Academic- 3Ps Assessment- Pathophysiology,
Pharmacology, and Physical Assessment
1.Sarcomere stretch beyond 2.2 microns is the physiologic mechanism be- ij ij ij ij ij ij ij ij ij
hind which condition?: CHF
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2.A female patient is taking amlodipine 10 mg daily, which controlled her blood
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pressure, but she could not tolerate the side effects. She was switched to
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losartan 100 mg daily, but her blood pressure never achieved goal. Which
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statement best characterizes the clinical comparison of these two medica-
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tions?: Amlodipine is more efficacious than losartan
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3.During a routine health assessment, the NP appreciates a decrease in ij ij ij ij ij ij ij ij ij ij
peripheral vision bilaterally while performing visual field assessment by con-
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frontation. Consequently, the NP anticipates which of the following findings
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during fundoscopic assessment?: A cup-to-disk ratio of 70%.
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4.A 66-year-old woman presents with a complaint of a 4-day history of a
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unilateral headache that will not go away despite taking ibuprofen and aceta-
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minophen. She has a history of hypertension that is usually well controlled
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with an ACE inhibitor, but today her blood pressure is 162/92 mm Hg. During the
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HPI she admits that she has had some transient visual loss over the few days,
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but it has been very short lived and resolves completely. The next step in the
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evaluation of this patient should include:: An erythrocyte sedimentation rate
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5.Which information best describes the pathophysiology of most mental
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health disorders?: Dysregulation of neurotransmitters in relevant
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pathways
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6.The commonality among all seizure etiologies is:: Increased neuron
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excitabil- ity
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7.The NP is managing a patient newly diagnosed with essential tremor dis-
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order and prescribed propranolol. The patient did an internet search for the
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medication and wants to know how a "heart medication" can make her stop
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having hand tremors. What is the best explanation for this patient?: Propranolol
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blocks the action of the sympathetic nervous system in all body systems
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and so it will calm many things, including the tremors
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8.A 48-year-old man presents with a complaint of a 3-week history of inter-
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mittent shooting pain that runs down the buttocks and left leg. Suspecting
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,Ac
sciatica, the NP would expect which of the following during physical examina-
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tion?: Pain with straight leg raise
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9.During the routine wellness examination of a 12-year-old male patient, the
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NP appreciates a grade II/VI systolic murmur at the apex while the patient is
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lying on the exam table. The murmur is louder when the patient moves to the
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sitting position, appreciated at grade IV/VI. The cardiac history and review of
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symptoms is negative. The appropriate approach to this patient is to:: Order
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an echocardiogram
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10.A 57-year-old woman presents with a 3-day history of fever, dyspnea, and a
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purulent cough. Auscultation of the lungs identifies an area of egophony in the
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lower left lobe. Palpation reveals increased tactile fremitus. The NP expects
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which of the following percussion findings?: Dullness
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11.The NP is learning about anginal chest pain unresponsive to nitroglycerin,
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when does necrotic injury occur?: The mitochondrial membrane ruptures
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12.A 35-year-old female is skiing fast down a steep trail. She falls forward and
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lands on an abducted and extended arm. She immediately feels a pop, has
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exquisite pain over her right upper shoulder, and has no sensation in her right
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hand. Her diagnosis is most likely:: Anterior dislocation of the glenohumeral
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joint.
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13.The NP is evaluating a patient with markedly elevated blood pressure that is
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unresponsive to traditional medications. There is some mild pedal edema, but
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other than the elevated BP, the physical exam is essentially normal. A
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metabolic panel reveals the following:
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Na+ 151 mEq/LK+ 3.0 mEq/LCl- 114 mEq/LCO2 28 mEq/LBUN 10 mg/dLCrea-
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tinine 0.9 mg/dL ij ij
The NP considers which of the following as a secondary cause of hyperten- sion
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in this patient?: Hyperaldosteronism
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14.Which of the following statins is preferred for a 67-year-old man with ij ij ij ij ij ij ij ij ij ij ij
hypercholesterolemia who drinks a glass of grapefruit juice every morning?-
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: Pravastatin
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15.A 41-year-old female is being managed by her mental health provider with
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lithium. She presents for a primary care wellness exam and has no complaints,
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but routine laboratory assessment reveals a TSH of 4.5 iU/L. What is the most
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appropriate approach for this patient?: Begin thyroid replacement therapy
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16.A 42-year-old man was recently evaluated for progressive fatigue. His di-
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agnostic evaluation included a comprehensive laboratory assessment which
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showed a HgbA1c of 8.4% and a urinalysis with 4+ glucose. Which of the
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following laboratory assessments is consistent with the presumed diagno-
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sis?: C-peptide of 9 ng/dL
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17.Which pathophysiologic feature do multiple sclerosis and Guillain-Barre ij ij ij ij ij ij ij
syndrome share?: Immune-mediated demyelination
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18.A 41-year-old woman presents with chronic diarrhea. She says she has had
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problems with her bowels for as long as she can remember, but it is getting
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worse; more often she has the urge to have a bowel movement and does not
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have time to get to the bathroom. To pursue a diagnosis of irritable bowel
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syndrome, which finding in the HPI is most likely present in this patient?: -
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Intermittent constipation
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