Which of the following is most accurate about nurse practitioner’s scope of practice?A. The organization that grants NP certification dictates a profession scope of practice.B. The employer is able to require the NP to provide services that are beyond what regulatory bodies outline.C. The law of the state where the NP practices provides regulatory guidance on scope of practice.D. Federal law advises on NP scope of practice.Visit fhea.com to learn more!

A four-week-old infant born at 39 weeks’ gestation, exclusively breast fed and has been healthy was brought in for an evaluation following a 2 day history of projectile vomiting that occurs after each feeding without with increased fussiness. The child's father mentioned that the baby appears to be without distress after vomiting and wants to feed immediately afterwards. Parents deny the infant has had fever, diarrhea or skin lesion; in addition, has not had exposure to individuals with simil...

A 25-year-old woman gravida 2, para 1 is 24 weeks pregnant and is being seen for an urgent care visit. She reports a constant headache over the past two days along with ankle swelling. Her BP today is 162/86 in, which is a significant elevation from her pre pregnancy blood pressure of 122/68.Laboratory results indicate 2 plus proteinuria as well as elevated ALT and AST. Platelets and LDH are within normal limits, as is fundoscopic and neurological exams. The most likely diagnosis is: A. Healt...

A 77-year-old man is in for a routine follow up visit. He has its twenty-year history of type 2 diabetes and hypertension as well as a 5-year history of stage 3B chronic kidney disease, or CKB. At this visit, his A1C is 8.4% and his estimated GFR is 42 mL per minute. His BP is 128/76. He states he's feeling well and denies headache, visual changes, dizziness and hypoglycemic episodes. His medications include metformin, amlodipine, lisinopril and rosuvastatin. In reviewing his current medicati...

A 72-year-old woman with a 20-year history of hypertension and dyslipidemia-- both at EBP goals with appropriate drug therapy, as well as a remote history of peptic ulcer disease-- presents for follow up. She is a nonsmoker, drinks about 1- 2 glasses of wine per week and denies the use of other substances. Her daily routine includes a 2- 3 mile walk and she denies history of acute coronary syndrome or other ASCVD related conditions. She mentions that one of her friends takes an aspirin a day ...

A 57-year-old man presents for a routine physical exam during history taking. He reports that he drinks approximately 7-to-8 12-ounce beers nightly and denies other substance use, including tobacco. His physical examination is unremarkable except for mild pharyngeal erythema without exudate. In consideration of his health history, which of the following lab results would be anticipated?A. Elevated plateletsB. MacrocytosisC. LymphocytosisD. Elevated sed rate ---YouTube: https://www.youtube.com...

Which of the following are the most common features of skin changes noted in areas of the feet affected by tinea pedis?A. Widely distributed with consistently raised with areas of hyperpigmentation.B. Localized to the dorsal aspect with central clearing and a raised borderC. Involving plantar crusting and interdigital fissuresD. Remains stable in size over time with lateral lichenification.---YouTube: https://www.youtube.com/watch?v=D70UTIMym6w&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&...

Mrs. Martinez is a 64-year-old woman with 10 year-history of type 2 diabetes mellitus, HTN, and dyslipidemia. Her current medications include metformin, an SGLT-2 inhibitor, statin, ARB and thiazide diuretic. She is at EBP-advised goals including recent A1c=6.9%. Today, she reports she is feeling well. Her history and physical examination are unremarkable. She mentions that, for the past year, in addition to her prescribed medications, she drinks a special tea blend that her sister makes, tak...

A 76-year-old woman with presbycusis presents for a follow-up visit on HTN and dyslipidemia, treated with an ARB, thiazide diuretic and a statin, and at treatment goal. Which of the following is she likely to report?A. Occasional difficulty with speech discriminationB. Need to use her prescription eyeglasses to readC. Altered sense of smellD. Diminished sense of touch---YouTube: https://www.youtube.com/watch?v=cj_Qj5hOvS4&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=87Visit fhea.com ...

A 24-year-old adult, assigned female at birth, presents to your practice chief complaint of bilateral lower abdominal pain for the past three days, worsening over this time frame. She describes the pain as a heavy pressure like feeling, accompanied by intermittent fever , mild dysuria, yellow vaginal discharge, as well as nausea without vomiting nausea without vomiting. She is tolerating fluids well and has a markedly decreased appetite. Additional history of present illness includes recent L...

A 14 yo presents with a 4 h history of sudden onset LLQ abdominal and scrotal pain, described as a pulling, burning sensation. He denies vomiting, diarrhea or constipation, and reports mild nausea and is taking fluids without difficulty. HPI is negative for recent trauma to the region, dysuria, penile discharge, genital lesions or fever. He reports milder, similar episodes during the past 3 months, “that just went away.” Physical exam reveals loss of the cremasteric reflex, negative Blumberg ...

A 24-year-old woman presents to your practice with a diagnosis of pelvic inflammatory disease, suitable for outpatient treatment. Which of the following is recommended? Chose two that apply.A. A single dose of IM ceftriaxoneB. A two-week course of oral doxycycline and oral metronidazoleC. A five-day course of oral azithromycin with a one-week course of oral ciprofloxacinD. A single dose of IM penicillin---YouTube: https://www.youtube.com/watch?v=yZg1jA7SkAc&list=PLf0PFEPBXfq592b5zCthlxSNI...

A 72-year-old man presents to primary care for a sick visit, with the chief complaint of a one-day history of fever, projective cough with yellow sputum and increasing shortness of breath. He denies GI distress but states his appetite is not what it usually is. He has a history of hypertension, type 2 diabetes, and dyslipidemia at guideline-based goals. He is a former smoker, quitting about 10 years ago with approximately a 35-pack-year history and was diagnosed 5 years ago with COPD. C...

A 9-year-old female presents for well child care with her parent. She is in the 4th grade, doing well academically, plays soccer on a local team, and reports, “I have 3 best friends”. Health history per parent and child reveals no concerns. On physical exam the clinician's notes the child is at about 40th percentile height and weight for age, and has breast budding and downy, straight, slightly pigmented pubic hair long the labia majora.These physical findings are consistent with:A. Precociou...

A 40-year-old computer programmer presents for a sick visit with the chief complaint of a two-day history of low back pain. He reports the pain started after many hour stretch of doing yard work. The pain is described as a dull constant ache, worse with activity, better with rest, across the lower back, without radiation to the legs. He denies leg weakness, tingling, or numbness, and states he had similar pain in the past after doing extensive lifting. In considering the diagnosis of lumbar s...

A 22-year-old woman who is 20-weeks pregnant was treated for C. trachomatis 4 weeks ago with an appropriate antimicrobial. She presents today for a follow-up visit and reports she is currently without symptoms, that her partner was also treated, “And we both took the medicine just as we were advised.” Which of the following represents next steps in this patient’s care?Choose two that apply. A. Testing for C. trachomatis should be obtained at today’s visit.B. A repeat of C. trachoma...

A 55-year-old man with a BMI of 40%, with the chief complaint of low back pain for the past two weeks. He describes the pain as originating in the lumbar sacral region, with radiation across the left buttock associated with numbness and tingling sensation in his left leg. The pain is worse with sitting and somewhat better with standing. He denies lower extremity weakness or a change in bowel or bladder function. He states, “I've tried ice, heat and ibuprofen and these just take the edge off. ...

A 45-year-old adult presents for a sick visit, with the chief complaint of three-day history of low back pain. Clinical assessment is consistent with lumbar sacral strain. Which of the following represents the most appropriate next step in this person's care? A. Advised three days of bed rest on a firm surface. B. Apply ice or heat to the affected area based on clinical response.C. Refer to neurology for further advice. D. Order a lumbar sacral x ray to help confirm the diagnosis.---YouTube: ...

You see a 44-year-old woman with a 6-month history of increasing fatigue despite adequate opportunity for sleep and rest. Laboratory results reveal a microcytic, hypochromic anemia with elevated RDW as well as TSH within normal limits. You expect to find which of the following upon review of the patient’s health history?A. Report that she has been consuming a plant-based diet since age 18 B. Report of menorrhagia C. A history of alcohol use disorderD. A diagnosis of rheumatoid arthritis...

A 48-year-old woman presents for follow up on T2DM and HTN. As part of today’s visit, routine labs are ordered. Which of the following is an appropriate form of electronic communication for sharing these results with the patient?A. Private message through Facebook® or similar social media website with patient permissionB. Electronic fax or scan uploaded to the patient’s personal account for a third-party file sharing service (e.g., DropBox®) C. Using encrypted email or other...

A 72-year-old man presents to primary care for a sick visit, with the chief complaint of a one day history of fever, productive cough with yellow sputum and increasing shortness of breath. His vital signs are as follows, temp 99.8 °F (37.6 °C) , BP 140/85, heart rate 98 beats per minute, and respiratory rate 22 at rest period O2 saturation is 94% on room air. He has a history hypertension and type 2 diabetes, at guideline-based goals. He is a former smoker, quitting about 35 years ago with ap...

A 49-year-old woman with type 2 diabetes mellitus was started on a standard dose of an ARB daily 6 weeks ago for the management of hypertension. Today her blood pressure is 128/78 mm Hg, stating she is taking the medication without difficulty and is feeling well. The appropriate action at this time would be to:A. Order a white blood cell count to assess for neutropenia.B. Continue her current medication regimen. C. Add HCTZ to enhance HTN control.D. Obtain a 12-lead ECG---YouTube: https...

Esteban is an 18-month-old child who presents with his father for a sick visit. The child, who is typically healthy and UTD with immunizations and has no drug allergies, has had URI-like symptoms for the past 6 days with congested cough and clear to yellow nasal discharge. Per parental report, Esteban is drinking fluids without difficulty and has a slightly reduced appetite and had a single episode of post tussive vomiting 3 days ago. For the past 36 hours, his father reports increased ...

An 18-month-old toddler, Estaban, presents with his father for a sick visit. The child, who is typically healthy and UTD with immunizations, has had URI-like symptoms for the past 6 days with congested cough and clear to yellow nasal discharge. Per parental report, Esteban is drinking fluids without difficulty and has a slightly reduced appetite and had a single episode of post tussive vomiting 3 days ago. For the past 36 hours, his father reports increased crankiness and intermittent f...