Extra credit: Summarize the acute and chronic neuromuscular changes that occur with training. Be sure to note the type of training you are referring to in your response. 

Extra credit: Summarize the acute and chronic cardiovascular changes that can occur with training. Be sure to note the type of training you are referring to in your response. 

Select the correct answer: A 57-year-old Black adult with a 15-year history of diabetes presents for diabetes follow-up and a blood pressure recheck. The last b/p in clinic was 145/88. Vitals: 158/92; pulse 70; resp 16; Weight 223 lb; Height 70 inches; BMI 32.0 Medications: metformin 1000 mg bid, semaglutide (Ozempic) 1 mg subcutaneously weekly Allergies: penicillin The physical exam in not remarkable. Chemistry panel (fasting) Glucose                  124 mg/dL Sodium                   140 mEq/L Potassium                3.9 mEq/L BUN                          15 mg/dL Creatinine                 1.2 mg/dL eGFR                           78 mL/min A1c                            7.1% Urine albumin/creatinine ratio (repeated x 3)       325 mg/g Cr; 303 mg/g Cr; 313 mg/g Cr Which of the following interventions should be incorporated into this patient’s clinical management plan?

Select the correct answer: The following thyroid function labs are obtained on a middle-aged adult during a routine annual physical: TSH           7.2 uIU/L Free T4      1.6 ng/dL Anti-TPO antibodies are positive. Other than complaints of periodic arthritic discomfort, the patient reports no physical complaints.  The physical exam is unremarkable. The primary care nurse practitioner should incorporate which of the following recommendations into the patient’s clinical management plan?

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?