A patient has a blood pressure of 150/95 mm HG and 148/90 mm Hg on two separate office visits. This is consistent with a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient's diagnostic tests are all normal. What will the patient's provider order to best manage the patient's hypertension?

Correct Answer: A

Rationale: The correct answer is A: A thiazide diuretic. Thiazide diuretics are recommended as the initial medication for managing hypertension in patients without compelling indications. They are effective in lowering blood pressure by reducing the volume of circulating blood. In this case, the patient's blood pressure readings are consistently elevated, indicating the need for pharmacological management. Thiazide diuretics have been shown to reduce cardiovascular events and mortality in hypertensive patients. Loop diuretics and Spironolactone (Choice B) are not first-line treatments for hypertension and are typically used in specific cases like heart failure. Beta blockers (Choice C) are not the preferred initial treatment for hypertension in the absence of other compelling indications. Thus, the most appropriate choice for managing this patient's hypertension would be a thiazide diuretic.

Correct Answer: C

Rationale: The correct answer is C (Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus influenzae) because these are the most common bacterial pathogens causing ABRS. Streptococcus pneumoniae is the most common, followed by Haemophilus influenzae and Moraxella catarrhalis. These bacteria are typically found in the upper respiratory tract and can cause infection when there is inflammation or blockage of the sinuses. The other choices are incorrect because they are not commonly associated with ABRS. Choice A includes bacteria commonly found in urinary tract infections. Choice B includes bacteria associated with hospital-acquired infections. Choice D includes bacteria that are more commonly associated with atypical pneumonia rather than sinus infections.

Correct Answer: D

Rationale: Step 1: Definition of agonist-antagonist opioid - It has both agonist (activates opioid receptors) and antagonist (blocks opioid receptors) properties. Step 2: Buprenorphine is a partial agonist opioid that activates and blocks opioid receptors. Step 3: Buprenorphine's agonist activity treats pain, while its antagonist activity reduces abuse potential. Step 4: Diprenorphine, Naloxone, and Morphine do not have both agonist and antagonist properties. Summary: Diprenorphine is a pure antagonist, Naloxone is a pure antagonist, and Morphine is a pure agonist, making them different from the agonist-antagonist opioid, Buprenorphine.

Correct Answer: C

Rationale: The correct answer is C: Nausea and/or vomiting are common side effects of therapy. Liraglutide is a GLP-1 receptor agonist commonly used to treat type 2 diabetes. The side effects of liraglutide often include gastrointestinal symptoms like nausea and vomiting. This side effect is commonly seen in patients initiating liraglutide therapy. Choices A and D are incorrect as liraglutide should not be stored in the refrigerator or freezer before use, and it is administered subcutaneously, not intramuscularly into the upper arm. Choice B is incorrect as Bydureon is a brand name for exenatide, not liraglutide.

Correct Answer: B

Rationale: The correct answer is B: Oxygen via a nasal cannula 2L/minute. In hypercapneic COPD patients, supplemental oxygen helps reduce the respiratory drive, leading to decreased carbon dioxide levels. Salmeterol and fluticasone propionate are used for long-term maintenance in COPD and do not address acute hypercapnia. Albuterol nebulizer is used for bronchodilation and does not directly lower carbon dioxide levels. Oxygen therapy is the most appropriate immediate intervention to address acute hypercapnia in COPD patients.