reports a 4 - month history of intermittent upper
abdominal pain and burning . It occurs 2 hours after
meals . Based on her symptoms , she most likely has : -
ANSWER-Duodenal ulcer
.A 21-year-old patient reports to the primary care clinic
complaining of urinary urgency, frequency and burning.
She also reports a small amount of vaginal discharge
that contains an odor. It is likely that the NP will
perform a vaginal exam at this visit. - ANSWER-true
.A 25 year- old female presents to the primary care
office with urinary burning and frequency for the last 3
days. She denies any fever, chills, back pain. Her
gynecological history is negative and reports no vaginal
,discharge. The only new information reported is that
she recently had sexual intercourse with a new male
partner.
The NP obtains a urinalysis and determines that the
urine contains leukocytes, RBCs, nitrites, and WBCs. No
casts are identified. Based on symptom presentation
and UA results, the patient can be diagnosed with: -
ANSWER-cystitis
.A 39 - year - old is diagnosed with a duodenal ulcer .
Which of the following behaviors may have contributed
to the development of the ulcer ? - ANSWER-Regular
NSAID use
.A 42-year-old female presents to the primary care clinic
with a three- month history of "feeling low", poor
energy, inability to concentrate and irritability. She is
concerned about her loss of interest in her usual social
activities of walking with her friends and participating in
her sewing group. She is especially concerned about her
recent 15-pound weight gain. Other reported symptoms
are frequent headaches, difficulty getting out of bed in
the morning, and feeling worthless. She denies suicide
,ideation. She reports a family history of depression
(mother and sister) and denies any consumption of
drugs and alcohol. She is divorced and has a grown son
who lives approximately one hour away but rarely sees
because of his work schedule. The patient is interested
in knowing if her symptoms are related to depression.
Upon initial evaluation, the NP considers if the patient
meets the criteria for MDD by consulting the DS -
ANSWER-Depressed mood
Fatigue/loss of energy
Loss of interest/Anhedonia
Feeling worthless or having excessive guilt
Insomnia or hypersomnia
Poor concentration
Recurrent thoughts of death, suicide, a suicide plan or
attempt
Psychomotor agitation or retardation
.A 45-year-old male presents to the primary care office
with right flank pain that he describes as unremitting;
he also reports nausea and vomiting. The NP performs
, an exam and observes him writhing in pain on the exam
table with the inability to find a comfortable position.
He is afebrile, BP 156/88 mmHg and HR 106/min. Right
flank is mildly tender on palpation. Abdominal exam is
negative for any abnormality. A urinalysis was
performed and revealed 1+ blood. Urine microscopy
also revealed 10-20 RBCs per high-power field (hpf). A
kidney stone is suspected. The patient reports no prior
history of a kidney stone. After providing the patient an
analgesic, where the patient reported mild relief, the
NP had the patient transferred to the emergency room
for intravenous fluids, pain management and further
work-up for the kidney stone. Upon follow-up in the
office a week later, the patient reported that he was
diagnosed with - ANSWER-adequate hydration
balanced diet
.A 50 - year - old is diagnosed with gastroesophageal
reflux disease . This condition is caused by : - ANSWER-
Loss of muscle tone at the lower esophageal sphincter
.A 50 - year - old male reports episodes of frequently
recurring crampy abdominal pain , diarrhea , and