A patient presenting with nasal congestion, fever, purulent nasal discharge, headache, and facial pain has been diagnosed with sinusitis and began treatment with amoxicillin (a penicillin class antibiotic).  At a follow-up visit 10 days after initiation of treatment, the patient continues to have purulent discharge, congestion, and facial pain without fever. What will the APRN order next?

A 45-year-old patient reports a recent onset of unilateral shoulder pain which is described as diffuse and is associated with weakness of the shoulder but no loss of passive range of motion. What do you suspect as the cause of those symptoms?

 You can include a reference from the National Sleep Foundation on tips for good sleep hygiene in your after visit summary.   When educating your patients regarding good sleep hygiene include the following information:

A 20-year-old patient presents with a 2-day history of right sided otalgia, itchy ear and a feeling like “my ear is full of water.” You palpate the external ear, helix and tragus. The patient withdraws and states “that hurts!” You diagnose this patient with otitis externa and note/recommend:

You ordered a CBC on your 72-year-old female patient with signs and symptoms of anemia. The results of her CBC confirm your diagnosis of anemia. Which of the following statements about anemia is incorrect?

Your last patient of the day is a 78-year-old man with a history of stage 2 chronic kidney disease. He is not anemic. His GFR is 54 mL/min/1.73 cm2. Based on this criteria, how often would you monitor this patient for anemia of CKD?

Your next patient has been diagnosed with Vitamin B12 deficiency. Which of the following conditions is NOT associated with vitamin B12 deficiency?

Your next patient is 73-year-old female with progressive right hip pain. She has been having symptoms for months. She has noticed the beginning signs of limited mobility, especially over the past 3-4 week. As you consider your patient’s age, hip anatomy, and previous history, you know the following:

Intractable dizziness can be complicated to evaluate in the older adult.  Always concerned about fall risk, fracture and/or head injury.  This population may multiple medications and have numerous specialists prescribing their medications.  It is your job as a primary care provider to look at all of their medications  What medications are NOT generally problematic and can be used safely without caution for the older patient population?

Your next patient is a 22-year-old woman who presents with shortness of breath. Asthma is in your list of differentials for shortness of breath. You ordered a short acting beta 2 treatment to determine reversible airflow obstruction. The APRN knows the following about the diagnosis of asthma: