NR 507 MIDTERM EXAM
QUESTIONS AND CORRECT
ANSWERS VERIFIED AND
GRADED A+
Kevin, a 19 year old male presents to your clinic with a racing feeling in
his chest. An EKG is performed and you hav diagnosed him
withsupraventricular tachycardia (SVT) at a rate of 220 and call for EMS.
Understanding the physiology of SVT, you anticipate Kevin will most likely
respond favorably to which of the following intravenous agents?
Adenosine
Your 52 year old male patient Gus has a diagnosis of heart failure with a
low ejection fraction (HFrEF) (EF 30%) following a recent myocardial
infarction and has been started on optimal medical therapy. Assuming he
tolerates all the following medicines without side effects or
contraindications, which one of the following agents should be avoided for
optimal medical therapy specifically aimed at optimizing his HFrEF?
Amlodipine (Norvasc)
Marvin, your 47 year old African American patient with a diagnosis of
severe COPD and coronary artery disease (CAD) has been complaining of
shortness of breath and wheezing after initiation of a new medicine for his
coronary artery disease management. Given his health history, which of
the following agents is considered the safest beta blocker for his CAD
management?
Metoprolol (Lopressor).
,Melissa, your 56 year old caucasian female patient presents with a health
history of hypertension, migraines, hyperlipidemia, seasonal depression,
and BMI 32 for a visit to establish care. She was without any medical care
for a long time and being newly established to your clinic si prescribed the
following:
Amlodipine (Norvasc)
Your patient has presented with progressive asthma which has prompted
you to increase therapy from short acting beta agonist only to other
agents. Which drug must never be used as monotherapy for asthma
management?
Long acting beta agonists.
Your 19 year old otherwise healthy male patient Vivek has been
monitoring their peak flow at home after a recent visit at which time his
symptoms suggest a new diagnosis of asthma. Which of the following is
the most likely drug to be the first prescription?
albuterol (Xopenex) MDI PRN for wheezing
Sara, a 28 year old female patient presented to your clinic with wheezing
and despite being treated with nebulized albuterol, she is not having any
relief. You believe she is experiencing status asthmaticus. As a prudent
nurse practitioner, you recall she may benefit from IM injection if which of
the following agent?
Terbutaline (Bricanyl).
Maya, your 52 year old patient is receiving education for her new
mediation regimen for her COPD. Which of the following agents should
include rinsing the mouth for risk of development of oral candidiasis
(thrush)?
Inhaled corticosteroids
,Margo, a 47 year old female patient recently underwent routine
surveillance labs during her annual visit. From a routine screening lab of
Hgb A1C of 7.2, you have diagnosed her with type 2 diabetes mellitus
(T2DM) and anticipate discharging her with medication and referral to
diabetic education. Yourpatient teaching should include notification of
which common side effect ofthe most commonly prescribed first agent for
T2DM?
diarrhea
Kaia, a 22 year old trans female patient who is actively undergoing
gender-affirming therapy abruptly stopped their medication regimen for
the last two weeks due to insurance issues. They present to your clinic
with hypotension, pallor, and hypothermia. Assuming they are taking al of
the following medications, which of these is most likely the culprit for
these symptoms after abrupt withdrawal.
Prednisone (Deltasone).
Based on current diabetes mellitus management guidelines bythe
American Academy of Family Physicians (AAFP), at which Hgb A1Clevel
should a second oral anti-diabetic agent be consideredif control is not
successful prior?
Hgb A1c of 8.0.
Your 51 year old female patient Sheila presents for routine health exam
and during your visit, states she is concerned about her weight gain,
especially with her history of diabetes mellitus type 2 and family history of
premature coronary artery disease. Which of the following pharmacologic
agents may be a reasonable solution for her unique health concerns of
weight gain as well as diabetes mellitus control?
Ozempic (Semaglutide).
, Oliver, a 62 year old otherwise healthy male patient with an active
lifestyle presents to your clinic today with a chief complaint of gnawing
abdominal pain with a history of orthopedic overuse injuries. In developing
a working differential diagnosis for this patient, which of the following
questions is most useful in probing this further to rule out more serious
conditions?
Have you been taking any non-steroidal anti-inflammatory medications
lately?
Your 55 year old female patient Eve has been diagnosed with acute
myeloid leukemia (AML). Which of the following agents would be most
likely to assist in management of her anticipated side effects of cancer
treatment?
Allopurinol (Zyloprim)
Rosie, a 19 year old college student presents to the student health
services for evaluation of abdominal pain. She has a history of Crohn's
disease with parital small bowel resection which has been managed well
on natalizumab (Tysabri), a monoclonal antibody. Her abdomen is
distended, tender, and she describes frequent bloody stools. Based on her
current presentation, what medication decisions are most appropriate at
this time?
Initiate prednisone (Deltasone) and maintain dosing of natalizumab
(Tysabri)
Shelly, a 19-year-old female patient presents for a routine health visit.
During your exam, she mentions recent symptoms of dysuria and urinary
frequency, and you suspect a urinary tract infection. You confirm this with
urinalysis which is as follows: urine positive for leukocyte esterase,
nitrites, and WBCs as well as the presence of bacteria. Most recent labs
were 6 months agoand showed normal CBC and BMP. She also has a
QUESTIONS AND CORRECT
ANSWERS VERIFIED AND
GRADED A+
Kevin, a 19 year old male presents to your clinic with a racing feeling in
his chest. An EKG is performed and you hav diagnosed him
withsupraventricular tachycardia (SVT) at a rate of 220 and call for EMS.
Understanding the physiology of SVT, you anticipate Kevin will most likely
respond favorably to which of the following intravenous agents?
Adenosine
Your 52 year old male patient Gus has a diagnosis of heart failure with a
low ejection fraction (HFrEF) (EF 30%) following a recent myocardial
infarction and has been started on optimal medical therapy. Assuming he
tolerates all the following medicines without side effects or
contraindications, which one of the following agents should be avoided for
optimal medical therapy specifically aimed at optimizing his HFrEF?
Amlodipine (Norvasc)
Marvin, your 47 year old African American patient with a diagnosis of
severe COPD and coronary artery disease (CAD) has been complaining of
shortness of breath and wheezing after initiation of a new medicine for his
coronary artery disease management. Given his health history, which of
the following agents is considered the safest beta blocker for his CAD
management?
Metoprolol (Lopressor).
,Melissa, your 56 year old caucasian female patient presents with a health
history of hypertension, migraines, hyperlipidemia, seasonal depression,
and BMI 32 for a visit to establish care. She was without any medical care
for a long time and being newly established to your clinic si prescribed the
following:
Amlodipine (Norvasc)
Your patient has presented with progressive asthma which has prompted
you to increase therapy from short acting beta agonist only to other
agents. Which drug must never be used as monotherapy for asthma
management?
Long acting beta agonists.
Your 19 year old otherwise healthy male patient Vivek has been
monitoring their peak flow at home after a recent visit at which time his
symptoms suggest a new diagnosis of asthma. Which of the following is
the most likely drug to be the first prescription?
albuterol (Xopenex) MDI PRN for wheezing
Sara, a 28 year old female patient presented to your clinic with wheezing
and despite being treated with nebulized albuterol, she is not having any
relief. You believe she is experiencing status asthmaticus. As a prudent
nurse practitioner, you recall she may benefit from IM injection if which of
the following agent?
Terbutaline (Bricanyl).
Maya, your 52 year old patient is receiving education for her new
mediation regimen for her COPD. Which of the following agents should
include rinsing the mouth for risk of development of oral candidiasis
(thrush)?
Inhaled corticosteroids
,Margo, a 47 year old female patient recently underwent routine
surveillance labs during her annual visit. From a routine screening lab of
Hgb A1C of 7.2, you have diagnosed her with type 2 diabetes mellitus
(T2DM) and anticipate discharging her with medication and referral to
diabetic education. Yourpatient teaching should include notification of
which common side effect ofthe most commonly prescribed first agent for
T2DM?
diarrhea
Kaia, a 22 year old trans female patient who is actively undergoing
gender-affirming therapy abruptly stopped their medication regimen for
the last two weeks due to insurance issues. They present to your clinic
with hypotension, pallor, and hypothermia. Assuming they are taking al of
the following medications, which of these is most likely the culprit for
these symptoms after abrupt withdrawal.
Prednisone (Deltasone).
Based on current diabetes mellitus management guidelines bythe
American Academy of Family Physicians (AAFP), at which Hgb A1Clevel
should a second oral anti-diabetic agent be consideredif control is not
successful prior?
Hgb A1c of 8.0.
Your 51 year old female patient Sheila presents for routine health exam
and during your visit, states she is concerned about her weight gain,
especially with her history of diabetes mellitus type 2 and family history of
premature coronary artery disease. Which of the following pharmacologic
agents may be a reasonable solution for her unique health concerns of
weight gain as well as diabetes mellitus control?
Ozempic (Semaglutide).
, Oliver, a 62 year old otherwise healthy male patient with an active
lifestyle presents to your clinic today with a chief complaint of gnawing
abdominal pain with a history of orthopedic overuse injuries. In developing
a working differential diagnosis for this patient, which of the following
questions is most useful in probing this further to rule out more serious
conditions?
Have you been taking any non-steroidal anti-inflammatory medications
lately?
Your 55 year old female patient Eve has been diagnosed with acute
myeloid leukemia (AML). Which of the following agents would be most
likely to assist in management of her anticipated side effects of cancer
treatment?
Allopurinol (Zyloprim)
Rosie, a 19 year old college student presents to the student health
services for evaluation of abdominal pain. She has a history of Crohn's
disease with parital small bowel resection which has been managed well
on natalizumab (Tysabri), a monoclonal antibody. Her abdomen is
distended, tender, and she describes frequent bloody stools. Based on her
current presentation, what medication decisions are most appropriate at
this time?
Initiate prednisone (Deltasone) and maintain dosing of natalizumab
(Tysabri)
Shelly, a 19-year-old female patient presents for a routine health visit.
During your exam, she mentions recent symptoms of dysuria and urinary
frequency, and you suspect a urinary tract infection. You confirm this with
urinalysis which is as follows: urine positive for leukocyte esterase,
nitrites, and WBCs as well as the presence of bacteria. Most recent labs
were 6 months agoand showed normal CBC and BMP. She also has a
