2025 Questions Question 1 A primary care NP is developing a clinical practice guideline

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NR 508 Week 4 Midterm Exam (Version 1) Latest 2025

Questions: Question 1: A primary care NP is developing a clinical practice guideline for management of a patient population in a midsized suburban hospital . The NP should: a . use an existing guideline from a leading research hospital . b . follow the guideline provided by a third-party payer to help ensure reimbursement . c . review expert opinion and experimental, anecdotal, correlational study data . d . write the guideline to adhere to long-standing practice protocols already in use Question 2: A primary care NP prescribes a nitroglycerin transdermal patch, 0 . 4 mg/hour release, for a patient with chronic stable angina . The NP should teach the patient to: a . change the patch four times daily . b . use the patch as needed for angina pain . c . use two patches daily and change them every 12 hours . d . apply one patch daily in the morning and remove in 12 hours . Question 3: A patient is diagnosed with asthma . The primary care nurse practitioner (NP) prescribes an inhaled corticosteroid and an inhaled bronchodilator medication and provides education about how to use inhalers . At a follow-up visit 2 weeks later, the patient’s pulmonary function tests are worse . The NP should: a . provide a detailed written asthma action plan for the patient . b . ask the patient to describe how the medications have been used . c . review the symptoms of an acute asthma exacerbation with the patient . d . teach the patient to use the albuterol more often and order an oral steroid . Question 4: A patient who will undergo surgery in implant a biosynthetic heart valve asks the primary care NP whether any medications will be necessary postoperatively . The NP should tell the patient that it will be necessary to take: a . daily low-dose aspirin for 1 year . b . heparin injections as needed based on activated partial thromboplastin time levels . c . lifelong warfarin combined with enoxaparin as needed . d . warfarin for 3 months postoperatively plus long-term aspirin . Question 5: A patient has a BMI of 35, a fasting plasma glucose of 120 mg/dL, elevated triglycerides, and a history of myocardial infarction . The primary care NP plans to initiate dietary and lifestyle counseling and should consider prescribing: a . ephedra . b . orlistat (Xenical) . c . phentermine (Adipex-P) . d . phentermine and topiramate (Onexa) . Question 6: A patient who has severe arthritis and who takes nonsteroidal antiinflammatory drugs (NSAIDs) daily develops a duodenal ulcer . The patient has tried a cyclooxygenase-2 selective NSAID in the past and states that it is not as effective as the current NSAID . The primary care nurse practitioner (NP) should: a . prescribe cimetidine (Tagamet) .

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