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%

A 61-year-old woman reports sudden, sharp, electric-shock–like pain on the left side of her jaw that lasts for a few seconds at a time. The pain is triggered by brushing her teeth or talking, and she has no facial weakness or numbness. What is the most appropriate next step in her care?

A 63-year-old client with uncontrolled type 2 diabetes is confused about their medications. They also mention feeling tired, skipping meals, and having difficulty managing their blood sugars at home. The team includes an NP, a pharmacist, a dietitian, and a social worker. Which of the following best reflects how the NP can lead a team-based care approach in this case?

During a routine visit, a 19-year-old college athlete reports that she is “trying to stay lean for performance.” BMI is 16.3. On exam, you note bradycardia and lanugo on her arms. She denies vomiting or laxative use. Which feature most strongly supports a diagnosis of anorexia nervosa over other eating disorders?

A 34-year-old woman comes in for her annual exam. She mentions she can’t “shut her brain off” at night, is always tense, and worries something bad will happen to her children even when they’re safe at school. This has been going on for 7–8 months. What is the most likely diagnosis?

You are an NP practicing in a state with reduced practice authority. A client needs a medication adjustment and a referral for imaging. What is the most appropriate next step?