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Important Reminder: If you are disqualified, you will receive a zero on this test, and all other tests will be reviewed for violations. Furthermore, your name may be forwarded to the Dean, and your final grade could be reduced by one letter grade in accordance with the Academic Integrity Policy Ensure your immediate working area is free of papers, including post-its. The use of electronics of any kind is prohibited, including calculators. and headphones. You are permitted to use a blank piece of white paper for scratch work, a pencil, an eraser, and your ID. Keep your gaze primarily on your computer screen. Use the built-in calculator of the proctoring software on your computer. Do not use any other calculators. Questions will be presented one at a time, and you will not be able to return to previous questions. Ensure your camera is properly set up so that proctors can see your face clearly at all times. A camera angle showing the floor, ceiling, or the top of your head is considered unfocused. To Do: Please show both sides of your blank piece of paper to the camera

Suppose that brown fur in rabbits is determined by a dominant allele (B) and white fur is determined by a recessive allele (b). In a population of 15,000 rabbits, 2,400 are of genotype BB, 6,250 are of genotype Bb, and 6,350 are of genotype bb.   From this information: 1. Calculate the observed frequencies for each genotype ( 1 point for each observed frequency; 3 points). Round to the nearest tenth of a percent. 2. Calculate the allele frequencies for B and for b (2 points for each allele frequency; 4 points)). Round to the nearest tenth of a percent. 3. Calculate the expected Hardy-Weinberg equilibrium frequencies (2 points for each expected frequency for BB, Bb, and bb; 6 points). The Hardy-Weinberg equation is 1 = p2+2pq+q2. Round to the nearest tenth of a percent.   Phenotype Genotype Observed Frequency Expected Frequency Brown Fur BB Brown Fur Bb White Fur bb Total 15,000

Extra credit: Summarize the acute and chronic neuromuscular changes that occur with training. Be sure to note the type of training you are referring to in your response. 

Select the correct answer: A 35-year-old adult presents to the primary care nurse practitioner with complaints of right calf discomfort. The patient assigns a pain rating of 3 out of 10.  The patient is employed as a cashier and stands for long periods of time and reports driving from Orlando to Tampa last week. She is taking low dose oral contraceptives for treatment of perimenopausal symptoms.  Vitals: B/P 114/70; Pulse 64 regular; Respirations 16 and unlabored; Temperature 98.2. BMI 34.5 kg/m2 Physical exam Unremarkable general exam. Both extremities are equal in size, color and warm to touch. Obvious varicosities bilaterally. 1+ pedal edema bilaterally. No abnormalities of the foot are noted. Homan’s sign is negative. Pedal pulses are 2+ bilaterally. Laboratory findings: CBC – all measures within normal limits Prothrombin time and partial thromboplastin time – within normal limits Highly sensitivite D-dimer test negative SED rate -within normal limts According to American Chest Physician Guidelines, what is the appropriate clinical management plan for this patient at this time? 

Select the correct answer: A 57-year-old Black adult with a 15-year history of diabetes presents for diabetes follow-up and a blood pressure recheck. The last b/p in clinic was 145/88. Vitals: 158/92; pulse 70; resp 16; Weight 223 lb; Height 70 inches; BMI 32.0 Medications: metformin 1000 mg bid, semaglutide (Ozempic) 1 mg subcutaneously weekly Allergies: penicillin The physical exam in not remarkable. Chemistry panel (fasting) Glucose                  124 mg/dL Sodium                   140 mEq/L Potassium                3.9 mEq/L BUN                          15 mg/dL Creatinine                 1.2 mg/dL eGFR                           78 mL/min A1c                            7.1% Urine albumin/creatinine ratio (repeated x 3)       325 mg/g Cr; 303 mg/g Cr; 313 mg/g Cr Which of the following interventions should be incorporated into this patient’s clinical management plan?

Select the correct answer:    A 58-year-old adult with excess weight presents to the primary care nurse practitioner with complaints of intermittent swelling and discomfort in both lower extremities after a day of work. The patient is a store cashier and states that the discomfort is worse on work days which require more standing.  The following is observed on physical exam:    Based upon these findings, what recommendation by the primary care nurse practitioner is indicated?

Select the correct answer: The primary care nurse practitioner is completing a first visit with a 58-year-old adult. During the course of the visit, the patient reports a prior history of “Barrett’s esophagus”. The patient lost health insurance 3 years ago after experiencing a job loss.  What is an appropriate plan for this patient to address this finding?

Select the correct answer: A middle-aged adult presents to the primary care nurse practitioner for evaluation of “heartburn” symptoms after meals. Symptoms have been present for about the past two months but “came and went” in the past based upon meal composition. The discomfort is worse when lying down or when eating late. The patient’s partner has made comments describing halitosis and that a dentist has noticed some wearing on the tooth enamel. The patient has noticed worsening of asthma symptoms in the past several months.  Which of the following first-line treatments should be incorporated into the clinical management plan of this patient?

Question 5: a. Identify the fifth lung sound. b. Indicate when you hear the lung sound in the respiratory cycle. 

Question 4: a. Identify the fourth lung sound. b. Indicate when you hear the lung sound in the respiratory cycle.