Select the correct answer:    A 38-year-old adult with a 3-year history of well-controlled hypertension informs a primary care nurse practitioner of plans to attempt pregnancy in the near future. Current medications:  losartan (Cozaar) 50 mg po daily multi-vitamin daily The patient has no known allergies. The blood pressure in clinic today was 118/74 and is consistent with home monitoring records. The physical exam was unremarkable. Findings of a chemistry panel, A1C, and lipid panel were all within lab reported reference ranges.  What is an appropriate management plan for this patient?

All lymphocytes are produced and mature in the bone marrow.

Select the correct answer: A 61-year-old adult with a 9-year history of type 2 diabetes and hyperlipidemia presents for diabetes follow-up. Most recent eye exam was 4 months ago and was normal. The patient is allergic to sulfa. Prescribed medications: metformin (Glucophage) 500 mg bid dapagliflozin (Farxiga) 10 mg daily simvastatin (Zocor) 20 mg daily Labs: The patient’s  A1c in clinic is 8.3%. No logs are brought to the clinic appointment, but the patient reports fasting glucoses of 160-175 mg/dL.  Vitals: B/P 128/83; pulse 75; respiration 16; weight 202 height 68 inches BMI 30.7. Physical exam is unremarkable.  The primary care nurse practitioner refers the patient to diabetes self-management.  What additional interventions should be incorporated into the clinical management plan at this time?

What is the distribution of the interarrival time of Type A customers? Specify the distribution and its mean in minutes.  Show your work on the scratch paper. Distribution: Mean:

Select the correct answer: The primary care nurse practitioner is treating a 58-year-old adult with a history of well-regulated type 2 diabetes (A1C 5.8%) and a PREVENT-ASCVD 10-year risk of 6.8% which was calculated today based upon current patient assessments and lab findings. The patient underwent recent cardiac exercise stress testing which was normal. The patient’s measured LDL-C level one week ago was 123 mg/dL. The patient was was prescribed simvastatin (Zocor) 20 mg daily at a clinic visit 2 months ago. During today’s follow-up visit the patient reports complaints of recent-onset of muscle aches and pains. History and physical examination confirm symptoms are medication-related. The patient has no known medication allergies. In addition to a risk/benefit discusssion, which of the following interventions should be incorporated into the patient’s clinical management plan? 

Select the correct answer: The primary care nurse practitioner is completing a first visit with a 58-year-old adult who experienced a 3-year lapse in healthcare. During the course of the visit, the patient reports a prior history of “Barrett’s esophagus”.  What is an appropriate plan for this patient to address this finding?

Select the correct answer:    A 55-year-old adult was found with a blood pressure of 154/94 during an insurance physical. A confirmatory blood pressure of 148/88 is found 1 week later. The patient has no other known chronic conditions, and follow-up renal and diabetes screenings were normal. The patient is taking no regularly prescribed medications and is allergic to sulfa. The patient is 210 pounds and 72 inches tall (BMI 28.5). In addition to home blood pressure monitoring, the primary care nurse practitioner should immediately incorporate which of the following interventions into the patient’s clinical management plan? 

Fernando Forrest and Mary Maroon are involved in a romantic relationship. Fernando is an employee of the Mayor’s Office in Atlanta, Georgia. Mary is a lawyer at a major law firm in Atlanta that does work for the Mayor’s Office. In an effort to keep their relationship secret, Fernando and Mary meet in public only for lunch. On their first-year anniversary as a couple, Fernando and Mary split a bottle of champagne during lunch. Upon returning to work, both Fernando and Mary smell of alcohol. Each employer decides to administer a breathalyzer to estimate blood alcohol level. Is it likely that these employees have constitutional protections against their employers?

Select the correct answer:    A 58-year-old adult presents for an annual wellness visit. The patient has no current complaints and is seeking follow-up for existing health concerns. Past medical history is positive for 3-year history of hypertension.  The patient has a history of pre-eclampsia and gestational diabetes.  The patient has no known allergies. Current medications include: amlodipine (Norvasc) 10 mg daily hydrochlorothiazide 12.5 mg daily Vitals signs: B/P 132/78; Pulse 73 beats/min: respiration 14 breaths/min; Weight 223 lb. Height 72 inches; BMI 30.2 Physical exam: unremarkable.  Labs obtained one-week prior to the current visit include: Chemistry (fasting): Glucose            115 mg/dL Sodium             140 mEq/L Potassium         4.3 mEq/L Chloride             96 mEq/L BUN                   12 mg/dL Creatinine           1.1 mg/dL eGFR                    98 mL/min A1c                     6.1% Lipid panel (fasting) Total cholesterol          204 mg/dL LDL                               128 mg/dL HDL                               44 mg/dL Triglyceride                   180 mg/dL Ratio                               3.8 The calculated 10-year risk for atherosclerotic cardiovascular disease (ASCVD) is 6.3%. In addition to providing cardiovascular lifestyle education (smoking cessation and exercise prescription), which of the following interventions should be included in this patient’s management plan?    

Select the correct answer:    During a routine wellness visit to a primary care nurse practitioner, a 62-year-old adult reports recent-onset of epigastric pain over a 2 month period. These symptoms are accompanied by bloating and abdominal pain. The patient also reports recent unintended weight loss of 15 pounds.  Upon exam, the abdomen is slightly distended and tympanic to percussion.  In the office, a stool for occult blood is positive.  What actions should be incorporated in this patient’s diagnostic/treatment mangement plan?