Academic- 3Ps Assessment-
Pathophysiology, Pharmacology, and
Physical Assessment
Sarcomere stretch beyond 2.2 microns is the physiologic mechanism behind which
condition? - answer CHF
A female patient is taking amlodipine 10 mg daily, which controlled her blood pressure,
but she could not tolerate the side effects. She was switched to losartan 100 mg daily,
but her blood pressure never achieved goal. Which statement best characterizes the
clinical comparison of these two medications? - answer Amlodipine is more efficacious
than losartan
During a routine health assessment, the NP appreciates a decrease in peripheral vision
bilaterally while performing visual field assessment by confrontation. Consequently, the
NP anticipates which of the following findings during fundoscopic assessment? –
answer A cup-to-disk ratio of 70%.
A 66-year-old woman presents with a complaint of a 4-day history of a unilateral
headache that will not go away despite taking ibuprofen and acetaminophen. She has a
history of hypertension that is usually well controlled with an ACE inhibitor, but today her
blood pressure is 162/92 mm Hg. During the HPI she admits that she has had some
transient visual loss over the few days, but it has been very short lived and resolves
completely. The next step in the evaluation of this patient should include: - answer An
erythrocyte sedimentation rate
Which information best describes the pathophysiology of most mental health disorders?
- answerDysregulation of neurotransmitters in relevant pathways
The commonality among all seizure etiologies is: - answerIncreased neuron excitability
The NP is managing a patient newly diagnosed with essential tremor disorder and
prescribed propranolol. The patient did an internet search for the medication and wants
to know how a "heart medication" can make her stop having hand tremors. What is the
best explanation for this patient? - answerPropranolol blocks the action of the
sympathetic nervous system in all body systems and so it will calm many things,
including the tremors
, A 48-year-old man presents with a complaint of a 3-week history of intermittent shooting
pain that runs down the buttocks and left leg. Suspecting sciatica, the NP would expect
which of the following during physical examination? - answerPain with straight leg raise
During the routine wellness examination of a 12-year-old male patient, the NP
appreciates a grade II/VI systolic murmur at the apex while the patient is lying on the
exam table. The murmur is louder when the patient moves to the sitting position,
appreciated at grade IV/VI. The cardiac history and review of symptoms is negative.
The appropriate approach to this patient is to: - answerOrder an echocardiogram
A 57-year-old woman presents with a 3-day history of fever, dyspnea, and a purulent
cough. Auscultation of the lungs identifies an area of egophony in the lower left lobe.
Palpation reveals increased tactile fremitus. The NP expects which of the following
percussion findings? - answerDullness
The NP is learning about anginal chest pain unresponsive to nitroglycerin, when does
necrotic injury occur? - answerThe mitochondrial membrane ruptures
A 35-year-old female is skiing fast down a steep trail. She falls forward and lands on an
abducted and extended arm. She immediately feels a pop, has exquisite pain over her
right upper shoulder, and has no sensation in her right hand. Her diagnosis is most
likely: - answerAnterior dislocation of the glenohumeral joint.
The NP is evaluating a patient with markedly elevated blood pressure that is
unresponsive to traditional medications. There is some mild pedal edema, but other
than the elevated BP, the physical exam is essentially normal. A metabolic panel
reveals the following:
Na+ 151 mEq/LK+ 3.0 mEq/LCl- 114 mEq/LCO2 28 mEq/LBUN 10 mg/dLCreatinine 0.9
mg/dL
The NP considers which of the following as a secondary cause of hypertension in this
patient? - answerHyperaldosteronism
Which of the following statins is preferred for a 67-year-old man with
hypercholesterolemia who drinks a glass of grapefruit juice every morning? -
answerPravastatin
A 41-year-old female is being managed by her mental health provider with lithium. She
presents for a primary care wellness exam and has no complaints, but routine
laboratory assessment reveals a TSH of 4.5 iU/L. What is the most appropriate
approach for this patient? - answerBegin thyroid replacement therapy
A 42-year-old man was recently evaluated for progressive fatigue. His diagnostic
evaluation included a comprehensive laboratory assessment which showed a HgbA1c
of 8.4% and a urinalysis with 4+ glucose. Which of the following laboratory assessments
is consistent with the presumed diagnosis? - answerC-peptide of 9 ng/dL
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