaginary friend Incorrect D. Reads a bedtime story each night
Reads a bedtime story each night
A 4-day-old male infant presents to the clinic to follow up on elevated bilirubin levels. He was born via an uncomplicated vaginal delivery at 37 weeks gestation and was discharged from the hospital 1 day ago with a total serum bilirubin level of 19 mg/dL. His mother reports he has been somewhat difficult to arouse and stimulate to breastfeed. The physical exam reveals a sleepy but arousable newborn with visible jaundice. His total serum bilirubin level measured during the current visit is 21 mg/dL. Which of the following is the next best step in management? A. Advise the mother to transition to formula feeding Incorrect B. Instruct the mother to place the newborn in front of a sunny window Incorrect C. Refer for phototherapy Correct D. Repeat a transcutaneous bilirubin level in 24 hours
Refer for phototherapy
A 31-year-old woman presents to the clinic for a follow-up visit after starting sertraline (Zoloft) for major depressive disorder 2 months ago. The patient reveals that she no longer feels depressed, but for the past 2 weeks, she has been increasingly distracted at work, sleeps only 3 hours each night, and experiences racing thoughts. Which of the following is the best next step in the treatment of this patient? A. Prescribe zolpidem tartrate (Ambien) to help the patient sleep Incorrect B. Reassure the patient that her side effects are normal with sertraline (Zoloft) Incorrect C. Recommend cognitive behavioral therapy Incorrect D. Refer the patient to psychiatry for suspected bipolar I disorder
Refer the patient to psychiatry for suspected bipolar I disorder
A 2-year-old girl with a medical history of asthma presents to the clinic for a follow-up visit. She was seen 3 days ago due to upper respiratory symptoms and tested positive for respiratory syncytial virus. Her mother reports that the patient's symptoms worsened overnight, and she refused to eat or drink this morning. Vital signs reveal a temperature of 100.5°F, heart rate of 135 bpm, respiratory rate of 65 breaths/min, and oxygen saturation of 91%, and her BMI is 16.3 kg/m2. On physical exam, the nurse practitioner notes diffuse wheezing, along with intercostal retractions and nasal flaring. Which of the following is the most appropriate next step in management? A. Administer oral dexamethasone (Decadron) Incorrect B. Order a chest X-ray Incorrect C. Prescribe a 3-day course of inhaled budesonide (Pulmicort) Incorrect D. Refer to the ED
Refer to the ED
An 11-month-old female infant presents to the clinic to follow up on adhesions of her labia minora. She was seen 4 weeks ago and prescribed topical estradiol (Estrace) 0.01% cream after being treated for recurrent UTIs. On reassessment, the nurse practitioner notes a well-appearing infant with a soft bladder that is nontender to palpation and almost complete fusion of the labia, with no visible improvement since her previous visit. Which of the following is the most appropriate next step in management? A. Add topical progesterone (Progestogel) 1% cream twice daily Incorrect B. Attempt physical separation at the bedside Incorrect C. Refer to pediatric gynecology for surgical separation Incorrect D. Review topical application instructions and technique with the patient's caregiver Corr
Review topical application instructions and technique with the patient's caregiver
An 80-year-old man presents to the clinic with concerns about occasional unsteadiness while walking. The nurse practitioner would like to evaluate the patient's proprioceptive function and vestibular system. Which of the following assessments is most appropriate for this purpose? A. Deep tendon reflexes Incorrect B. Finger-to-nose test Incorrect C. Romberg test Correct D. Two-point discrimination
Romberg test
A 58-year-old man presents to the clinic for a follow-up on his hypertension and reports no issues. His additional medical history includes chronic kidney disease stage IV, gout, and diabetes mellitus. His laboratory studies reveal hemoglobin of 10 g/dL, hematocrit of 36%, total iron of 50 mcg/dL, and ferritin of 200 ng/mL. Which of the following should be included in the plan of care at this time? A. Blood transfusion Incorrect B. Iron chelation therapy Incorrect C. Referral to a hematologist Incorrect D. Routine iron studies and CBC
Routine iron studies and CBC
A 30-year-old woman presents to the clinic with acute abdominal pain, anorexia, fever, and vomiting. The nurse practitioner suspects appendicitis because right lower quadrant pain is elicited when the left lower quadrant is palpated. Which of the following signs describes this finding? A. Dunphy sign Incorrect B. Markle sign Incorrect C. Psoas sign Incorrect D. Rovsing sign
Rovsing sign
What is the most common type of hearing loss in the older adult population? A. Cerumen impaction Incorrect B. Chronic otitis media with effusion Incorrect C. Otosclerosis Incorrect D. Sensorineural hearing loss
Sensorineural hearing loss
A 27-year-old woman presents for clinic follow-up for hypertension. She has been attempting to lower her BP with lifestyle modifications for the past 3 months, and her BP today is 160/90 mm Hg on two separate readings. The nurse practitioner is considering starting treatment with lisinopril (Zestril). Which of the following would be a contraindication to starting this medication? A. She has a 20 mm Hg drop in BP when she stands Incorrect B. She has a family history of kidney disease Incorrect C. She has a personal history of diabetes Incorrect D. She is planning to become pregnant in the next few months
She is planning to become pregnant in the next few months
A 77-year-old man with a history of diabetes and hypertension presents to the clinic for an annual wellness visit. He reports no acute issues at the current visit. On fundoscopic examination of the patient's eyes, the nurse practitioner notices white, ovoid lesions with irregular borders. What is the nurse practitioner visualizing on fundoscopic examination? A. Arteriovenous nicking Incorrect B. Hard exudates Incorrect C. Microaneurysms Incorrect D. Soft exudates
Soft exudates
A 55-year-old man with a history of depression treated with duloxetine (Cymbalta) presents for follow-up for a skin abscess. He was recently evaluated in the ED and underwent incision and drainage of a left forearm abscess, and the wound culture grew methicillin-resistant Staphylococcus aureus. He is currently on cephalexin (Keflex) and has a known allergy to sulfa drugs. What is the best next step in his management? A. Continue cephalexin (Keflex) Incorrect B. Stop cephalexin (Keflex) and start doxycycline (Vibramycin) Correct C. Stop cephalexin (Keflex) and start linezolid (Zyvox) Incorrect D. Stop cephalexin (Keflex) and start trimethoprim-sulfamethoxazole (Bactrim DS)
Stop cephalexin (Keflex) and start doxycycline (Vibramycin)
A 60-year-old man with a past medical history of COPD presents to the clinic for follow-up. He was diagnosed with COPD 3 months ago and started on daily tiotropium (Spiriva). Since starting treatment, he has experienced two significant exacerbations, with the more recent episode requiring hospitalization. He is asymptomatic today in the office and is able to successfully demonstrate proper use of his inhalers. Laboratory studies from his recent hospitalization reveal an elevated eosinophil count. What is the best next step in this patient's management? A. Continue tiotropium (Spiriva) and add albuterol (ProAir HFA) as needed for exacerbations Incorrect B. Continue tiotropium (Spiriva) and start an oral prednisone taper Incorrect C. Stop tiotropium (Spiriva) and start fluticasone furoate-umeclidinium-vilanterol (Trelegy Ellipta) Correct D. Stop tiotropium (Spiriva) and start roflumilast (Daliresp)
Stop tiotropium (Spiriva) and start fluticasone furoate-umeclidinium-vilanterol (Trelegy Ellipta)
A 19-year-old woman calls the clinic to report that she missed two oral contraceptive pills during the last week of the hormone-containing pack and had unprotected sexual intercourse within 5 days. Which is the best counseling for this patient? A. Emergency contraception should be taken as soon as possible Incorrect B. Take the next dose as soon as possible, but there is no need for any other action Incorrect C. Take the next dose as soon as possible, use backup contraception, and skip the placebo week Correct D. Take two pills for each of the next two doses to make up for the missed pills and continue to the end of the pack
Take the next dose as soon as possible, use backup contraception, and skip the placebo week
A 12-year-old girl presents to the clinic for a well-child checkup. The nurse practitioner notes that the patient has enlargement of her breasts and areolas but no separation of their contour, as well as sparse growth of straight pubic hair along the labia. Which of the following is the appropriate Tanner staging for this patient? A. Tanner stage 1 breast and pubic hair Incorrect B. Tanner stage 2 breast and pubic hair Incorrect C. Tanner stage 2 breast and Tanner stage 3 pubic hair Incorrect D. Tanner stage 3 breast and Tanner stage 2 pubic hair
Tanner stage 3 breast and Tanner stage 2 pubic hair
A nurse practitioner recently graduated and is preparing to start practicing in a new state. In reviewing the state's regulations for practice, the requirements for a nurse practitioner license and a separate prescriptive authority are listed. Which of the following best describes prescriptive authority? A. The authority to diagnose medical conditions Incorrect B. The authority to order and interpret diagnostic tests Incorrect C. The legal ability to prescribe medications and other treatments Correct D. The legal authorization to prescribe controlled substances
The legal ability to prescribe medications and other treatments
While reading a journal article, a nurse practitioner comes across a section discussing the efficacy of a new drug. The article mentions a P value of .03 in relation to the drug's effect. Which of the following best defines what a P value is? A. A measure of the relationship between two variables Incorrect B. The odds of an event in one group versus another Incorrect C. The percentage of patients who responded to the drug Incorrect D. The probability that observed results occurred by chance
The probability that observed results occurred by chance
A 25-year-old patient is seen in the clinic for preconception counseling. The laboratory evaluation reveals hemoglobin of 14.8 g/dL, hematocrit of 49%, and heterozygous hemoglobin S. Evaluation of the partner's laboratory results reveals hemoglobin of 15.1 g/dL, hematocrit of 46%, and heterozygous hemoglobin S. What should the nurse practitioner advise them about the associated risk of disease for their future child? A. Additional testing for presence of a JAK2V617F mutation is recommended Incorrect B. The child will have beta-thalassemia, and the symptom onset is between 6 and 12 months of age Incorrect C. There is a 25% chance that the child will have sickle cell disease Correct D. There is a 75% chance that the child will be a carrier for the sickle cell trait
There is a 25% chance that the child will have sickle cell disease
A 54-year-old patient presents to your office with a history of nasal congestion. They have been taking oxymetazoline (Afrin) daily. What education regarding this medication should the nurse practitioner provide the patient? A. This medication is a nasal decongestant and should not be taken for more than 3-5 days Correct B. This medication is a nasal steroid and should not be taken for more than 3-5 days Incorrect C. This medication is an anticholinergic and can cause blurred vision and dry mouth Incorrect D. This medication is an antihistamine and can cause drowsiness
This medication is a nasal decongestant and should not be taken for more than 3-5 days
Which of the following medications reduces increased intraocular pressure in patients with open-angle glaucoma by decreasing aqueous humor production and is considered first-line therapy? A. Brimonidine ophthalmic (Alphagan) Incorrect B. Dorzolamide (Trusopt) Incorrect C. Ketorolac ophthalmic (Acular) Incorrect D. Timolol ophthalmic (Betimol)
Timolol ophthalmic (Betimol)
A 73-year-old woman presents to the clinic with reports of mild aching pain in her right knee that has occurred for the past few months. She reports no known exacerbating injury and no history of knee surgery. The pain is worse with walking and improves with rest. She has not tried anything to alleviate the pain. The physical examination reveals bony enlargement of the knee and joint line tenderness. A knee X-ray reveals narrowed joint spaces and subarticular reactive sclerosis. Which of the following is the best initial pharmacologic treatment for the suspected diagnosis? A. Acetaminophen (Tylenol) Incorrect B. Glucosamine and chondroitin Incorrect C. Topical diclofenac (Voltaren)
Topical diclofenac (Voltaren)
A 3-year-old boy presents with a 1-day history of right ear pain that began after swimming lessons. The patient's mother states that he has a history of frequent ear infections and broke out in hives approximately 1 month ago after taking amoxicillin. On physical exam, the nurse practitioner notes a bulging tympanic membrane with erythema and displaced landmarks. Which of the following is the most appropriate treatment for the patient's suspected condition? A. Cefdinir Incorrect B. Erythromycin (Erythrocin) Incorrect C. Penicillin G benzathine (Bicillin) Incorrect D. Trimethoprim-sulfamethoxazole (Bactrim DS)
Trimethoprim-sulfamethoxazole (Bactrim DS)
A 17-year-old boy presents with intermittent diarrhea with blood in the stool for the past 2 months. He states the symptoms have been gradually worsening, and now he is having more than six bowel movements per day. He reports abdominal pain and urgency with bowel movements. Colonoscopy reveals erythematous and swollen mucosa with areas of friability from the rectum to the transverse colon. Which of the following is the most likely diagnosis? A. Crohn disease Incorrect B. Diverticulitis Incorrect C. Infectious colitis Incorrect D. Ulcerative colitis
Ulcerative colitis
Which of the following best describes the pathophysiology of asthma? A. Mixed obstructive and restrictive airway pattern with thickened secretions Incorrect B. Progressive airway limitation and narrowing of the small airways Incorrect C. Variable airway bronchoconstriction and inflammation Correct D. Vasoconstriction of pulmonary blood flow
Variable airway bronchoconstriction and inflammation
A 38-year-old woman presents to the clinic with reports of fatigue. A CBC reveals hemoglobin of 10.6 g/dL, hematocrit of 31%, and a mean corpuscular volume of 118 fL. The physical exam reveals pallor. Which of the following is most likely to confirm the patient's suspected diagnosis? A. Ferritin Incorrect B. Platelet count Incorrect C. Transferrin saturation Incorrect D. Vitamin B12
Vitamin B12
The nurse practitioner is seeing a 68-year-old woman for a follow-up from her previous visit. The patient has been diagnosed with heart failure with a preserved ejection fraction of 55%. The patient was started on empagliflozin (Jardiance) in order to reduce cardiovascular death or hospitalization in patients with a similar diagnosis. Which of the following is a common side effect of the new medication? A. Bradycardia Incorrect B. Hyperkalemia Incorrect C. Vision changes Incorrect D. Vulvovaginal candidiasis
Vulvovaginal candidiasis
