A 45-year-old male is being seen in the clinic for a yearly check-
up and lab work. His history includes hypertension and
hyperlipidemia for which he currently takes Norvasc 5 mg daily
and Lipitor 20 mg nightly. Patient has a family history of diabetes,
hypertension, heart disease, and hyperlipidemia. After obtaining
lab work, the provider notices the patient's hgbA1c is elevated at
7.5. The patient is already on a DASH diet and watching the
amount of sweets and carbohydrates he eats daily. The patient is
not overweight and participates in moderate physical activity at
least 4-5 days a week. He was started on Metformin three months
ago, and his hemoglobin A1c is now 6.9. The nurse expects to
see a class of medication prescribed which is proven to reduce
the risk of cardiovascular events. Considering the treatment
guidelines from the American College of Cardiology, which
medication should be recommended for this patient
- Correct Answer - Invokana 100 mg daily
--Invokana is a medication used to treat type 2 diabetes. It is a
third-line medication to metformin. It is used together with
,exercise and diet. It is not recommended in type 1 diabetes. It is
taken by mouth.
A 78-year-old female presents to the clinic for a checkup and
refills on her medications. She is currently taking lisinopril
(Zestril), metformin (Glucophage), and levothyroxine (Synthroid).
The patient has a history of hypertension, type 2 diabetes,
hypothyroidism, GERD, and gastric ulcers. The patient is
concerned about heart disease and wants to start taking a low-
dose aspirin. Which aspirin regimen recommendation should the
advanced professional nurse (APN) give to the patient?
- Correct Answer - Low-dose enteric coated aspirin 81 mg daily
A 28-year-old married female presents to primary care
accompanied by her husband with complaints of weight gain,
fatigue, muscle aches, bloating, constipation, and difficulty
concentrating. The patient explains that she has been
experiencing these symptoms with increasing frequency over the
last two months and reports feeling upset that she has gained 10
pounds over the past month despite no significant changes in
dietary intake or activity level. The patient holds a bachelor's
degree and is employed full time as an accountant. The patient
reports feeling frustrated with her poor concentration and
,identifies recent work errors to be due to this symptom. The
patient explains that she and her spouse plan to start trying to
conceive soon, and she is worried that she may have trouble
becoming pregnant. The patient reports using over-the-counter
laxative products over the last week to combat constipation. The
patient repo
- Correct Answer - 5.31 mIU/L
A 74- year-old male with Cushing syndrome presents to the
emergency department (ED) with pain in his left leg, and is
diagnosed with a deep vein thrombosis (DVT).What is this
patient's symptoms related to?
- Correct Answer - Elevated Von Willebrand factor
A 42-year-old asthmatic who has been using beta-adrenergic
agonists for several years began to experience premature atrial
contractions (PACs). To treat the PACs, metoprolol (Toprol XL)
therapy was started. What is a likely consequence of this patient
taking metoprolol (Toprol XL)?
- Correct Answer - Metoprolol (Toprol XL) worsened asthma
symptoms, but improved the PACs.
-- Beta blockers are widely used in the management of cardiac
conditions and thyrotoxicosis, and to reduce perioperative
, complications. Asthma and chronic obstructive pulmonary disease
(COPD) have been classic contraindications to the use of beta
blockers because of their potential for causing bronchospasm.
Which inhaler prescription would support long-acting treatment for
twice-daily use in controlled asthma management?
- Correct Answer - Fluticasone propionate/salmeterol (Advair
Diskus)
--Fluticasone and salmeterol is a combination of two medicines
that are used to help control the symptoms of asthma and
improve breathing.
A 65-year-old male presents for a visit regarding his type 2
diabetes. He has been dealing with diabetes for the last 15 years.
He has a history of diabetic neuropathy in his feet. Six months
ago his symptoms were mild to almost nonexistent. He currently
describes the neuropathy as painful, and it wakes him up at night.
Which medication would be the first line treatment for this patient?
- Correct Answer - Pregabalin (Lyrica)
A 55-year-old male presents for a new diagnosis of Parkinson's
Disease. He has experienced gait disorders and a pill rolling
tremor. The patient was a former boxer with a history of multiple
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