Question 3:  a. Identify the third lung sound. b. Indicate when you hear the lung sound in the respiratory cycle. 

Question 5: a. Identify the fifth lung sound. b. Indicate when you hear the lung sound in the respiratory cycle. 

Which of the following statements is true based on the diagram of gel electrophoresis results above?

Select the correct answer: The primary care nurse practitioner is completing a first visit with a 58-year-old adult. During the course of the visit, the patient reports a prior history of “Barrett’s esophagus”. The patient lost health insurance 3 years ago after experiencing a job loss.  What is an appropriate plan for this patient to address this finding?

Choose the correct answer: A 60-year-old adult with a 15-year history of type 2 diabetes and co-existing coronary artery disease presents to the primary care nurse practitioner for diabetes follow-up. The patient reports fatigue and has noted urinary frequency. The patient is intermittently monitoring glucose. Current medications include: metformin (Glucophage) 1000mg bid dapagliflozin (Farxiga) 10 mg po daily semaglutide (Rybelsus) 7 mg po daily The patient has no known allergies.   The following labs were obtained last week. Chemistry: Glucose               330 mg/dL Sodium                138 mEq/L Potassium           4.7 mEq/L BUN                    27  mg/dL Creatinine           1.4 mg/dL A1c                        9.7% What, if any, adjustments to the clinical management are indicated at this time?   

Select the correct answer: A 52-year-old adult presents to the primary care nurse practitioner for an annual wellness exam and to address bothersome vasomotor menopause-related complaints.  The patient reports a history of preelampsia with the first of her three pregnancies and asthma which is well-managemed with daily inhalers.  The patient takes a multivitamin daily and melatonin periodically for sleep. She has never smoked. The patient has no known allergies.  Vital signs: B/P 150/88; pulse 62 beats/min; respirations 12 breaths/min; BMI 29.8 kg/m2 The physical exam was normal for age.  Labs obtaned prior to the visit include: Chemistry panel – within normal limits with eGFR of 103 mL/min Lipid panel: Total cholesterol: 291 mg/dL LDL-C: 195 mg/dL HDL: 66 mg/dL Triglycerides: 152 mg/dL A1C: 5.3% The patient has an estimated 10-year risk for ASCVD of 3.2%. In addition to recommendations related to home blood pressure monitoring, what interventions should be incorporated in the clinical management plan?  

Question 4: a. Identify the fourth lung sound. b. Indicate when you hear the lung sound in the respiratory cycle. 

Select the correct answer: A 20-year-old male college student presented to college health with an acute onset of abdominal pain. During examination, the primary care nurse practitioner elicits increased pain in the right lower quadrant following release of pressure during deep palpation of the the left lower quadrant. This finding is documented as:

Select the correct answer: A middle-aged adult presents to the primary care nurse practitioner for evaluation of “heartburn” symptoms after meals. Symptoms have been present for about the past two months but “came and went” in the past based upon meal composition. The discomfort is worse when lying down or when eating late. The patient’s partner has made comments describing halitosis and that a dentist has noticed some wearing on the tooth enamel. The patient has noticed worsening of asthma symptoms in the past several months.  Which of the following first-line treatments should be incorporated into the clinical management plan of this patient?

Which layer or tunic of the alimentary canal contains isolated lymphoid particles, part of MALT, that help to defend against bacteria and other pathogens.