Grumpy helps a reader choose the best hydrangea for their hometown. Plus, Grumpy’s gripe of the week. You can find us online at southernliving.com/askgrumpy Ask Grumpy Credits: Steve Bender aka The Grumpy Gardener - Host Nellah McGough - Co-Host Krissy Tiglias - GM, Southern Living Lottie Leymarie - Executive Producer Michael Onufrak - Audio Engineer/Producer Isaac Nunn - Recording Tech Learn more about your ad choices. Visit podcastchoices.com/adchoices…
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תוכן מסופק על ידי Fitzgerald Health Education Associates. כל תוכן הפודקאסטים כולל פרקים, גרפיקה ותיאורי פודקאסטים מועלים ומסופקים ישירות על ידי Fitzgerald Health Education Associates או שותף פלטפורמת הפודקאסט שלהם. אם אתה מאמין שמישהו משתמש ביצירה שלך המוגנת בזכויות יוצרים ללא רשותך, אתה יכול לעקוב אחר התהליך המתואר כאן https://he.player.fm/legal.
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Daily Deals
Anemic Lab Findings
Manage episode 428976292 series 3456065
תוכן מסופק על ידי Fitzgerald Health Education Associates. כל תוכן הפודקאסטים כולל פרקים, גרפיקה ותיאורי פודקאסטים מועלים ומסופקים ישירות על ידי Fitzgerald Health Education Associates או שותף פלטפורמת הפודקאסט שלהם. אם אתה מאמין שמישהו משתמש ביצירה שלך המוגנת בזכויות יוצרים ללא רשותך, אתה יכול לעקוב אחר התהליך המתואר כאן https://he.player.fm/legal.
You see a 44-year-old woman with a 6-month history of increasing fatigue despite adequate opportunity for sleep and rest. Laboratory results reveal a microcytic, hypochromic anemia with elevated RDW as well as TSH within normal limits. You expect to find which of the following upon review of the patient’s health history?
A. Report that she has been consuming a plant-based diet since age 18
B. Report of menorrhagia
C. A history of alcohol use disorder
D. A diagnosis of rheumatoid arthritis
---
YouTube: https://www.youtube.com/watch?v=fSmpWW2doHE&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=77
Visit fhea.com to learn more!
114 פרקים
שתפוManage episode 428976292 series 3456065
תוכן מסופק על ידי Fitzgerald Health Education Associates. כל תוכן הפודקאסטים כולל פרקים, גרפיקה ותיאורי פודקאסטים מועלים ומסופקים ישירות על ידי Fitzgerald Health Education Associates או שותף פלטפורמת הפודקאסט שלהם. אם אתה מאמין שמישהו משתמש ביצירה שלך המוגנת בזכויות יוצרים ללא רשותך, אתה יכול לעקוב אחר התהליך המתואר כאן https://he.player.fm/legal.
You see a 44-year-old woman with a 6-month history of increasing fatigue despite adequate opportunity for sleep and rest. Laboratory results reveal a microcytic, hypochromic anemia with elevated RDW as well as TSH within normal limits. You expect to find which of the following upon review of the patient’s health history?
A. Report that she has been consuming a plant-based diet since age 18
B. Report of menorrhagia
C. A history of alcohol use disorder
D. A diagnosis of rheumatoid arthritis
---
YouTube: https://www.youtube.com/watch?v=fSmpWW2doHE&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=77
Visit fhea.com to learn more!
114 פרקים
Semua episod
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A 10-year-old of Middle Eastern ancestry , assigned female at birth, is seen for routine well child care. She is generally healthy and plays soccer, reporting excellent exercise tolerance, stating, “I’m the fastest midfield on the team.” Physical examination is within normal limits with Tanner stage 2. Height and weight are at 40% tile, consistent with previous measures. Laboratory evaluation reveals a mild microcytic hypochromic anemia with a NL RDW. This likely represents which of the following? A. Vitamin B 12 deficiency B. G6PD deficiency C. Iron deficiency D. Beta thalassemia minor --- YouTube: https://www.youtube.com/watch?v=ch5dbCqkPTM&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=114 Visit fhea.com to learn more!…
1 Clinical Findings in Heart Failure 11:30
11:30 
הפעל מאוחר יותר 
הפעל מאוחר יותר 
רשימות 
לייק 
אהבתי11:30
הפעל מאוחר יותר הפעל מאוחר יותר רשימות לייק אהבתיA 70 year old man with a 35 year history of hypertension, dyslipidemia, and a 20 year history of type 2 diabetes presents. He was recently diagnosed with systolic heart failure, presenting with dyspnea on exertion and orthopnea. Prior clinical assessment revealed the murmur of mitral regurgitation. Which of the following would the NP anticipate finding on today’s physical exam? A. A mid to late systolic murmur that follows a mid systolic click. B. In early to mid systolic murmur harsh in quality, that radiates to the neck. C. A holosystolic murmur that radiates to the axilla. D. A localized mid to late diastolic murmur. --- YouTube: https://www.youtube.com/watch?v=jN29-on3tn8&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=113 Visit fhea.com to learn more!…
Which of the two following findings would be anticipated in the normal funduscopic exam of a healthy 40-year-old woman who is normotensive, generally in good health and without ocular complaint? A. Arteriovenous nicking B. Optic cup to disc ratio < .0.5 C. Retinal arteries are brighter and narrower than veins D. Slight bulging of the optic disk --- YouTube: https://www.youtube.com/watch?v=VchTtrKTmfw&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=112 Visit fhea.com to learn more!…
Which of the following is most consistent with the clinical presentation of a person with folate-deficiency anemia? A. A 45-year-old woman with uterine fibroids, menorrhagia and a microcytic, hypochromic anemia with elevated RDW B. A 35-year-old woman with newly diagnosed systemic lupus and a normocytic, normochromic anemia with NL RDW C. A 40-year-old woman with alcohol use disorder who drinks 5-6 glasses of wine per day and a macrocytic normocytic anemia with an elevated RDW D. A 65 yo woman with a 20 year-history of hypothyroidism presenting with a 6-month history of stocking-glove neuropathy and a macrocytic, normochromic anemia with an elevated RDW. --- YouTube: https://www.youtube.com/watch?v=VsxbJMBLd4U&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=111 Visit fhea.com to learn more!…
1 Acute Bacterial Prostatitis Treatment 11:37
11:37 הפעל מאוחר יותר הפעל מאוחר יותר רשימות לייק אהבתי11:37
הפעל מאוחר יותר הפעל מאוחר יותר רשימות לייק אהבתיA 70 year old man with a history of BPH, HTN and dyslipidemia presents with a 3-day history of perineal pain, intermittent fever, dysuria, and difficulty initiating urine stream. He denies GI upset and is taking fluids without difficulty. He denies sexual activity with others for the past three years. He is alert, oriented and appears slightly uncomfortable while seated. Abdominal and scrotal exam are WNL, there is no penile discharge and digital rectal exam reveals a tender, enlarged prostate. UA reveals positive leukocyte esterase and > 10 WBCs per HPF. With a working diagnosis of acute bacterial prostatitis, which of the following is the most appropriate antimicrobial option in this clinical scenario? A. Ciprofloxacin PO x 10 days B. IM Ceftriaxone as a one-time dose with doxycycline PO BID X 10 days C. IV piperacillin with tazobactam for 5 days D. Nitrofurantoin PO BID x 5 days. --- YouTube: https://www.youtube.com/watch?v=gS2EITYZ1ps&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=110 Visit fhea.com to learn more!…
1 Diagnosing Acute Bacterial Prostatitis 14:35
14:35 הפעל מאוחר יותר הפעל מאוחר יותר רשימות לייק אהבתי14:35
הפעל מאוחר יותר הפעל מאוחר יותר רשימות לייק אהבתיWhich of the following clinical scenarios is most consistent with an older adult presenting with acute bacterial prostatitis? A. A 65 year old male who presents with a 6 month history of urinary frequency, occasional difficulty initiating urine stream, without dysuria or fever. GU exam within normal limits with the exception of prostate enlargement. B. A 50-year-old male with a 4 day history of increased urinary frequency, end-void dysuria, and intermittent fever. GU exam reveals suprapubic tenderness, without prostatic enlargement or scrotal abnormalities. C. A 70 year old man with a 3-day history of perineal pain, intermittent fever, dysuria, and difficulty initiating urine stream. Scrotal exam WNL and digital rectal exam reveals a tender, enlarged prostate. D. A 78 year old man with a 3 month history of intermittent gross hematuria and urinary frequency without dysuria. GU exam is WNL with the exam of a nontender enlarged prostate with multiple nodular lesions. --- YouTube: https://www.youtube.com/watch?v=tHiLger_l68&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=109 Visit fhea.com to learn more!…
The NP sees a 74-year-old woman with a BMI=30 kg/m2 who has a 30-year history of type 2 diabetes, HTN, and dyslipidemia. Pertinent social history includes the following: a retired elementary school teacher who lives in a 1-story home with her spouse and adult child, nonsmoker, drinks approximately 2, 5 oz glasses of wine per month, and walks approximately 2 miles per day. Her current medications include telmisartan, HCTZ, rosuvastatin, metformin, semaglutide and canagliflozin at optimized doses, and current A1c=9.2%. Her current A1c= 9.2% and is at HTN and lipid goal. Prior mediations have included sitagliptin, with patient stating, “That medication did not help my sugar at all.” She states she is adherent to her medications and dietary advice. Her eGFR is within acceptable parameters and she is feeling well. Physical exams are unremarkable. Which of the following is the most appropriate next step? A. Advise that her A1c is at an age-acceptable level. B. Add post-meal sliding scale rapid acting insulin C. Prescribe basal and pre meal insulin. D. Add oral glipizide. --- YouTube: https://www.youtube.com/watch?v=uZqb0nZpa8k&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=108 Visit fhea.com to learn more!…
Mrs. Mahem is a 68-year-old patient with a 25-year history of type 2 diabetes mellitus. In the past year, her A1c remains at around 8.5% with the use of the following medications: metformin, sitagliptin, and canagliflozin, at optimized doses and with adherence. She states, “ I haven’t changed the way I eat and I walk about ½ h a day, just like I have for years”. Additional health issues include HTN and dyslipidemia, treated with medications and at therapeutic goal, and obesity with a BMI= 33. Her eGFR is 65. Which of the following is the most appropriate next step in the pharmacologic management of her diabetes? A. Add glyburide to enhance glycemic control. B. Consider discontinuing metformin due to age and renal function. C. Advise that her glycemic control is adequate for an older adult. D. Prescribe semaglutide to help her achieve A1c goal. --- YouTube: https://www.youtube.com/watch?v=CBH6MbYUIBQ&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=107 Visit fhea.com to learn more!…
A patient presents with a chief complaint of a gradual onset vision change, present for the past 6 months, while denying eye pain, redness or trauma. The funduscopic exam, extraocular movements and pupillary reactions are within normal limits. When considering a diagnosis of presbyopia, which of the following best describes patient presentation? A. A 50-year-old who states, "I need to hold what I'm reading really far away in order to see it clearly". B. A 75-year-old who states,"When I look at a bright light, I see a colored halo around it". C. An 80-year-old who states, "I have a blurry spot in the middle of my eyesight". D. A 17-year-old who states, "I went to get my driver’s license, but failed the distance vision exam". --- YouTube: https://www.youtube.com/watch?v=KYfi3O-ZMEc&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=106 Visit fhea.com to learn more!…
A 27-year-old woman presents as a new patient to your practice. She is without chief complaint. She asks to, “get a refill on my birth control pills” , having used combined oral contraceptives for the past 12 years without adverse effects. Social history reveals she is a nonsmoker, without recreational drug use, drinks approximately 1-2 mixed drinks per week, and runs 2-3 miles 5 days a week with reported excellent activity tolerance. Her health history is generally unremarkable, but with patient report of a “mild heart murmur that was picked up when I was a teenager during a physical I needed so I could run track. I was told not to worry about it.” Physical exam is unremarkable with the exception of a mid-systolic click followed by a grade II mid to late systolic murmur without radiation. The remainder of the cardiac exam is within normal limits. These findings most likely represent which type of murmur? A. Physiologic B. Aortic stenosis C. Mitral regurgitation D. Mitral valve prolapse --- YouTube: https://www.youtube.com/watch?v=wmGI7v_DPMY&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=105 Visit fhea.com to learn more!…
A 29-year-old who is 8 weeks pregnant presents with a chief complaint of nausea and vomiting. She states, “I’ve been like this for three weeks. I don’t know why this is called morning sickness since I feel sick to my stomach almost all the time”, reporting that she vomits 2-3 times nearly every day, stating, “I was worse 2-3 weeks ago, when I was throwing up 4-5 times a day. I figured out what food really bothers my stomach and cut those out.” A 24-h dietary recall reveals frequent low-fat meals and consistent sipping of liquids. She denies thirst or infrequent urination, and reports, “I’m just tired of feeling this way. I’ve missed so much work and can hardly keep up with my 3-year-old.” Physical exam reveals the following; Alert, appears fatigued, with moist mucous membranes, a 1 lb. weight loss since last visit 4 weeks ago, and minimal epigastric tenderness without rebound. The NP considers advising on the following: A. Initiate therapy with an oral 5HT-3 antagonist such as ondansetron (Zofran®). B. Referral to high-risk for advise on further management. C. Advise on the use of daily dose of oral vitamin B6 with doxylamine. D. Increase fluid and fiber intake. --- YouTube: https://www.youtube.com/watch?v=bh8EQsz8QnI&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=104 Visit fhea.com to learn more!…
The NP sees a 44-year-old male of African ancestry with a BMI=34 kg/m2 and recently diagnosed type 2 diabetes mellitus. He works on a rotating shift in healthcare and reports eating irregularly. He was started on metformin therapy 4 months ago, is at maximum recommended dose, and states he is tolerating the medication well. His initial A1c was 9.8%, with today’s A1c=8.7%. eGFR is within acceptable parameters and he is feeling well, stating, “I was so thirsty and needed to urinate all the time before I started that pill”. Physical exam reveals extensive acanthosis nigricans. He mentions that his health insurance. “Does not pay for all that much. I’m OK with paying for the pill I am taking now, but really cannot afford expensive medicines. “ Which of the following is the most appropriate next step? A. Prescribe weekly injectable semaglutide. B. Adding post-meal sliding scale rapid acting insulin. C. Add a daily dose of pioglitazone. D. Add glipizide on days when his eating schedule is predictable. --- YouTube: https://www.youtube.com/watch?v=xyh0ld2l9_M&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=103 Visit fhea.com to learn more!…
As we step away for a holiday break, we’re excited to revisit some of the most popular episodes of the FNP Certification Q & A Podcast . These listener favorites have informed, inspired, and empowered aspiring NPs on their journey to certification success. Enjoy some of our favorites. We'll catch you in 2025 with fresh questions from Dr. Fitzgerald! In evaluating a 66-year-old man with dilated cardiomyopathy and heart failure, the NP notes a grade 3/6 medium-pitched blowing systolic murmur that radiates to the axillae. What do these findings most likely represent? A.Innocent murmur B. Mitral stenosis C. Aortic regurgitation D. Mitral regurgitation --- YouTube: https://www.youtube.com/watch?v=jhrYmC-kq6Y&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=102 Visit fhea.com to learn more!…
1 [Fan Favorite] COPD Exacerbation 15:20
15:20 הפעל מאוחר יותר הפעל מאוחר יותר רשימות לייק אהבתי15:20
הפעל מאוחר יותר הפעל מאוחר יותר רשימות לייק אהבתיAs we step away for a holiday break, we’re excited to revisit some of the most popular episodes of the FNP Certification Q & A Podcast . These listener favorites have informed, inspired, and empowered aspiring NPs on their journey to certification success. Enjoy some of our favorites. We'll catch you in 2025 with fresh questions from Dr. Fitzgerald! A 72-year-old woman with severe COPD, who uses an inhaled LAMA/ LAMA daily on a set schedule and SABA via MDI as needed for symptom relief, presents with a 4-day history of URI symptoms, starting with sore throat and clear nasal discharge, without fever. She denies N, V, or other GI upset. She now reports a 2-day history of increasing shortness of breath and production of clear to white sputum. SaO2= 97% and she is no acute distress. In considering the diagnosis of COPD exacerbation, which of the following best describes the role of imaging in the evaluation of COPD exacerbation? A. A chest x-ray should be ordered in COPD exacerbation in the patient with fever and/or low SaO2 to help rule out concomitant pneumonia. B. A chest x-ray should be ordered routinely in the evaluation of a person with COPD exacerbation. C. Given the frequency of COPD exacerbations that typically occur in a person with COPD, chest x-ray use should be limited due to radiation exposure risk. D. A thoracic ultrasound is the preferred imaging study to order in a COPD exacerbation. --- YouTube: https://www.youtube.com/watch?v=B3LrB-m6Q7g&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=101 Visit fhea.com to learn more!…
As we step away for a holiday break, we’re excited to revisit some of the most popular episodes of the FNP Certification Q & A Podcast . These listener favorites have informed, inspired, and empowered aspiring NPs on their journey to certification success. Enjoy some of our favorites. We'll catch you in 2025 with fresh questions from Dr. Fitzgerald! A 45-year-old woman with no chronic health problems presents a 6-month history increasing fatigue despite adequate opportunity for rest , worsening dry skin and increased menstrual flow volume. In analyzing the laboratory data below, which is most consistent with the diagnosis of hypothyroidism? A. TSH <0.15 mIU/L (0.4–4.0 mIU/L), free T4=79 pmol/L (10–27 pmol/L) B. TSH=8.9 mIU/L (0.4–4.0 mIU/L), free T4=15 pmol/L (10–27 pmol/L) C. TSH=1.9 mIU/L (0.4–4.0 mIU/L), free T4=22 pmol/L (10–27 pmol/L) D. TSH=64 mIU/L (0.4–4.0 mIU/L), free T4=3 pmol/L (10–27 pmol/L) --- YouTube: https://www.youtube.com/watch?v=vPaY65eXMwU&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=100 Visit fhea.com to learn more!…
As we step away for a holiday break, we’re excited to revisit some of the most popular episodes of the FNP Certification Q & A Podcast . These listener favorites have informed, inspired, and empowered aspiring NPs on their journey to certification success. Enjoy some of our favorites. We'll catch you in 2025 with fresh questions from Dr. Fitzgerald! Saundra is a 72-year-old with hypertension who is on an appropriate dose of an ACE inhibitor with adherence. Today’s BP= 152/96 and is without HTN-related complaint. Physical exam is unremarkable.She has a history of well-controlled asthma and is using ICS/LABA therapy. Due to osteoarthritis, she reports, “I get up slowly. Sometimes I do not get the bathroom on time and I lose my urine control.” Which of the following represents the next best step in Saundra’s HTN therapy? A.Advise that her BP is in an acceptable range B. Thiazide diuretic therapy should be initiated C. Add a CCB to her current therapy D. A beta blocker represents the optimal additional therapy --- YouTube: https://www.youtube.com/watch?v=JRjErXhuqpY&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=99 Visit fhea.com to learn more!…
As we step away for a holiday break, we’re excited to revisit some of the most popular episodes of the FNP Certification Q & A Podcast . These listener favorites have informed, inspired, and empowered aspiring NPs on their journey to certification success. Enjoy some of our favorites. We'll catch you in 2025 with fresh questions from Dr. Fitzgerald! Josh is a well 16-year-old male who presents with a reporting a 4-day history of moderate left-sided otalgia with intermittent fever. Clinical assessment is consistent with acute otitis media (AOM). No drug allergy or recent (within the past month) antimicrobial use is reported. Which of the following represents the most appropriate first-line antimicrobial therapy? A. Oral moxifloxacin B. Oral amoxicillin C. Oral trimethoprim-sulfamethoxazole D. Oral azithromycin --- YouTube: https://www.youtube.com/watch?v=8qSpIir5ht4&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=98 Visit fhea.com to learn more!…
As we step away for a holiday break, we’re excited to revisit some of the most popular episodes of the FNP Certification Q & A Podcast . These listener favorites have informed, inspired, and empowered aspiring NPs on their journey to certification success. Enjoy some of our favorites. We'll catch you in 2025 with fresh questions from Dr. Fitzgerald! A 35-year-old w presents complaining of a 15+ year history of recurrent cramping abdominal pain that is often relieved with defecation that occurs intermittently. Symptom onset is often accompanied by bloating and a change in stool frequency and form, particularly when “I eat certain foods.” She denies bloody or tarry stools, nausea, vomiting or fever. The NP notes the patient’s weight is stable, and there is no evidence of anemia. The most likely diagnosis is? A. Irritable bowel syndrome B. Paralytic ileus C. Peptic ulcer disease D. Ulcerative colitis --- YouTube: https://www.youtube.com/watch?v=2exovTbGVvI&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=97 Visit fhea.com to learn more!…
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NP Certification Q&A
As we step away for a holiday break, we’re excited to revisit some of the most popular episodes of the FNP Certification Q & A Podcast . These listener favorites have informed, inspired, and empowered aspiring NPs on their journey to certification success. Enjoy some of our favorites. We'll catch you in 2025 with fresh questions from Dr. Fitzgerald! The NP sees a 34-year-old woman with a chief complaint of 6-month history of increasing fatigue despite adequate opportunity to sleep and rest. Laboratory results reveal a microcytic, hypochromic anemia with elevated RDW. You expect to find which of the following upon review of the patient’s health history? A. Report that she has been eaten a plant-based diet since age 18 B. History of prolonged menses with the need for =8 pads per day C. Report of drinking 5 or more 5 oz glasses of wine daily D. A prior diagnosis of rheumatoid arthritis --- YouTube: https://www.youtube.com/watch?v=bXell7YIQKE&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=96 Visit fhea.com to learn more!…
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NP Certification Q&A
Which of the following is most accurate about nurse practitioner’s scope of practice? A. The organization that grants NP certification dictates a profession scope of practice. B. The employer is able to require the NP to provide services that are beyond what regulatory bodies outline. C. The law of the state where the NP practices provides regulatory guidance on scope of practice. D. Federal law advises on NP scope of practice. --- YouTube: https://www.youtube.com/watch?v=jNdOys7R_Qs&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=95 Visit fhea.com to learn more!…
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NP Certification Q&A
A four-week-old infant born at 39 weeks’ gestation, exclusively breast fed and has been healthy was brought in for an evaluation following a 2 day history of projectile vomiting that occurs after each feeding without with increased fussiness. The child's father mentioned that the baby appears to be without distress after vomiting and wants to feed immediately afterwards. Parents deny the infant has had fever, diarrhea or skin lesion; in addition, has not had exposure to individuals with similar symptoms. His last BM was about 18 hours ago, described as small and firm. Physical exam reveals an alert, active infant with a small palpable mask that is appreciated in the right upper quadrant of the abdomen. The most likely diagnosis is: A. Viral gastroenteritis B. Pyloric stenosis C. Intussusception D. Gastroesophageal reflux --- YouTube: https://www.youtube.com/watch?v=dBwlvf6QtXc&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=94 Visit fhea.com to learn more!…
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NP Certification Q&A
A 25-year-old woman gravida 2, para 1 is 24 weeks pregnant and is being seen for an urgent care visit. She reports a constant headache over the past two days along with ankle swelling. Her BP today is 162/86 in, which is a significant elevation from her pre pregnancy blood pressure of 122/68.Laboratory results indicate 2 plus proteinuria as well as elevated ALT and AST. Platelets and LDH are within normal limits, as is fundoscopic and neurological exams. The most likely diagnosis is: A. Health syndrome B. Gestational hypertension C. Preeclampsia D. Hypertensive emergency --- YouTube: https://www.youtube.com/watch?v=-HSR0zonmZA&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=93 Visit fhea.com to learn more!…
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NP Certification Q&A
A 77-year-old man is in for a routine follow up visit. He has its twenty-year history of type 2 diabetes and hypertension as well as a 5-year history of stage 3B chronic kidney disease, or CKB. At this visit, his A1C is 8.4% and his estimated GFR is 42 mL per minute. His BP is 128/76. He states he's feeling well and denies headache, visual changes, dizziness and hypoglycemic episodes. His medications include metformin, amlodipine, lisinopril and rosuvastatin. In reviewing his current medication, the NP considers which of the following options? A. Prescribe glipizide B. Add pioglitazone C. Continue on his current medication without adjustment D. Initiate therapy with Canagliflozin --- YouTube: https://www.youtube.com/watch?v=rOuR7ATNdMQ&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=92 Visit fhea.com to learn more!…
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NP Certification Q&A
A 72-year-old woman with a 20-year history of hypertension and dyslipidemia-- both at EBP goals with appropriate drug therapy, as well as a remote history of peptic ulcer disease-- presents for follow up. She is a nonsmoker, drinks about 1- 2 glasses of wine per week and denies the use of other substances. Her daily routine includes a 2- 3 mile walk and she denies history of acute coronary syndrome or other ASCVD related conditions. She mentions that one of her friends takes an aspirin a day to “prevent a heart attack or a stroke”, and further states, “I live alone, and I need to maintain my independence.” According to the latest recommendations from US Preventative Services Task Force, which of the following is the most appropriate advice regarding low dose aspirin use in this patient? A. Start low dose aspirin therapy 81 mg daily as the vascular benefits outweigh the risk. B. Best evidence for primary prevention of ASCBT event is with higher dose aspirin at 325 mg a day. C. The risks associated with aspirin therapy in this patient outweigh the potential benefits. D. Start aspirin therapy only if the patient has a family history of heart disease and 1st degree relatives. --- YouTube: https://www.youtube.com/watch?v=9uK3CINTFOg&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=91 Visit fhea.com to learn more!…
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NP Certification Q&A
A 57-year-old man presents for a routine physical exam during history taking. He reports that he drinks approximately 7-to-8 12-ounce beers nightly and denies other substance use, including tobacco. His physical examination is unremarkable except for mild pharyngeal erythema without exudate. In consideration of his health history, which of the following lab results would be anticipated? A. Elevated platelets B. Macrocytosis C. Lymphocytosis D. Elevated sed rate --- YouTube: https://www.youtube.com/watch?v=57EyxtFcUUY&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=90 Visit fhea.com to learn more!…
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NP Certification Q&A
Which of the following are the most common features of skin changes noted in areas of the feet affected by tinea pedis? A. Widely distributed with consistently raised with areas of hyperpigmentation. B. Localized to the dorsal aspect with central clearing and a raised border C. Involving plantar crusting and interdigital fissures D. Remains stable in size over time with lateral lichenification. --- YouTube: https://www.youtube.com/watch?v=D70UTIMym6w&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=89 Visit fhea.com to learn more!…
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NP Certification Q&A
Mrs. Martinez is a 64-year-old woman with 10 year-history of type 2 diabetes mellitus, HTN, and dyslipidemia. Her current medications include metformin, an SGLT-2 inhibitor, statin, ARB and thiazide diuretic. She is at EBP-advised goals including recent A1c=6.9%. Today, she reports she is feeling well. Her history and physical examination are unremarkable. She mentions that, for the past year, in addition to her prescribed medications, she drinks a special tea blend that her sister makes, taking this each day to help “draw out the sugar” in her blood. She states, “I feel much better when I take it.” Your most appropriate response is: A. “I don’t believe the tea is helpful in controlling your blood sugar.” B. "Please stop using the tea until I can look into its contents." C. "Homemade teas might interact with your medicines” D. “Tell me more about how the tea draws out the sugar.” --- YouTube: https://www.youtube.com/watch?v=5GGHqGo59LQ&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=88 Visit fhea.com to learn more!…
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NP Certification Q&A
A 76-year-old woman with presbycusis presents for a follow-up visit on HTN and dyslipidemia, treated with an ARB, thiazide diuretic and a statin, and at treatment goal. Which of the following is she likely to report? A. Occasional difficulty with speech discrimination B. Need to use her prescription eyeglasses to read C. Altered sense of smell D. Diminished sense of touch --- YouTube: https://www.youtube.com/watch?v=cj_Qj5hOvS4&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=87 Visit fhea.com to learn more!…
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NP Certification Q&A
A 24-year-old adult, assigned female at birth, presents to your practice chief complaint of bilateral lower abdominal pain for the past three days, worsening over this time frame. She describes the pain as a heavy pressure like feeling, accompanied by intermittent fever , mild dysuria, yellow vaginal discharge, as well as nausea without vomiting nausea without vomiting. She is tolerating fluids well and has a markedly decreased appetite. Additional history of present illness includes recent LMP, ending about three days ago with normal timing and normal flow, she is sexually active with two male partners, and describes that the last episode of coitus six days ago was painful for deep pelvic discomfort. The physical exam reveals a temp of 100.4 Fahrenheit, rest of vital signs within normal limits, mild lower abdominal discomfort to light and deep palpation without rebound, yellow vaginal discharge and cervical motion tenderness without palpable pelvic mass. This clinical presentation is most consistent with: A. Acute Appendicitis B. Pelvic Inflammatory Disease C. Ovarian Cyst D. Ectopic Pregnancy --- YouTube: https://www.youtube.com/watch?v=hS0zWLA9b_A&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=86 Visit fhea.com to learn more!…
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NP Certification Q&A
A 14 yo presents with a 4 h history of sudden onset LLQ abdominal and scrotal pain, described as a pulling, burning sensation. He denies vomiting, diarrhea or constipation, and reports mild nausea and is taking fluids without difficulty. HPI is negative for recent trauma to the region, dysuria, penile discharge, genital lesions or fever. He reports milder, similar episodes during the past 3 months, “that just went away.” Physical exam reveals loss of the cremasteric reflex, negative Blumberg sign and a high riding left testicle. A. Testicular Neoplasia B. Acute Epididymitis C. Incarcerated Inguinal Hernia D. Testicular Torsion --- YouTube: https://www.youtube.com/watch?v=cGczKmYTdVU&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=85 Visit fhea.com to learn more!…
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