Question 1. Osteopenia is diagnosed in a 55-year-old woman who has not had a period in 15 months. She has a positive family history of breast cancer. The primary care NP should recommend:

a. testosterone therapy.
b. estrogen-only therapy.
c. nonhormonal drugs for osteoporosis.
d. estrogen-progesterone therapy for 1 to 2 years.

Question 2. A woman is in her first trimester of pregnancy. She tells the primary care nurse practitioner (NP) that she continues to have severe morning sickness on a daily basis. The NP notes a weight loss of 1 pound from her previous visit 2 weeks prior. The NP should consult an obstetrician and prescribe:

a. aprepitant (Emend).
b. ondansetron (Zofran).
c. scopolamine transdermal.
d. prochlorperazine (Compazine).

Question 3. A 75-year-old patient who has cardiovascular disease reports insomnia and vomiting for several weeks. The primary care NP orders thyroid function tests. The tests show TSH is decreased and T4 is increased. The NP should consult with an endocrinologist and order:

a. thyrotropin.
b. methimazole.
c. levothyroxine.
d. propylthiouracil.

Question 4.(2pts): A 55-year-old patient with no prior history of hypertension has a blood pressure greater than 140/90 on three separate occasions. The patient does not smoke, has a body mass index of 24, and exercises regularly. The patient has no known risk factors for cardiovascular disease. The primary care NP should:

a. prescribe a thiazide diuretic and an angiotensin-converting enzyme inhibitor.
b. perform a careful cardiovascular physical assessment.
c. counsel the patient about dietary and lifestyle changes.
d. order a urinalysis and creatinine clearance and begin therapy with a b-blocker.

Question 5. A patient reports fatigue, weight loss, and dry skin. The primary care nurse practitioner (NP) orders thyroid function tests. The patient’s thyroid stimulating hormone (TSH) is 40 microunits/mL, and T4 is 0.1 ng/mL. The NP should refer the patient to an endocrinologist and prescribe:

a. methimazole.
b. liothyronine.
c. levothyroxine.
d. propylthiouracil.

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