A 45-year-old female presents to the clinic with complaints of persistent headaches for the past two weeks. She describes the pain as sudden and severe, unlike any headache she has experienced before. She denies any visual disturbances but reports feeling nauseous during the headaches. She has no significant past medical history. Which of the following red flags suggests a potentially serious underlying cause of her headaches?

A 55-year-old male presents to the emergency department with a productive cough, fever, and chest pain. A chest X-ray confirms the diagnosis of community-acquired pneumonia (CAP). He is started on antibiotic therapy with levofloxacin. After 48 hours of treatment, the patient’s fever resolves, and his vital signs stabilize. He is afebrile with a heart rate of 90 beats/min, respiratory rate of 22 breaths/min, blood pressure of 120/80 mm Hg, and oxygen saturation of 95% on room air. He is tolerating oral intake well and has normal mental status. What is the appropriate course of action regarding antibiotic therapy for this patient?

Which of the following medicatons has been associated with a high risk of developing a clostridium difficile (C. diff) infection?

A 68-year-old female presents to the clinic with complaints of chronic knee pain exacerbated by movement and weight-bearing activities. She reports a history of osteoarthritis (OA) and states that she has been using acetaminophen as needed for pain relief. Recent evidence indicates that acetaminophen monotherapy is ineffective or only modestly better than placebo for long-term OA treatment in most individuals. However, acetaminophen is still considered appropriate for short-term or episodic use in individuals who cannot tolerate or have contraindications to NSAID use. How should the nurse practitioner advise the patient regarding the use of acetaminophen for her OA pain?

Which of the following is a contraindication to the use of spironolactone?

Lynette is a 68 yo female who presents to your clinic for a follow up appointment after her recent heart failure diagnosis.  She complains of weakness, loss of appetite, and she is seeing a blue/green halo.  Her daughter comments that she has appeared confused over the past day or so.  Which medication may be causing these side effects?

Tyson is a 50 yo black male with a past medical history significant for hypertension and a heart attack (resulting in reduced LVEF) one year ago.  He is currently taking lisinopril (Zestril*) and a higher dose of amlodipine (Norvasc*).  He says he is having ankle edema over the past couple months since amlodipine (Norvasc*) was started.  His kidney function is normal, and he has no other signs/symptoms of fluid accumulation (e.g. pulmonary congestion, weight gain).  His BP is 138/70, and HR 72. His laboratory values are normal. Considering not only hypertension, but his past medical history ( prior MI / stable HFrEF) and most recent complaint (ankle edema), which of the following recommendations is most appropriate for Tyson to correct the edema and optimize heart failure therapy?

Angela is a 79yo Caucasian female with a history of heart failure with reduced ejection fraction (HFrEF) and hypertension.  Her BP is 142/76 and heart rate is 73 bpm.  Medications include carvedilol (Coreg*) 25mg twice daily, lisinopril (Zestril*) 40 mg daily, Empagliflozin (Jardiance*) 10mg daily and furosemide (Lasix*) 40 mg daily. She has been fairly compliant with the recommended lifestyle modifications.  Angela returns to your clinic 2 months later with a new complaint of a dry cough.  Her lungs are clear, weight and labs are unchanged, and she has no other symptoms.  Which of the following is most appropriate?

John is a 57yo Caucasian male who presents for a routine visit for his hyperlipidemia.  His PMH includes hyperlipidemia and hypertension.  He has no family history of heart disease.  He is a current smoker (1 PPD x 45 years).  He currently takes quinapril (Accupril*) 20mg daily.  Vitals include BP 165/90 x 2, HR 84, EKG shows normal sinus rhythm.  Weight 210 lbs, ht 5’10”.  Fasting labs include K 5.1 , Cr 1.1 [

NJ is receiving 40 mg po morphine/day.  You wish to convert him to po oxycodone (Oxy IR).  Which of the following regimens is the best recommendation for this patient?   Assume a 25% reduction for incomplete cross tolerance.  The following conversions are provided for you:   Drug IV (mg) Oral (mg) Morphine 10 30 Oxycodone N/A 20