FNP Scope of Practice by State

Normal age-related cognitive decline involves occasional memory lapses, such as forgetting names but remembering them later, and fully preserved instrumental activities of daily living like managing finances and medications. The ability to recall information with a cue indicates intact encoding, which is typical of normal aging rather than dementia. Reassurance is the most appropriate action. Option B is unnecessary because there are no functional red flags for dementia. Option C is inappropriate as cholinesterase inhibitors are indicated for Alzheimer disease, not normal aging. Option D is unwarranted without focal neurologic deficits, sudden onset, or signs of pathological decline.

The ADA guidelines recommend that all patients aged 40 to 75 years with diabetes and no established ASCVD should be prescribed a moderate-intensity statin for primary prevention, regardless of their baseline lipid levels. Prescribe a moderate-intensity statin for primary prevention is the correct plan because it aligns directly with this age and risk profile. Prescribe a high-intensity statin for secondary prevention is incorrect because she has no history of cardiovascular events or multiple high-risk ASCVD indicators. Recommend strict dietary changes before starting statin therapy delays necessary evidence-based pharmacologic intervention that is universally indicated for her demographic. Recommend adding a daily fibrate for primary prevention is inappropriate because fibrates do not provide the proven cardiovascular mortality benefits that statins offer in diabetic populations.

When titrating basal insulin, standard guidelines advise increasing the dose by 2 units every 3 days until the patient reaches their individualized fasting blood glucose target without experiencing hypoglycemia. Option C is correct because it applies this safe and systematic titration schedule. Option A is incorrect because a 4-unit increase is generally too aggressive for routine outpatient titration and increases the risk of sudden hypoglycemia. Option B is incorrect because clinical inertia leaves the patient exposed to ongoing hyperglycemia; timely and frequent titration is essential for success. Option D is incorrect because prandial insulin should only be considered after fasting targets are met or if the basal dose exceeds 0.5 units/kg/day.