NUR 550 Primary Care Finalwith 100% complete solutions

A 30-year-old man comes to the clinic because of fatigue and sleepiness throughout the day. His past medical, family and social histories are noncontributory. His wife says he snores very loudly while sleeping and she has recently noticed that he will stop breathing momentarily, multiple times throughout the night. Pulse oximetry shows a blood oxygen saturation of 90%. He has a BMI of 33kg/m2, having gained 5.4-kg (12-lb) over the past year without any significant lifestyle or dietary changes. You advise the patient to lose weight and see a relevant specialist. Which is the most likely cause of this patient's condition? A. Anemia B. Obstructive sleep apnea C. Orthopnoea D. Platypnoea E. Type 2 diabetes mellitus B. Obstructive sleep apnea Obstructive sleep apnea is characterized by intermittent upper airway obstruction during sleep. It is an important cause of fatigue to recognize and treat as it can have serious long term complications. Jason, age 62, has obstructive sleep apnea. What do you think is one of his contributing factors? a. He is a recovering alcoholic of 6yrs b. His collar size is 17in c. He is the only person in his family who has this d. He is extremely thin b. His collar size is 17in 00:01 01:28 Nathan, a 32yo policeman, has a 15-pack-year history of smoking and continues to smoke heavily. During every visit, he gets irate when you try to talk to him about quitting. What should you do? A. Hand him literature about smoking cessation at every visit. B. Wait until he is ready to talk to you about quitting. C. Document in the record that he is not ready to quit. D. Continue to ask him at every visit if he is ready to quit. D. Continue to ask him at every visit if he is ready to quit Your pt has decided to try to quit smoking with Chantix. You are discussing his quit date and he will begin taking the med tomorrow. When should he plan to quit smoking? a. He should stop smoking today. b. He should stop smoking tomorrow. c. His quit date should be in 1 week. d. He will be ready to quit after the first 30 days. c. His quit date should be in 1 week Which info should be included when you are teaching your pt about the use of nicotine gum? a. The gum must be correctly chewed to a softened state and then placed in the buccal mucosa. b. Pt's should not eat for 30min prior to or during the use of the gum. c. Initially, one piece is chewed every 30min while awake. d. Acidic foods and beverages should be encouraged during nicotine therapy. a. The gum must be correctly chewed to a softened state and then placed in the buccal mucosa. Cydney presents with a h/o asthma. She has not been treated for a while. She c/o daily but not continual symptoms, greater than 1 week and at nighttime. She has been using her rescue inhaler. Her FEV1 is 60-80% predicted. How would you classify her asthma severity? a. Mild intermittent b. Mild persistent c. Moderate persistent d. Severe persistent c. Moderate persistent Joyce is taking a long-acting beta-agonist for her asthma. What additional med should she be taking? a. Inhaled corticosteroid b. Leukotriene receptor antagonist c. Systemic corticosteroid d. Methyl xanthenes a. Inhaled corticosteroid Your pt is on Therabid for his asthma. You want to maintain his serum levels between: a. 0 to 5 mcg/mL b. 5 to 10 mcg/mL c. 5 to 15 mcg/mL d. 10 to 20 mcg/mL c. 5-15mcg/mL George has COPD and an 80% forced expiratory volume in 1 second. How would you classify the severity of his COPD? a. Stage 1 mild COPD b. Stage 2 moderate COPD c. Stage 3 severe COPD d. Stage 5 very severe COPD a. Stage 1 mild COPD Which obstructive lung dz is classified as reversible? a. Asthma b. Chronic bronchitis c. Emphysema d. COPD a. Asthma You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her? a. "Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow." b. "Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow." c. "Drive to the emergency room now." d. "Call 911." b. "Use your rescue inhaler, begin the Rx of PO glucocorticoids you have, and call back tomorrow." Which statement about adenocarcinoma of the lung is accurate? a. It is the least common type of lung cancer, representing approximately 5-10% of cases b. It is the most prevalent carcinoma of the lungs in both sexes and in nonsmokers, representing 35-40% of all tumors c. It is more common in men than in women and occurs almost entirely in cigarette smokers d. It is aggressive, with rapid growth and early local and distant metastases via the lymphatic and blood vessels. b. It is the most prevalent carcinoma of the lungs in both sexes and in nonsmokers, representing 35-40% of all tumors