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Higher rates of fat oxidation always lead to improved race performance. 

How many rounds of fluid exchange does the lab protocol require the class to complete?

Select the correct answer:  An older adult describes left chest pain and a burning sensation of the skin that began 3 days ago. Today the patient presents with complaints of a rash that partially extends across the back and chest. Current medications include: lisinopril (Prinivil) 10 mg daily simvastatin (Zocor) 40 mg daily levothyroxine (Synthroid) 75 mcg daily The patient has no known food or drug allergies.  Physical examination shows the following (see image below).    Which of the following interventions should the primary care nurse practitioner incorporate into this patient’s immediate management plan? 

Select the correct answer: The primary care nurse practitioner is treating an adult patient with who was diagnosed with moderate persistent asthma 6 months ago. The patient presents for a 3 month follow-up visit.  The patient is currently managed with medium dose budesonide/formoterol (Symbicort) daily and as needed for symptoms. The patient’s peak flow records indicate that 90% of days have been in the green zone since the last visit. The patient has used the rescue inhaler twice in the past 2 weeks and reports no nighttime awakening with asthma symptoms. The patient is better tolerating exercise.  According to current guidelines, which of the following treatment plans would be most appropriate for management of this patient?    

Bonus question (2 points possible) Hematuria is reported on a urinalysis that was obtained during the diagnostic work-up of a middle-age patient. Identify 3 potential differential diagnoses for this finding. For each potential differential diagnosis also identify two supporting and refuting data elements that would confirm or negate that diagnosis.  This item is worth two points which will be a bonus on this exam.

Select the correct answer: A  67-year-old adult presents to a primary care nurse practitioner in a walk-in clinic with symptoms of a dry, non-productive cough for 10 days which began with the onset of a “cold”. The cough is worse at night and interrupts sleep. The patient experienced a low grade fever that accompanied the first days of illness, but that has since resolved. Past medical history: osteoarthritis Current medications: acetaminophen (Tylenol) prn for arthritic pain; multivitamin Allergies: no known drug or food allergies.  Physical exam: afebrile; scattered wheezes in upper lobes; remaining physical exam unremarkable The NP obtains a chest x-ray which shows no evidence of consolidation at this time.     Giving consideration to pertinent positive and negative patient data, what is the current working diagnosis for this patient?

Select the correct answer  A middle-age adult with a history of type 2 diabetes presents to the clinic complaining of a painful swollen lower leg. The patient admits to scratching a bug bite in the same area of the leg over the course of several days. The patient initially managed the condition with a topic corticosteroid but that was ineffective in managing symptoms which are worsening.  What organisms are most likely responsible for this condition (see image below)?

Select the correct answer: A middle adult who is undergoing treatment for ulcerative colitis with a biologic agent presents to a primary care nurse practitioner with an acute onset of chills, fever, headache, muscle aches and general myalgia. Symptoms began 24 hours ago. The patient received trivalent influenza vaccine one month ago and has received COVID vaccines consistent with current CDC guidelines.  Vitals: 128/86; Pulse 88; respirations 20; temp 101.1 Medications: multivitamins, adalimumab (Humira) 40 mg every other week. Allergies: Penicillin Physical exam: Acutely ill appearing adult; Skin hot and moist; HEENT: nasal mucosa mildly erythematous with clear drainage, tympanic membranes unremarkable; throat clear; right anterior cervical lymph nodes mildly enlarged and tender; S1/S2 regular rate and rhythm; Chest resonant; no areas of increased fremitus; chest clear. Abdomen unremarkable. Rapid flu test: positive for influenza A; COVID 19 – negative Which of the following interventions should the primary care nurse practitioner incorporate into this patient’s management plan?

Select the correct answer:  A young adult presents to urgent care with complaints of 24 hours of burning on urination and urinary frequency accompanied by blood in the urine.  The patient denies associated pain or discomfort in the penis, scrotum or testes. The patient denies recent sexual activity and is in a long-standing monogamous relationship with a woman. This is the first presentation of these symptoms.  The patient is allergic to penicillin (wheezing and airway edema).  Current medications: none Vital signs: B/P 116/73; pulse 88; respirations 14; Temperature: 99.1 F Physical exam including examination of the penis, testes, and scrotum is normal.  The patient is afebrile. Urinalysis shows 3+ blood, 2+ WBC, and positive nitrites. A urine has been sent for culture and sensitivity.   Which action by the primary care nurse practitioner is most indicated at this time?

In terms of performance management, MBO stands for: