Question 1: A primary care NP is developing a clinical practice guideline for management of a patient population in a midsized suburban hospital The NP should: a use an existing guideline from a leading research hospital b follow the guideline provided by a third-party payer to help ensure reimbursement c review expert opinion and experimental, anecdotal, correlational study data d write the guideline to adhere to long-standing practice protocols already in use Question 2: A primary care NP prescribes a nitroglycerin transdermal patch, 0 4 mg/hour release, for a patient with chronic stable angina The NP should teach the patient to: a change the patch four times daily b use the patch as needed for angina pain c use two patches daily and change them every 12 hours d apply one patch daily in the morning and remove in 12 hours Question 3: A patient is diagnosed with asthma The primary care nurse practitioner (NP) prescribes an inhaled corticosteroid and an inhaled bronchodilator medication and provides education about how to use inhalers At a follow-up visit 2 weeks later, the patients pulmonary function tests are worse The NP should: a provide a detailed written asthma action plan for the patient b ask the patient to describe how the medications have been used c review the symptoms of an acute asthma exacerbation with the patient d teach the patient to use the albuterol more often and order an oral steroid 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)
