A 48 year old female patient presents to clinic with bilateral hand and finger pain. The patient also notes that her finger joints are swollen. She identifies that the pain is worst in the early morning and improves after about 2 hours when she “gets up and moving” for the day. Based on the patient’s presentation, you know which of the following is the most important to order?

A 49-year-old woman reports difficulty sleeping due to an uncomfortable, crawling sensation in her legs that improves when she walks. Symptoms are worse in the evening. Which additional finding would best support the diagnosis of restless legs syndrome?

Which of the following statements best describes a key difference in the scope of practice between a physician (MD), physician assistant (PA), and nurse practitioner (NP) in California?

A nurse practitioner’s role on the interdisciplinary team includes which of the following responsibilities? (SELECT ALL THAT APPLY)

A 56 year old patient is following up on their new diagnosis of diabetes type 2. During the last visit, you focused on teaching BG checks at home, lifestyle changes, and about the patient’s new medications. You also prescribed metformin 1000 mg BID. During your follow up today, you know it is important to complete/order which of the following: (SELECT ALL THAT APPLY)

A 38-year-old man reports bursts of extreme energy every few months. During these periods, he doesn’t sleep, spends excessive money, and talks nonstop. He admits that afterward, he crashes and feels hopeless for weeks. What should be your top concern?

A 45-year-old man presents with fatigue, painless swelling in his neck, and a 15-pound unintentional weight loss over two months. He reports night sweats and intermittent fevers. On physical exam, he has firm, non-tender cervical lymphadenopathy. CBC shows a normal white blood cell count. What is the most likely diagnosis?

As a Nurse Practitioner in California, you are preparing to prescribe a Schedule II controlled substance for a new patient with chronic pain. Which of the following actions demonstrates responsible prescribing practices in accordance with state requirements?

A 68-year-old client is recovering from a recent stroke and presents with mild aphasia, difficulty managing medications, and concerns about meal prep at home. The NP completes a focused assessment. Which of the following best reflects a team-based next step?

A 56 year old male reports to clinic for a lab follow up after his annual physical. His PMH includes HLD (diet controlled), ACL status post surgical autograft repair, thyroidectomy, and prediabetes. His labs are as follows: Complete Metabolic Panel (CMP) Test Result Reference Range Sodium 139 mmol/L 135 – 145 mmol/L Potassium 4.2 mmol/L 3.5 – 5.1 mmol/L Chloride 102 mmol/L 98 – 107 mmol/L Bicarbonate (CO₂) 24 mmol/L 22 – 29 mmol/L BUN 13 mg/dL 7 – 20 mg/dL Creatinine 0.9 mg/dL 0.6 – 1.2 mg/dL Glucose (fasting) 89 mg/dL 70 – 99 mg/dL Calcium 7.1 mg/dL 8.5 – 10.5 mg/dL AST (SGOT) 20 U/L 10 – 40 U/L ALT (SGPT) 23 U/L 7 – 56 U/L ALP 72 U/L 40 – 129 U/L Total Protein 7.0 g/dL 6.0 – 8.3 g/dL Albumin 4.5 g/dL 3.4 – 5.4 g/dL Total Bilirubin 0.7 mg/dL 0.1 – 1.2 mg/dL Complete Blood Count (CBC) Test Result Reference Range WBC 6.2 x10⁹/L 4.0 – 10.5 x10⁹/L Hemoglobin 14.6 g/dL 13.5 – 17.5 g/dL (male) Hematocrit 44% 41 – 53% (male) MCV 90 fL 80 – 100 fL Platelets 250 x10⁹/L 150 – 450 x10⁹/L Neutrophils 58% 40 – 70% Lymphocytes 32% 20 – 45% Thyroid Panel Test Result Reference Range TSH 1.8 μIU/mL 0.4 – 4.5 μIU/mL Free T4 1.2 ng/dL 0.8 – 1.8 ng/dL Free T3 3.1 pg/mL 2.3 – 4.1 pg/mL Hemoglobin A1c Test Result Reference Range A1c 5.9%