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NR 601 / NR601 Primary Care of the Maturing and Aged Family Practicum Final Exam Review Quiz Bank| Questions and Answers | LATEST, 2020/2021 |Download to score A| Chamberlain College

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NR 601 / NR601 Primary Care of the Maturing and Aged Family Practicum Final Exam Review Quiz Bank| Questions and Answers | LATEST, 2020/2021 |Download to score A| Chamberlain College 1. 6mo ago an ... elderly pt was dx'd with subclinical hypothyroidism. Today the pt returns and has a TSH of 11 and c/o fatigue. He has taken Synthroid 25mcg daily as prescribed. What is the best course of action for you?: Double the dose of Synthroid 2. 48yo female presents for annual exam. A1C is 6.2%. You interpret this result as: a. Prediabetes b. T2DM c. T1DM d. Normal: ANS: A 3. 52yo Caucasian woman comes in for annual exam. She has mitral valve prolapse, no symptoms. PE reveals clear/equal breath sounds, midsystolic click. You know her stage of HF is: a. A b. B c. D d. C: ANS: B (Stage B) 4. 55yo Caucasian man follows up w/you after referral to cardio. He reports that he thinks the med is causing a cough and sometimes he has dyspnea. Which of the following meds was most likely prescribed? a. Metolazone b. Enalapril c. Amlodipine d. Irbesartan: ANS: B 5. 55yo Caucasian man w/T2DM presents as new pt. Take metformin 500mg BID. Labs reveal albuminuria and A1C was 7%. He's current on eye/foot exams. BP today is 136/84. According to 2017 ACC Guidelines, the most appropriate med for his current status is: a. Furosemide b. Amlodipine c. Lisinopril d. Clonidine: ANS: C 6. 55yo post-menopausal woman with h/o HTN c/o jaw pain on heavy exertion. There were no c/o CP. Her EKG indicates NSR w/out ST segment abnormalities. Your plan may include:: Exercise stress test 7. 55yo woman presents with somatic complaints. You suspect anxiety. You know that somatic symptoms of anxiety include: a. All answers are appropriate b. Palpitations, CP, tachycardia c. Fatigue, insomnia, diaphoresis d. Diarrhea, nausea, vomiting: ANS:A 8. 55yo woman w/BMI of 28, has 20yr h/o primary HTN, has been on HCTZ 25mg for years w/excellent response. During this follow up visit, she reports that for the last 6mo she has felt thirsty all of the time even though she drinks at least 10 glasses of water/day. Previous fasting BGL was 136. No further testing was done at that time. You check random BGL now, is 210. What is the next appropriate step? a. Order 3hr OGTT b. Order another random BGL in 2wks c. Order A1C d. Prescribe metformin XR 500mg PO: ANS: D 9. 59yo female c/o pain when she urinates. She has been seen three times for this in the last 3mo. Each time, dx'd with UTI, given abx. She carefully followed instructions, but has no relief of symptoms. Last UA: WBC: 2-3 RBC: 0-2 Epithelial cells: few Nitrite: neg Leuk: neg Which should be done next? a. Perform pelvic exam b. Reassure the pt that she has asymptomatic bacteriuria and does not need abx c. Obtain clean catch urin for UA and C&S d. Order pelvic ultrasound: ANS: A 10. 59yo woman presents w/following: h/o MI, new onset SOB, especially w/exertion, an occasional rapid fluttering heartbeat and swollen feet. You know this pt's stage of HF is: a. Stage A b. Stage B c. Stage D d. Stage C: ANS:D (stage C) 11. 60yo obese male has T2DM and lipid panel of TC 250, HDL 32, LDL 165. You teach the pt about his modifiable cardiac risk factors, which include?: ANS:DM, obesity, hyperlipidemia 12. 60yo woman w/30-pack year hx presents for eval of persistent, daily cough w/increased sputum production, worse in the AM, occurring over past 3mo. She says, "I have the same thing year after year." Which of the following choices would you consider strongly in your critical thinking process? a. Acute bronchitis b. Chronic bronchitis c. Seasonal allergies d. Bronchial asthma: ANS: B 13. 62yo female c/o fatigue and lack of energy. Constipation has increased and the pt has gained 10lbs in the past 3mo. Depression is denied although she reports lack of interest in usual hobbies. VS are WNL and her skin is dry and cool. Which of the following must be included in the DD?: Hypothyroidism 14. 62yo male has chronic kidney dz that has been relatively stable. He has h/o hyperlipidemia, OA, HTN. He is compliant w/meds, BP has been well-controlled on a CCB. Last lipids showed TC 201, HDL 40, TG 180, LDL 98. He currently takes Crestor 20mg daily. Today his BP is 188/90 and urine dip shows significant proteinuria. He denies any changes in dietary habits or med regimen. What would be the best med change for him at this point?: Change CCB to ACEI 15. 65yo Caucasian female presents with h/o mitral valve stenosis, PE unremarkable. You know the stage of HF is: a. D b. A c. B d. C: ANS: C (stage B) 16. 65yo female presents to the clinic for the first time and c/o urinary incontinence and dyspareunia. She went through menopause 10yrs ago w/out any hormone replacement therapy and had hysterectomy for a fibroid. Her mom had hip fx at 82. Pt's most recent mammo was 5yrs ago, no known fam h/o breast ca. She is not taking any meds. Exam is unremarkable except for findings consistent w/atrophic vaginitis. You decide to begin topical hormone replacement therapy. Which of the following evals would be necessary prior to initiating HRT?: Mammo 17. 65yo man presents for eval of CP and L-sided shoulder pain, begins after strenuous activity, including walking. Characterized by dull, aching, 8/10 during activity, otherwise 0/10. Began few months ago, intermittent, aggravated by exercise, relieved by rest. Occasional nausea. Pain is retrosternal, radiating to L shoulder, affects QOL by limiting activity. Pain is worse today, did not go away with rest. BP 120/80, HR 72 regular. Normal heart sounds, S1/2, no murmurs. Which of the following diff dx would be most likely? a. Afib b. Coronary artery dz w/angina pectoris c. Esophagitis d. Musculoskeletal chest wall syndrome w/radiation: [Show More]

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