A 55-year-old male presents to the clinic with complaints of sudden onset severe pain, erythema, and swelling in his right big toe joint. Based on the presenting symptoms, the nurse practitioner suspects an acute gout attack. Which of the following statements regarding the diagnosis of gout is true?

NJ is receiving 40 mg po morphine/day.  You wish to convert him to po oxycodone (Oxy IR).  Which of the following regimens is the best recommendation for this patient?   Assume a 25% reduction for incomplete cross tolerance.  The following conversions are provided for you:   Drug IV (mg) Oral (mg) Morphine 10 30 Oxycodone N/A 20

Anthony is a 70yo male who presents with complaints of substernal chest pain (he ranked as a 5 out of 10) that occurred while doing yard work.  His pain resolved after he rested.  He feels frustrated because this problem is limiting him from getting exercise.  His PMH includes hypertension for which he takes metoprolol (Lopressor) 12.5 mg BID.  He takes no other medications and does not smoke. Vitals:  BP 140/70, HR 72, RR 20, and EKG is normal sinus rhythm (NSR).  Now with the diagnosis of angina, which is (are) the most appropriate recommendation(s) for Anthony at this time?

KP is a 64-year-old African American woman with a history of ischemic stroke several months ago. She was previously prescribed ASA 325 mg daily but developed an allergy to ASA and stopped taking it 2 weeks ago. Which one of the following is the most appropriate recommendation at this time?

An orthopedic surgeon writes an order for a 85 y/o elderly male patient who is post-op hip replacement. He has acute pain from his procedure (7 on scale 0-10) and no history of chronic pain.  The surgeon asks for your opinion on his order. He writes: Hydrocodone 5mg/Acetaminophen 500mg (Vicodin, Norco) per tablet. Dosage: i-ii (One or Two) tablets Q3H (Every Three Hours) as needed for pain. What is the best response to this order?

JP, a 17-year-old male, presents with a three-day history of redness, tenderness, and warmth in his left lower leg, where he also reports a spider bite that has not healed properly. Given that the infection is non-purulent and localized, with no systemic signs or symptoms, you suspect an uncomplicated case of cellulitis. Considering JP’s medical background of hypothyroidism, for which he takes levothyroxine, and his obesity, which pathogens are most likely responsible for his cellulitis?

Which medication is considered to be the drug of choice for children with acute otitis media? Assume no drug allergies or recent antibiotic therapy.

Which of the following medication (s) is a xanthine oxidase inhibitor and can therefore be beneficial in hyperuricemia?

Angela is a 79yo Caucasian female with a history of heart failure with reduced ejection fraction (HFrEF) and hypertension.  Her BP is 142/76 and heart rate is 73 bpm.  Medications include carvedilol (Coreg*) 25mg twice daily, lisinopril (Zestril*) 40 mg daily, Empagliflozin (Jardiance*) 10mg daily and furosemide (Lasix*) 40 mg daily. She has been fairly compliant with the recommended lifestyle modifications.  Angela returns to your clinic 2 months later with a new complaint of a dry cough.  Her lungs are clear, weight and labs are unchanged, and she has no other symptoms.  Which of the following is most appropriate?

The use of metoprolol (Lopressor* / Toprol XL*), a cardioselective (also known as β1 selective) beta blocker, is absolutely contraindicated in patients with COPD (or asthma) despite any possible compelling indications (e.g. stable heart failure or IHD).