,Question 4: A patient who will undergo surgery in implant a biosynthetic heart valve asks the
primary care NP whether any medications will be necessary postoperatively. The NP should tell
the patient that it will be necessary to take:
a. daily low-dose aspirin for 1 year.
b. heparin injections as needed based on activated partial thromboplastin time levels.
c. lifelong warfarin combined with enoxaparin as needed.
d. warfarin for 3 months postoperatively plus long-term aspirin.
Question 5: A patient has a BMI of 35, a fasting plasma glucose of 120 mg/dL, elevated
triglycerides, and a history of myocardial infarction. The primary care NP plans to initiate dietary
and lifestyle counseling and should consider prescribing:
a. ephedra.
b. orlistat (Xenical).
c. phentermine (Adipex-P).
d. phentermine and topiramate (Onexa).
Question 6: A patient who has severe arthritis and who takes nonsteroidal antiinflammatory
drugs (NSAIDs) daily develops a duodenal ulcer. The patient has tried a cyclooxygenase-2
selective NSAID in the past and states that it is not as effective as the current NSAID. The
primary care nurse practitioner (NP) should:
a. prescribe cimetidine (Tagamet).
b. prescribe omeprazole (Prilosec).
c. teach the patient about a bland diet.
d. change the NSAID to a corticosteroid.
, Question 7: A patient comes to the clinic reporting dizziness and fatigue associated with nausea
and vomiting. The primary care NP suspects anemia and orders a complete blood count. The
patient’s hemoglobin is elevated. The NP correctly concludes that the patient is not anemic. The
NP has made an error in:
a. context formulation.
b. inappropriate knowledge base.
c. cost-versus-benefit analysis.
d. hypothesis triggering and information processing.
Question 8: A patient who has diabetes is taking metformin 1000 mg daily. At a clinic visit, the
patient reports having abdominal pain and nausea. The primary care NP notes a heart rate of 92
beats per minute. The NP should:
a. obtain LFTs.
b. decrease the dose of metformin.
c. change metformin to glyburide.
d. order electrolytes, ketones, and serum glucose.
Question 9: An 80-year-old patient asks a primary care NP about OTC antacids for occasional
heartburn. The NP notes that the patient has a normal complete blood count and normal
electrolytes and a slight elevation in creatinine levels. The NP should recommend:
a. calcium carbonate (Tums).
b. aluminum hydroxide (Amphojel).
c. sodium bicarbonate (Alka-Seltzer).
d. magnesium hydroxide (Milk of Magnesia).
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