3Ps Assessment- Pathophysiology,
Pharmacology, and Physical
Assessment
A 24-year-old male takes fluoxetine for his major depressive disorder with
anxiety symptoms. Today the NP diagnoses comorbid bipolar II disorder and
believes that he will be best managed with aripiprazole, a CYP2D6 substrate.
Recognizing that fluoxetine is a CYP2D6 inhibitor, the NP knows that:
The starting dose of aripiprazole should be cut in half.
The NP is examining a 55-year-old woman who presents with insidious onset
of lower lumbar pain and right hip pain. She denies injury or trauma. X-ray
and MRI demonstrate degenerative disc disease. Which of the following
symptoms would not be expected by the patient with this diagnosis?
QID: 4245027
Mark For Review
Pain relieved with rest
Persistent joint pain and stiffness throughout the day
Numbness and tingling of the right lower extremity
,The pain that wakes her from sleep with position changes
A routine annual examination of a 55-year-old female reveals a Hgb of 17.8
g/dL and a hematocrit of 64%. The RBC count is more than 6 million. The
remainder of the red and white blood cell differential is within normal limits.
The patient is without complaint and the physical examination is within
normal limits. The next step in the patient’s evaluation should include:
Persistent joint pain and stiffness throughout the day
A 14-year-old patient presents to urgent care with her mother complaining of
acute onset throat pain. She reports she thinks she has a fever, and her
throat is so painful that she believes she has strep throat, although she has
never had strep before. Mom reports that she has not had anything to eat or
drink today because it hurts so much. Physical examination reveals slight
pharyngeal erythema and palpable tender anterior cervical nodes on the
right. The patient has a temperature of 102.4o F. the NP suspects:
Epiglottitis
The NP is seeing a patient who was diagnosed with hypothyroidism three
months ago and started on levothyroxine 112 mcg daily. The patient is
feeling well today, has no acute complaints, and maintains that she is taking
her medication every day as prescribed. Laboratory assessment today
reveals a TSH of 3.2 mIU/L. What is the next step in the management of this
patient?
, Continuing the current plan of care
The NP is selecting among available agents for the management of type 2
diabetes mellitus. Which of the following is true about incretin hormones?
The effect of incretins is decreased in type 2 diabetes
Sarcomere stretch beyond 2.2 microns is the physiologic mechanism behind
which condition?
CHF
A female patient is taking amlodipine 10 mg daily, which controlled her blood
pressure, but she could not tolerate the side effects. She was switched to
losartan 100 mg daily, but her blood pressure never achieved goal. Which
statement best characterizes the clinical comparison of these two
medications?
Amlodipine is more efficacious than losartan
Pharmacology, and Physical
Assessment
A 24-year-old male takes fluoxetine for his major depressive disorder with
anxiety symptoms. Today the NP diagnoses comorbid bipolar II disorder and
believes that he will be best managed with aripiprazole, a CYP2D6 substrate.
Recognizing that fluoxetine is a CYP2D6 inhibitor, the NP knows that:
The starting dose of aripiprazole should be cut in half.
The NP is examining a 55-year-old woman who presents with insidious onset
of lower lumbar pain and right hip pain. She denies injury or trauma. X-ray
and MRI demonstrate degenerative disc disease. Which of the following
symptoms would not be expected by the patient with this diagnosis?
QID: 4245027
Mark For Review
Pain relieved with rest
Persistent joint pain and stiffness throughout the day
Numbness and tingling of the right lower extremity
,The pain that wakes her from sleep with position changes
A routine annual examination of a 55-year-old female reveals a Hgb of 17.8
g/dL and a hematocrit of 64%. The RBC count is more than 6 million. The
remainder of the red and white blood cell differential is within normal limits.
The patient is without complaint and the physical examination is within
normal limits. The next step in the patient’s evaluation should include:
Persistent joint pain and stiffness throughout the day
A 14-year-old patient presents to urgent care with her mother complaining of
acute onset throat pain. She reports she thinks she has a fever, and her
throat is so painful that she believes she has strep throat, although she has
never had strep before. Mom reports that she has not had anything to eat or
drink today because it hurts so much. Physical examination reveals slight
pharyngeal erythema and palpable tender anterior cervical nodes on the
right. The patient has a temperature of 102.4o F. the NP suspects:
Epiglottitis
The NP is seeing a patient who was diagnosed with hypothyroidism three
months ago and started on levothyroxine 112 mcg daily. The patient is
feeling well today, has no acute complaints, and maintains that she is taking
her medication every day as prescribed. Laboratory assessment today
reveals a TSH of 3.2 mIU/L. What is the next step in the management of this
patient?
, Continuing the current plan of care
The NP is selecting among available agents for the management of type 2
diabetes mellitus. Which of the following is true about incretin hormones?
The effect of incretins is decreased in type 2 diabetes
Sarcomere stretch beyond 2.2 microns is the physiologic mechanism behind
which condition?
CHF
A female patient is taking amlodipine 10 mg daily, which controlled her blood
pressure, but she could not tolerate the side effects. She was switched to
losartan 100 mg daily, but her blood pressure never achieved goal. Which
statement best characterizes the clinical comparison of these two
medications?
Amlodipine is more efficacious than losartan
