Randell is a 38-year-old male who is 5 feet 8 inches tall and weighs 191 pounds. He reports that he has had intermittent heartburn for several months and takes antacids with temporary relief. He has been waking during the night with a burning sensation in his chest. Which additional information would lead you to believe that gastroesophageal reflex disease (GERD) is the cause of his pain?

A young woman complains to the FNP that she is experiencing headaches, irritability, decreased appetite, and fatigue about 1 week before menses. Appropriate initial management includes which of the following?

Gary, a 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The fundoscopic exam demonstrates cupping of the optic disc. There is no identified opacification of the lens. The nurse practitioner suspects which differential diagnosis?

A 45-year-old female present to the clinic for her wellness exam. She mentions since she turned 41 she has been experiencing difficulty in reading, especially menus at restaurants. The nurse practitioner determines that this patient should be screened for:

You are caring for Cathy, a 14-year-old with suspected appendicitis. Clinical findings most consistent with appendiceal rupture include all of the following except:

A NP student asks her preceptor what is the gold standard when diagnosing patients with otitis media. The preceptor’s best response would be:

Harris, age 68, is complaining of crooked, painful erections. He has palpable, nontender, hard plaques just beneath the skin of his circumcised penis. Based on the chief complaint and assessment, which of the following diagnoses is most likely?

You are the nurse practitioner at an occupational health clinic located in a large factory. A 36-year-old male presents with right eye pain immediately after he has been pounding a metal object with a metal chisel. He was not wearing his safety goggles and felt something strike his right eye. He says since this happened, he has been having tearing and blurred vision of that eye. The nurse practitioner identifies what appears to be a 1mm metal shard to the right of the iris. Blood is noted in the anterior chamber. What does the nurse anticipate as the initial management?

A 59-year-old man reports intermittent right upper quadrant abdominal pain. He is obese and being actively treated for hyperlipidemia. Which diagnostic study should be ordered for this patient?

The nurse practitioner is caring for a 68-year-old with a history of COPD, asthma and hypertension. He presents today for a wellness exam. He mentions to the nurse practitioner that the eye specialist just diagnosed him with open-angle glaucoma. He cannot remember the name of the eye drops that were prescribed. With his medical history, which of the following classes of medication (for glaucoma) would be contraindicated for this patient?