3Ps Assessment- Pathophysiology, Pharmacology, and Physical assessment questions with answers
1. Sarcomere stretch beyond 2.2 microns is the physiologic mechanism behind which
condition?: CHF
2. A female patient is taking amlodipine 10 mg daily, which controlled her blood pressure,
but she could not tolerate the side effects. She was switched to losar- tan 100 mg daily, but her
blood pressure never achieved goal. Which statement best characterizes the clinical
comparison of these two medications?: Amlodipine is more eflcacious than losartan
3. During a routine health assessment, the NP appreciates a decrease in periph- eral vision
bilaterally while performing visual field assessment by confronta- tion. Consequently, the NP
anticipates which of the following findings during fundoscopic assessment?: A cup-to-disk ratio
of 70%.
4. A 66-year-old woman presents with a complaint of a 4-day history of a uni- lateral
headache that will not go away despite taking ibuprofen and aceta- minophen. She has a
history of hypertension that is usually well controlled with an ACE inhibitor, but today her blood
pressure is 162/92 mm Hg. During the HPI she admits that she has had some transient visual
loss over the few days, but it has been very short lived and resolves completely. The next step
in the evaluation of this patient should include:: An erythrocyte sedimentation rate
5. Which information best describes the pathophysiology of most mental health
disorders?: Dysregulation of neurotransmitters in relevant pathways
6. The commonality among all seizure etiologies is:: Increased neuron excitability
7. The NP is managing a patient newly diagnosed with essential tremor disorder and
prescribed propranolol. The patient did an internet search for the medica- tion and wants to
know how a "heart medication" can make her stop having hand tremors. What is the best
explanation for this patient?: Propranolol blocks the action of the sympathetic nervous system
in all body systems and so it will calm many things, including the tremors
8. A 48-year-old man presents with a complaint of a 3-week history of intermit- tent
shooting pain that runs down the buttocks and left leg. Suspecting sciatica, the NP would expect
which of the following during physical examination?: Pain with straight leg raise
, 3Ps Assessment- Pathophysiology, Pharmacology, and Physical assessment questions with answers
9. During the routine wellness examination of a 12-year-old male patient, the NP
appreciates a grade II/VI systolic murmur at the apex while the patient is lying on the exam
table. The murmur is louder when the patient moves to the sitting position, appreciated at
grade IV/VI. The cardiac history and review of symptoms is negative. The appropriate approach
to this patient is to:: Order an echocardiogram
10. A 57-year-old woman presents with a 3-day history of fever, dyspnea, and a purulent
cough. Auscultation of the lungs identifies an area of egophony in the lower left lobe. Palpation
reveals increased tactile fremitus. The NP expects which of the following percussion findings?:
Dullness
11. The NP is learning about anginal chest pain unresponsive to nitroglycerin, when does
necrotic injury occur?: The mitochondrial membrane ruptures
12. A 35-year-old female is skiing fast down a steep trail. She falls forward and lands on an
abducted and extended arm. She immediately feels a pop, has exquisite pain over her right
upper shoulder, and has no sensation in her right hand. Her diagnosis is most likely:: Anterior
dislocation of the glenohumeral joint.
13. The NP is evaluating a patient with markedly elevated blood pressure that is
unresponsive to traditional medications. There is some mild pedal edema, but other than the
elevated BP, the physical exam is essentially normal. A metabolic panel reveals the following:
Na+ 151 mEq/LK+ 3.0 mEq/LCl- 114 mEq/LCO2 28 mEq/LBUN 10 mg/dLCreati-
nine 0.9 mg/dL
The NP considers which of the following as a secondary cause of hypertension in this patient?:
Hyperaldosteronism
14. Which of the following statins is preferred for a 67-year-old man with hyper-
cholesterolemia who drinks a glass of grapefruit juice every morning?: Pravastatin
15. A 41-year-old female is being managed by her mental health provider with lithium. She
presents for a primary care wellness exam and has no complaints, but routine laboratory
assessment reveals a TSH of 4.5 iU/L. What is the most appropriate approach for this patient?:
Begin thyroid replacement therapy
1. Sarcomere stretch beyond 2.2 microns is the physiologic mechanism behind which
condition?: CHF
2. A female patient is taking amlodipine 10 mg daily, which controlled her blood pressure,
but she could not tolerate the side effects. She was switched to losar- tan 100 mg daily, but her
blood pressure never achieved goal. Which statement best characterizes the clinical
comparison of these two medications?: Amlodipine is more eflcacious than losartan
3. During a routine health assessment, the NP appreciates a decrease in periph- eral vision
bilaterally while performing visual field assessment by confronta- tion. Consequently, the NP
anticipates which of the following findings during fundoscopic assessment?: A cup-to-disk ratio
of 70%.
4. A 66-year-old woman presents with a complaint of a 4-day history of a uni- lateral
headache that will not go away despite taking ibuprofen and aceta- minophen. She has a
history of hypertension that is usually well controlled with an ACE inhibitor, but today her blood
pressure is 162/92 mm Hg. During the HPI she admits that she has had some transient visual
loss over the few days, but it has been very short lived and resolves completely. The next step
in the evaluation of this patient should include:: An erythrocyte sedimentation rate
5. Which information best describes the pathophysiology of most mental health
disorders?: Dysregulation of neurotransmitters in relevant pathways
6. The commonality among all seizure etiologies is:: Increased neuron excitability
7. The NP is managing a patient newly diagnosed with essential tremor disorder and
prescribed propranolol. The patient did an internet search for the medica- tion and wants to
know how a "heart medication" can make her stop having hand tremors. What is the best
explanation for this patient?: Propranolol blocks the action of the sympathetic nervous system
in all body systems and so it will calm many things, including the tremors
8. A 48-year-old man presents with a complaint of a 3-week history of intermit- tent
shooting pain that runs down the buttocks and left leg. Suspecting sciatica, the NP would expect
which of the following during physical examination?: Pain with straight leg raise
, 3Ps Assessment- Pathophysiology, Pharmacology, and Physical assessment questions with answers
9. During the routine wellness examination of a 12-year-old male patient, the NP
appreciates a grade II/VI systolic murmur at the apex while the patient is lying on the exam
table. The murmur is louder when the patient moves to the sitting position, appreciated at
grade IV/VI. The cardiac history and review of symptoms is negative. The appropriate approach
to this patient is to:: Order an echocardiogram
10. A 57-year-old woman presents with a 3-day history of fever, dyspnea, and a purulent
cough. Auscultation of the lungs identifies an area of egophony in the lower left lobe. Palpation
reveals increased tactile fremitus. The NP expects which of the following percussion findings?:
Dullness
11. The NP is learning about anginal chest pain unresponsive to nitroglycerin, when does
necrotic injury occur?: The mitochondrial membrane ruptures
12. A 35-year-old female is skiing fast down a steep trail. She falls forward and lands on an
abducted and extended arm. She immediately feels a pop, has exquisite pain over her right
upper shoulder, and has no sensation in her right hand. Her diagnosis is most likely:: Anterior
dislocation of the glenohumeral joint.
13. The NP is evaluating a patient with markedly elevated blood pressure that is
unresponsive to traditional medications. There is some mild pedal edema, but other than the
elevated BP, the physical exam is essentially normal. A metabolic panel reveals the following:
Na+ 151 mEq/LK+ 3.0 mEq/LCl- 114 mEq/LCO2 28 mEq/LBUN 10 mg/dLCreati-
nine 0.9 mg/dL
The NP considers which of the following as a secondary cause of hypertension in this patient?:
Hyperaldosteronism
14. Which of the following statins is preferred for a 67-year-old man with hyper-
cholesterolemia who drinks a glass of grapefruit juice every morning?: Pravastatin
15. A 41-year-old female is being managed by her mental health provider with lithium. She
presents for a primary care wellness exam and has no complaints, but routine laboratory
assessment reveals a TSH of 4.5 iU/L. What is the most appropriate approach for this patient?:
Begin thyroid replacement therapy
