NP Risk Assessment & Management 4

Question 1

A 50-year-old African American male has a blood pressure of 138/88 mmHg at two separate visits. Per JNC 8/ACC/AHA guidelines, what is the appropriate threshold for initiating pharmacologic treatment in this patient?

Accepted Answer

130/80 mmHg

Answer

ACC/AHA 2017 guidelines recommend initiating antihypertensive therapy in adults with stage 1 hypertension (≥130/80 mmHg) who have 10-year ASCVD risk ≥10%.

Question 2

Which factor is MOST associated with increased risk of opioid misuse when initiating opioid therapy for chronic pain?

Accepted Answer

History of substance use disorder

Answer

A personal history of substance use disorder is the strongest predictor of opioid misuse risk and should be carefully weighed using validated tools such as the ORT before prescribing.

Question 3

A nurse practitioner uses the STOP-BANG questionnaire and a patient scores 5. What is the appropriate next step in management?

Accepted Answer

Refer for polysomnography (sleep study)

Answer

A STOP-BANG score ≥3 indicates high risk for obstructive sleep apnea (OSA), and a score of 5 warrants referral for polysomnography to confirm the diagnosis.

Question 4

When performing a skin cancer risk assessment, which patient characteristic carries the HIGHEST independent risk for melanoma?

Accepted Answer

Use of indoor tanning beds before age 35

Answer

Indoor tanning bed use before age 35 increases melanoma risk by 59–75% and is classified as a Group 1 carcinogen by the IARC.

Question 5

A 60-year-old male is prescribed warfarin for atrial fibrillation. Which tool BEST assesses his bleeding risk?

Accepted Answer

HAS-BLED

Answer

The HAS-BLED score is the most widely used and validated tool to estimate major bleeding risk in patients on anticoagulation for atrial fibrillation.

NP - Nurse Practitioner Practice Test

NP - Nurse Practitioner Practice Test

NP Risk Assessment & Management 4