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This concludes this portion of Exam 2B. At this time, hold up the scratch paper and show the camera the front and back side of the scratch paper. Even if you did not use the paper, still display the paper. Failure to display both sides of the scratch paper will result in zero credit for this portion of the exam. 

Choose the correct answer: The primary care nurse practitioner is evaluating a young adult who survived a multi-car accident in which several persons died, including a best friend.  Since the accident two months ago, the patient has experienced nightmares, irritability, difficulty concentrating, and voices a personal responsibility for the accident. The patient verbalized the following during the patient interview, ” My partner just left because of how I am acting, but I can’t help it. I feel so alone and feel like I have no future.” The patient has no known drug allergies and is currently taking no medications. Which of the following interventions is most urgent to incorporate in this patient’s treatment plan? 

AA is a 27-year-old with asthma who is 6 months pregnant. She presents to the emergency room with shortness of breath and states her albuterol inhaler has not been adequate. She is treated in the emergency room and the physician sends her home with a prednisone burst. You are the pharmacy intern tasked with discussing the prednisone with her when she comes to pick up her medication. AA tells you she concerned about taking additional medications while pregnant. What do you say to her:

Which of the following as needed pain medications is safe for patients with aspirin exacerbated respiratory disease?

Choose the correct answer: A late, middle-aged adult presents to the primary care nurse practitioner with complaints of daily pain in the right foot. The pain begins at the heal and radiates to the arch of the foot when the patient is walking. The patient reports that the symptoms are worse when first applying pressure to the foot after a period of rest, such as when getting out of bed in the morning or up from a chair after a period of sitting. The pain began when the patient was breaking in a new pair of sneakers. On physical exam, the NP observes no obvious defects to the foot. The patient does have increased pain with forced dorsiflexion.  What initial recommendations are appropriate for this patient? 

Choose the correct answer: An older adult has recently relocated to a new community to live closer to family following the death of a long-term partner. The patient is establishing with a new primary care provider and is requesting refill of all medications. Past medical history is positive for hypothyroidism, obstructive sleep apnea treated by c-pap, and osteoarthritis of the knees and hips – the patient deferred surgical correction of the left knee and is being managed “medically”.  The patient participated in physical therapy in the past. The patient voices concerns about worsening pain if a prescription of pain medication is not renewed. Allergies: none Medications: levothyroxine 75 mcg daily oxycodone every 6 hours as needed for pain (patient doses 2 times per day typically)   Review of prescription drug monitoring program data shows appropriate prescription fills for oxycodone by the prior primary care nurse practitioner.   Which of the following is an appropriate initial component for the primary care nurse practitioner to include in this patient’s treatment plan today?    

What is it called when myosin pulls actin closer to the center of the sarcomere?

Differentiation and integration are essentially the same concept, as both involve dividing and coordinating tasks within an organization.

In Mintzberg’s Model, which of the following is the group where senior managers such as executives belong?

Choose the correct answer: A middle-aged adult with a negative health history presents to an urgent care clinic with complaints of an acute paralysis of the left side of the face that began 2 days ago and has worsened since that time. The patient is unable to fully close the left eye.  Physical assessment including neurological exam shows facial asymmetry including at the forehead and minimal movement of the left side of the face including the eye. The patient has no allergies or known chronic illnesses. What clinical management plan is most appropriate for this patient?