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NR 667 Vise call focused Possibilities with complete answers latest 2025/2026NR 667 Vise call focused Possibilities with complete answers latest 2025/2026
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dental abscess migraine Sinusitis labs - correct answerCBC, Sinus X-ray/CT if chronic Diagnosis based on history and PE unless complications Sinusitis non-pharm - correct answerRest, hydration, warm compress to sinuses Use humidifier/ saline nose spray Sinusitis pharm - correct answerWatchful waiting for viral vs bacterial Start prior to bacterial timeframe for immunocompromised or severe illness such as fever, moderate-severe pain, unilateral tenderness, worsening symptoms Adults- Augmentin 875/125mg BID x 10 days PCN allergy Doxy 100mg BID x 7 days Peds- Amoxiciilin 80-90mg/kg BID 5-7 days PCN allergy cefpodoxime 5 mg/kg q12h for 10 days (2 mo-12 yrs) or 200 mg q12h for 10 days (>12 yrs) Sinusitis follow-up - correct answerf/u 1 week for effectiveness or if symptoms worsen 3-5 days ENT if recurrent infections ER if meningitiis Immediate referral for periorbital edema
Reflux differentials - correct answerH. Pylori infection PUD Asthma
or Intranasal antihistamines may be prescribed for patients with seasonal, perennial, or episodic AR. Allergic Rhinitis follow-up - correct answerF/U 5-7 days after mono therapy, switch to another first line monotherapy if first failed Referral to ENT needed if symptoms persist or worsen
Cardio- heart sounds, perform symmetrical pulses Lungs- SOB, pulmonary edema Neuro- occipital headache, headache upon awakening, dizziness Auscultate for carotid bruits bilaterally, abdominal bruits, and kidney bruits HTN Diagnostics - correct answerCBC, CMP, UA TSH, Lipid, fasting glucose EKG, CXR HTN non pharm - correct answerLifestyle modification: weight loss, smoking/alcohol cessation, healthy diet, and sodium reduction Maintain BP log 2x/ daily and bring to next f/u HTN pharm - correct answerDiuretics: Hydrochlorothiazide (HCTZ) 25mg/day max 50mg/day) *May worsen gout and elevate lipids and glucose. Preferred in patient with osteoporosis and African Americans. o Ace inhibitors (-PRIL): Complicated HTN, renal/cardio protective for DM patients. (Lisinopril 10mg/day) *Hyperkalemia risk. If patient develops angioedema transition to ARBs o ARB's (-SARTAN): Renal/cardio protective for DM patients. (Losartan 25mg/day) *Hyperkalemia risk. o CCB's (-PINE): Preferred in African American and patient >65 years old with (with stiff artery). (Amlodipine besylate 5mg/day) *Watch for lower extremity edema and avoid in GERD patients (weakens gastric sphincter). o Consider ACE/ARB in patients with DM, proteinuria, HF. (ACE/ARB contraindicated in pregnancy). o If stage 2 HTN, initiate 2 drug classes (Diuretics and CCB). o BP meds safe for pregnancy: Nifedipine, Labetalol, and Methyldopa HTN F/U - correct answerReassess in 1 month for effectiveness of BP-lowering medication therapy. If goal is met at 1 month, reassess in 3 to 6 months. If goal is not met after 1 month, consider different medication or titration
Lipid panel UA Liver function Hyperlipidemia non pharm - correct answerLifestyle changes (diet and exercise), weight loss, smoking cessation, avoid alcohol, eat food with high omega 3 (fish) Hyperlipidemia pharm - correct answerhigh intensity if LDL > Moderate risk- statin + lifestyle changes Intitiate statin therapy as secondary prevention for patients with risk factors such as history of stroke