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The Nurse Practitioner examines a 45-year-old male complaining of trouble with his vision. He has been diagnosed with diabetes for several years and has not been taking his medications as prescribed. He misses many appointments for follow-up. He doesn’t remember when he last had a dilated eye exam. You have no recent documentation from ophthalmology. You examine the patient and observe abnormal blood vessels in the retina but your ability to examine the patient thoroughly is limited. His visual acuity as determined with the Snellen chart is decreased from what was documented from two years ago. You refer the patient to ophthalmology, suspecting that his problem is most likely associated with which condition?

Which of the following is an age-related laboratory change?

A patient presents to the clinic with a complaint of right ear pain. He denies fever or chills and notes the pain has been increasing over the last 2 days. It was painful last night and he had difficultly sleeping on his right side due to pain. He notes that the ear feels “wet” inside. He also notes that his hearing is somewhat muffled.   During the examination, the Nurse Practitioner observes the following: The tympanic membrane is intact.   What is the most likely cause of the patient’s symptoms?

A 77-year-old woman presents to the clinic for an annual wellness examination. Which subcategory of the older population does she fit into, based on her age?

Which of the following is a long-term management strategy in patients with hyperthyroidism?

The Nurse Practitioner is treating a patient who has confirmed positive culture for strep pharyngitis. She is penicillin allergic. What is the next choice for an antibiotic?

Which of the following medications is NOT safe to use for Bacterial Otitis External when an adult patient has a perforated tympanic membrane?

SE: FOR ACCIDENTAL AND UNPLANNED EVENTS. Find the appropriate phrase to form correct and logical the sentences.  

¿PRETÉRITO O IMPERFECTO? Choose the appropriate verb to complete the sentences.  El enfermero Jorge [1] tarde al hospital todos los días. Ana [2] al consultorio anoche. Los doctores [3] comiendo cuando llegó el paciente muy enfermo. Esta mañana, Ana y Luisa [4] al parque a correr. Mi padre [5] muy joven cuando conoció a mi madre por primera vez.

EL IMPERFECTO. Choose the verb that completes the sentences in a logical way and conjugate using the imperfect tense. Cuando éramos niños, mi hermano y yo (1) [1] (ser/estudiar) muy activos y sanos. Yo siempre (2) [2] (desayunar/viajar) frutas y verduras y siempre (3) [3] (hacer/estar) ejercicio. Cuando yo jugaba al fútbol, mi padre me (4) [4] (pedir/llevar) a las competencias y mi madre me (5) [5] (preparar/beber) almuerzos nutritivos. Algunas veces, yo me (6) [6] (enfermar/comprar) y tenía que ir al doctor. El doctor siempre nos (7) [7] (decir/recetar) que comer bien es muy importante. Algunas veces, mi hermano no (8) [8] (comer/estornudar) las verduras y ensaladas que mi madre (9) [9] (servir/ir) en la cena. Mi hermano y yo siempre (10) [10] (tener/ir) con el Dr. Sanchez para revisiones (check-ups). Él es un buen doctor y es muy simpático.