1
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,c. teach the patient about a bland diet.
d. change the NSAID to a corticosteroid.
Question 7: A patient comes to the clinic reporting dizziness and fatigue associated with nausea
and vomiting. The primary care NP suspects anemia and orders a complete blood count. The
patient’s hemoglobin is elevated. The NP correctly concludes that the patient is not anemic. The
NP has made an error in:
a. context formulation.
b. inappropriate knowledge base.
c. cost-versus-benefit analysis.
d. hypothesis triggering and information processing.
Question 8: A patient who has diabetes is taking metformin 1000 mg daily. At a clinic visit, the
patient reports having abdominal pain and nausea. The primary care NP notes a heart rate of 92
beats per minute. The NP should:
a. obtain LFTs.
b. decrease the dose of metformin.
c. change metformin to glyburide.
d. order electrolytes, ketones, and serum glucose.
Question 9: An 80-year-old patient asks a primary care NP about OTC antacids for occasional
heartburn. The NP notes that the patient has a normal complete blood count and normal
electrolytes and a slight elevation in creatinine levels. The NP should recommend:
a. calcium carbonate (Tums).
b. aluminum hydroxide (Amphojel).
, c. sodium bicarbonate (Alka-Seltzer).
d. magnesium hydroxide (Milk of Magnesia).
Question 10: A patient who has angina is taking nitroglycerin and long-acting nifedipine. The
primary care NP notes a persistent blood pressure of 90/60 mm Hg at several follow-up visits.
The patient reports lightheadedness associated with standing up. The NP should consult with the
patient’s cardiologist about changing the medication to:
a. amlodipine (Norvasc).
b. isradipine (DynaCirc).
c. verapamil HCl (Calan).
d. short-acting nifedipine (Procardia).
Question 11: A patient comes to the clinic to discuss weight loss. The primary care NP notes a
BMI of 32 and performs a health risk assessment that reveals no obesity-related risk factors. The
NP should recommend:
a. orlistat (Xenical).
b. surgical intervention.
c. changes in diet and exercise.
d. changes in diet and exercise along with short-term phentermine.
Question 12: A patient brings written information about a medication to a primary care NP about
a new drug called Prism and wants to know if the NP will prescribe it. The NP notes that the
information is from an internet site called “Prism.com.” The NP should tell this patient that:
a. this information is probably from a drug advertisement website.
b. this is factual, evidence-based material with accurate information.
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,c. teach the patient about a bland diet.
d. change the NSAID to a corticosteroid.
Question 7: A patient comes to the clinic reporting dizziness and fatigue associated with nausea
and vomiting. The primary care NP suspects anemia and orders a complete blood count. The
patient’s hemoglobin is elevated. The NP correctly concludes that the patient is not anemic. The
NP has made an error in:
a. context formulation.
b. inappropriate knowledge base.
c. cost-versus-benefit analysis.
d. hypothesis triggering and information processing.
Question 8: A patient who has diabetes is taking metformin 1000 mg daily. At a clinic visit, the
patient reports having abdominal pain and nausea. The primary care NP notes a heart rate of 92
beats per minute. The NP should:
a. obtain LFTs.
b. decrease the dose of metformin.
c. change metformin to glyburide.
d. order electrolytes, ketones, and serum glucose.
Question 9: An 80-year-old patient asks a primary care NP about OTC antacids for occasional
heartburn. The NP notes that the patient has a normal complete blood count and normal
electrolytes and a slight elevation in creatinine levels. The NP should recommend:
a. calcium carbonate (Tums).
b. aluminum hydroxide (Amphojel).
, c. sodium bicarbonate (Alka-Seltzer).
d. magnesium hydroxide (Milk of Magnesia).
Question 10: A patient who has angina is taking nitroglycerin and long-acting nifedipine. The
primary care NP notes a persistent blood pressure of 90/60 mm Hg at several follow-up visits.
The patient reports lightheadedness associated with standing up. The NP should consult with the
patient’s cardiologist about changing the medication to:
a. amlodipine (Norvasc).
b. isradipine (DynaCirc).
c. verapamil HCl (Calan).
d. short-acting nifedipine (Procardia).
Question 11: A patient comes to the clinic to discuss weight loss. The primary care NP notes a
BMI of 32 and performs a health risk assessment that reveals no obesity-related risk factors. The
NP should recommend:
a. orlistat (Xenical).
b. surgical intervention.
c. changes in diet and exercise.
d. changes in diet and exercise along with short-term phentermine.
Question 12: A patient brings written information about a medication to a primary care NP about
a new drug called Prism and wants to know if the NP will prescribe it. The NP notes that the
information is from an internet site called “Prism.com.” The NP should tell this patient that:
a. this information is probably from a drug advertisement website.
b. this is factual, evidence-based material with accurate information.
