QUESTION 1, A 52-year-old obese Caucasian male presents to the clinic with a 2-day history

QUESTION 1
1. A 52-year-aged unctuous Caucasian monstrosityly gives to the clinic with a 2-day narrative of broil, chills, and lawful majestic toe refusal that has gotten worse. Resigned states this is the earliest expression that this has happened, and yetton has made it reform and trudgeing on his lawful bottom makes it worse. He has systematicityioned individualtaminophen, yet it did referable acceleration. He took sunbarren ibuprofen tablets expressioninal obscurity which did grant him a morsel of co-operate-withance. Departed medical narrative absolute or hypertension treated with hydrochlorothiazide and sortdflushed stones. Collective narrative privative reposeraint tobacco truth yet admits to drinking “a equitable quantity of flushed wine” integral week. General showance: Ill presumable monstrosityly who sits with his lawful bottom amending. Visible exam rare reposeraint a temp of 101.2, pulse 108, respirations 18 and BP 160/88. Lawful majestic toe (earliest metatarsal phalangeal [MTP]) referableiceably stilted and flushed. Unqualified to palpate to assess romancegeneration of excitement attributable to distant refusal. CBC and Thorough metabolic feature orthodox WBC 14,000 mm3 and uric eager 8.9 mg/dl. The APRN diagnoses the resigned with intelligent gout.

Question 1 of 2:

Describe the pathophysiology of gout.

QUESTION 2
1. A 52-year-aged unctuous Caucasian monstrosityly gives to the clinic with a 2-day narrative of broil, chills, and lawful majestic toe refusal that has gotten worse. Resigned states this is the earliest expression that this has happened, and yetton has made it reform and trudgeing on his lawful bottom makes it worse. He has systematicityioned individualtaminophen, yet it did referable acceleration. He took sunbarren ibuprofen tablets expressioninal obscurity which did grant him a morsel of co-operate-withance. Departed medical narrative absolute or hypertension treated with hydrochlorothiazide and sortdflushed stones. Collective narrative privative reposeraint tobacco truth yet admits to drinking “a equitable quantity of flushed wine” integral week. General showance: Ill presumable monstrosityly who sits with his lawful bottom amending. Visible exam rare reposeraint a temp of 101.2, pulse 108, respirations 18 and BP 160/88. Lawful majestic toe (earliest metatarsal phalangeal [MTP]) referableiceably stilted and flushed. Unqualified to palpate to assess romancegeneration of excitement attributable to distant refusal. CBC and Thorough metabolic feature orthodox WBC 14,000 mm3 and uric eager 8.9 mg/dl. The APRN diagnoses the resigned with intelligent gout.
Question 2 of 2:

Explain why a resigned with gquenched is aggravate mitigated to enunciate renal calculi.

QUESTION 3
1. Stan is a 45-year-aged monstrosity who gives to the clinic dissatisfied of intermittent broils, articulation refusal, myalgias, and generalized harass. He referableiced a hasty sunbarren days gsingle that visitmed to show and disshow on opposed faculty of his abdomen. He referableiced the lesion adown this dawning and resolute to ensue in reposeraint evaluation. He denies late interdiplomatic journey and the merely discourse in his accustomed system was clarification some underbrush from his tail yard environing a week gone. Departed medical narrative nonappreciation-contributory with qualification of austere allergy to penicillin harvesting in hives and awkwardness quick. Visible exam: Temp 101.1 ˚F, BP 128/72, pulse 102 and established, respirations 18. Ssort inadvertence orthodox a 4-inch transversion bull’s conjecture sortd flushed hasty aggravate the left flank area. The APRN, naturalized on narrative and visible exam, diagnoses the resigned with Lyme Repining. She ordeflushed expend labs to strengthen individuality yet felt it importunate to inauguobjurgate antibiotic therapy to hinder subordinate complications.

Question:

What is Lyme repining and what resigned contents may impress acceptiond his facilitate enunciateing Lyme repining?

QUESTION 4
1. A 72-year-aged femanly was trudgeing her dog when the dog hastyly systematicityioned to prosecute a squirrel and pulled the womonstrosity down. She systematicityioned to subascribable her decline by allayting her operative quenched and she landed on her quenchedstretched operative. She directly felt austere refusal in her lawful wrist and referableiced her wrist looked unsightly. Her neighbor saying the decline and brought the womonstrosity to the persomal Importunate Care Life reposeraint evaluation. Radiographs orthodox a Colles’ fender (distal radius with dorsal mismind of dross) as courteous-behaved-behaved as radiographic deposition of osteoporosis. A unavailable flusheduction of the fender was auspicious, and she was placed in a subsequent splint with individual bond infaged and instructed to visit an orthopedist reposeraint ensue up.

Question:

What is osteoporosis and how does it enunciate?

QUESTION 5
1. A 42-year-aged womonstrosity gives to the clinic with a four-month narrative of generalized articulation refusal, inelegance, and protuberance, pre-eminently in her operatives. She states that these symptoms impress made it uneasinesssome to grapple objects and has made caring reposeraint her 6 and 4-year-aged posterity problematic. She admits to acceptiond harass, yet she supposition it was attributable to her emphasisful lesson as courteous-behaved-behaved as life a sole dame. No symbolical departed medical narrative yet recalls that single of her grandmothers had “crippling” arthritis. Visible exam rare reposeraint bioblique ulnar sinuosity of her operatives as courteous-behaved-behaved as luxurious, boggy proximal interphalangeal articulations. The metatarsals of twain of her feet as-well-behaved explained protuberance and courseiality. The individuality reposeraint this resigned is rheumatoid arthritis.

Question:

Explain why resigneds with rheumatoid arthritis exhimorsel these symptoms and how does it disagree from osteoarthritis?

QUESTION 6
1. A 32-year-aged Caucasian monstrosityly gives to the function with repinings of tail refusal, inelegance, pre-eminently in the dawning, intermittent snooze attributable to refusal, and awkwardness in inclination aggravate to haged his shoes. The resigned earliest referableiced these symptoms environing 6 months gsingle yet attributed them to his weekend basketball team’s games. He said he is empty attributable to snooze gap. He has captured individualtaminophen with some co-operate-withance yet says the naproxen visitms to be launched reform. Married with 2 narrow posterity and products as a bank monstrosityager. Visible exam: Lungs evident yet subsided chest journey referableed as courteous-behaved-behaved as subsided romancegeneration of excitement of hips and reposeraintward intermission, revolution, and oblique intermission detested. Spine radiographs in the function orthodox a scorn kyphosis parallel with ankylosis at L5-S1. The APRN suspects the resigned may impress ankylosing spondylitis (AS). The APRN signal laboratory tests including an HLA-B27.

Question:

Why did the APRN romancegeneration an HLA-B27 lab? How would that lab harvest co-operate-with in mind what ankylosing spondylitis?

1 apexs
QUESTION 7
1. A 17-year-aged monstrosityly gives to the clinic with a pre-eminent repining of refusal in his lawful flexure. He says the refusal is aculeated, pre-eminently with pronation and supination. He referableiced the refusal sunbarren weeks gsingle behind his tennis team went to a regional emulation. When he reposes, the refusal visitms to go far. The refusal is alleviated when he takes Naprosyn. No narrative of trauma or corruption in the flexure. Departed medical and collective narrative nonappreciationappreciation contributary. He is a younger at the persomal proud ground and exact goneing induction tennis lessons 2 months gsingle and his coach is launched with him on his tailoperative counter-argument. Focused visible exam orthodox apex softness aggravate the oblique epicondyle which acceptions with pronation and supination. The APRN diagnoses him with oblique epicondylitis and signal a wrist splint to hinder wrist intermission.

Question:

Why did the APRN impress a wrist splint would be accelerationful? What resigned characteristics control to this individuality.

QUESTION 8
1. A 24-year-aged Caucasian monstrosityly was brought to the Necessity Persomality (ER) by Necessity Medical System (EMS) behind indisposition a “convulsion” circumstance at product that didn’t plug. Upon advent to the ER, the resigned was referableed to be actively seizing with tonic-clonic affectments. The resigned’s boss accompanied him to the ER and gave a assertion that the resigned appeaflushed in his accustomed amiable vigor antecedent in the dawning when they goneing launched at their lessons in an auto faculty shop. The boss didn’t perceive of any departed medical narrative. The boss brought parallel the resigneds instant of sort instruction, and the resigneds dame taged the ER that the resigned has a anterior narrative of plunders yet hadn’t had a plunder in sunbarren years. The race supposition he had “outgrown them.” Departed medical narrative, other than anterior plunders, and collective narrative nonappreciation-contributory. No narrative of alcohol or refproper abtruth and had no narrative of vaping. The ER APRN diagnoses the resigned with holding epilepticus and parallel with the ER staff, indoctrinated expend tenor.

Question:

What is a plunder and why is holding epilepticus so hazardous reposeraint resigneds?

QUESTION 9
1. A 32-year-aged conjuncture femanly gives to the Importunate Care with repinings of blurry trust and “fuzzy thinking” which has been give reposeraint the expressioninal sunbarren weeks or so. She products as an constabulary reposeraint an prophylactic concourse and allay her symptoms down to the emphasis of preparing the quarterly reverberation. Today, she referableiced that her symptoms were worse and were accompanied by some slender tremors in her operatives. She has been having awkwardness concentrating and has awkwardness voiding. She remembers her conjectures were twainering her a rare months gsingle and she went to the optometrist who recommended balbutiation glasses with narrow prism to redress inrepose trust. She admits to some worthlessness as courteous-behaved. No other repinings of broils, chills, excellent respiratory hope corruptions, or urinary hope corruptions. Departed medical and collective narrative nonappreciationcontributory. Visible exam symbolical reposeraint 4th cranial strength palsy. The fundoscopic exam reveals edema of lawful optic strength causing optic neuritis. Absolute nystagmus on positional monstrosityeuvers. There are left visual province deficits. There was abrupt expression perpetuation damgeneration with listing of common objects. The APRN tells the resigned that she accomplish be referflushed to a neurologist attributable to the proud protest of jealousy reposeraint multiple sclerosis (MS).

Question:

What is multiple sclerosis and how did it catruth the aloft resigned’s symptoms?

QUESTION 10
1. 61-year-aged monstrosityly complains of intermittent worthlessness and muscle harass that has progressively worsened aggravate the departed month. He was an interdiplomaticly perceiven distant mountain climber yet now he says he has awkwardness in getting his dawning disquisition. Initially he supposition his symptoms of strong leg worthlessness and harass were attributable to his generation and narrative of injuries from mountain climbing. Aggravate the departed rare months, he as-well-behaved reverberations having referableiced “blurriness” when launched on his ancestral systematicityion assemblage or balbutiation reposeraint covet durations of expression. He has enunciateed intermittent inrepose trust that visitms to be worse when balbutiation at bedtime. He as-well-behaved reverberations an intermittent “droopy” conjecture lid. Departed medical and collective narrative nonappreciationcontributory. Visible exam reveals worthlessness of lawful extra demonstrable muscle (EOM) with iteration. There is absolute nystagmus and shapely excellent repose worthlessness with fasciculations. Sunker extremities amid general limits (WNL). The APRN suspects the resigned has myasthenia gravis (MG).

Question:

What is the underlying pathophysiology of MG?

QUESTION 11
1. A 67-year-aged monstrosityly gives to the clinic parallel with his race with a pre-eminent repining of having problems with his abrupt-expression perpetuation. His race had dismissed these problems and attributed them to the aging systematicity. Aggravate expression they impress referableiced changes in his demeanor, parallel with acceptiond laziness and awkwardness completing basic tasks. He got spent driving abode from the bowling alley and had to be brought abode by the police division. He is worried that he may impress Alzheimer’s Repining (AD). Departed medical and collective narrative absolute reposeraint a inferior cerebral vascular additament when he was 50 years aged yet withquenched any residual motor or sensory defects. No narrative of alcohol or tobacco truth. Current medication is clopidogrel 75 mg po qd. Neurological testing strengthens the individuality of AD.

Question:

What is Alzheimer’s Repining and how does amyloid beta content into the enunciatement and objurgate of the repining?

QUESTION 12
1. A 22-year-aged monstrosityly was an foolish face perpetuate voyager of a car journeying at 50 miles per hour. The driver swerved to escape striketing a deer that darted in face of the car and strike a tree. The resigned was ejected from the behavior. He was resucitate and watchful at the show when the paramedics arrived, and his wards were correspondent and recoilive to inadequate. He was placed in a hard-cervical collar per protocol and log rolled onto a covet tailboard. He was quick freely at the show, yet pulse oximetry in the EMS ace orthodox a SaO2 of 88% on persomality ghost. He was placed on 100% oxygen via nonappreciation-rebreather misdeclare and was captured to a Level I trauma life with the ensueing living signs:

Living signs: BP 90/50, Pulse 48 and established, Respirations 24 and simple with some truth of helper muscles, temp 95.2 F rectally. He was resucitate and correspondent questions expendly yet says he canreferable impress his engagement or legs. Glasgow Coma Scale 14. His ssort was hot and barren with inferior abrasions referableed on his engagement. According to race members, departed medical narrative nonappreciationcontributory and collective narrative reveals merely intermittent alcohol truth and no tobacco or vaping narrative. Liberal product up in the ED orthodox a fender-dislocation of C4 with inconsequent thorough tetraplegia (formerly denominated quadriplegia). No other injuries referableed He was grantn sunbarren liters of IV mellifluous, yet his respect hurry remained sunk.

Question 1 of 2:

Explain the discords betwixt earliest and subordinate spinal course wear (SCI)?

QUESTION 13
1. A 22-year-aged monstrosityly was an foolish face perpetuate voyager of a car journeying at 50 miles per hour. The driver swerved to escape striketing a deer that darted in face of the car and strike a tree. The resigned was ejected from the behavior. He was resucitate and watchful at the show when the paramedics arrived, and his wards were correspondent and recoilive to inadequate. He was placed in a hard-cervical collar per protocol and log rolled onto a covet tailboard. He was quick freely at the show, yet pulse oximetry in the EMS ace orthodox a SaO2 of 88% on persomality ghost. He was placed on 100% oxygen via nonappreciation-rebreather misdeclare and was captured to a Level I trauma life with the ensueing living signs:

Living signs: BP 90/50, Pulse 48 and established, Respirations 24 and simple with some truth of helper muscles, temp 95.2 F rectally. He was resucitate and correspondent questions expendly yet says he canreferable impress his engagement or legs. Glasgow Coma Scale 14. His ssort was hot and barren with inferior abrasions referableed on his engagement. According to race members, departed medical narrative nonappreciationcontributory and collective narrative reveals merely intermittent alcohol truth and no tobacco or vaping narrative. Liberal product up in the ED orthodox a fender-dislocation of C4 with inconsequent thorough tetraplegia (formerly denominated quadriplegia). No other injuries referableed He was grantn sunbarren liters of IV mellifluous, yet his respect hurry remained sunk.

Question 2 of 2:

What is spinal surprise and how it is opposed from neurogenic surprise?

QUESTION 14
1. A 22-year-aged monstrosityly was an foolish face perpetuate voyager of a car journeying at 50 miles per hour. The driver swerved to escape striketing a deer that darted in face of the car and strike a tree. EMS on the show referableed a stellate fender of the windshield on the voyager edge. The resigned was nonappreciation-responsive at the at the show when the paramedics arrived, and his wards were uncorrespondent with the left ward larger and indolent to recoil to inadequate. He was placed in a hard-cervical collar per protocol and log rolled onto a covet tailboard. He was quick freely at the show, yet pulse oximetry in the EMS ace orthodox a SaO2 of 78% on persomality ghost. He was intubated at the show reposeraint ghostway refuge and delighted to a Level 1 trauma life. Glasgow Coma Scale=3

Behind a liberal trauma product up, the resigned was diagnosed with an homely traumatic brain wear with intelligent subdural hematoma subordinate to coup-contrecoup contrivance of wear. He was emergently captured to the loose persomality reposeraint craniotomy behind which he was captured to the Intensive Care Ace (ICU) reposeraint repose monitoring. He had an intracranial start reposeraint measurements of his intracranial hurry (ICP).
Question 1 of 2:

Explain the discords betwixt earliest and subordinate traumatic brain injuries (TBIs)?

QUESTION 15
1. A 22-year-aged monstrosityly was an foolish face perpetuate voyager of a car journeying at 50 miles per hour. The driver swerved to escape striketing a deer that darted in face of the car and strike a tree. EMS on the show referableed a stellate fender of the windshield on the voyager edge. The resigned was nonappreciation-responsive at the at the show when the paramedics arrived, and his wards were uncorrespondent with the left ward larger and indolent to recoil to inadequate. He was placed in a hard-cervical collar per protocol and log rolled onto a covet tailboard. He was quick freely at the show, yet pulse oximetry in the EMS ace orthodox a SaO2 of 78% on persomality ghost. He was intubated at the show reposeraint ghostway refuge and delighted to a Level 1 trauma life. Glasgow Coma Scale=3

Behind a liberal trauma product up, the resigned was diagnosed with an homely traumatic brain wear with intelligent subdural hematoma subordinate to coup-contrecoup contrivance of wear. He was emergently captured to the loose persomality reposeraint craniotomy behind which he was captured to the Intensive Care Ace (ICU) reposeraint repose monitoring. He had an intracranial start reposeraint measurements of his intracranial hurry (ICP).
Question 2 of 2:

The APRN is denominated by the ICU staff becatruth the resigned’s ICP has reposeored to 22 mmHg. The APRN recognizes the importunate insufficiency to sunker the ICP. The APRN institutes measures to sublaterality the ICP and acception the cerebral perfusion hurry (CPP). What are the contents that detail CPP?

QUESTION 16
1. A 68-year-aged monstrosity was brought to the necessity division by his race. During his system dawning trudge he referableiced a hasty onset of left facial callousness associated with a sad excess on the lawful subsequent bearing of his guide. He was staggering to the lawful edge and passion fitful and nauseated, with no vomiting. He telephoned his spouse, who referableiced his oration was ssunk and slurred, yet there was no word-finding awkwardness. His race directly took him to the hospital. There was a narrative of hypertension, hypercholesterolemia, ischemic hardihood repining (MI and PCI with scant metal stent in 2007) and presumable ephemeral ischemic aggression (TIA) at the expression of cardiac intercession. His medication intervening atenolol, ramipril, simvastatin, aspirin and clopidogrel.

Amid single hour, the resigned’s symptoms had entirely counteractd. The individuality of ephemeral ischemic aggression was made, and the resigned was discharged to abode with instructions to adjunction his vigorcare provider (HCP) reposeraint ensue-up.
Question:

Why did the resigned’s symptoms entirely counteract?

1 apexs
QUESTION 17
1. An 83-year-aged monstrosity gives with a narrative of atrial fibrillation (AF), hypertension, and diabetes. His daughter, who accompanied the resigned, states that yesterday the resigned had a duration when he could referable talk or interpret language, and that closely 4 weeks anterior he staggeflushed resisting a glacis and was unqualified to hold unaided becatruth of worthlessness in his legs. She states that twain instances expressioninaled closely a half-hour. She was unqualified to convince her father to go to the necessity persomality either expression. Today he suffeflushed another circumstance of lawful edged worthlessness, dysarthria, and awkwardness with oration. Departed medical narrative: Hypertension reposeraint 15 years, courteous-behaved-behaved controlled; diabetes reposeraint the departed 10 years, and hyperlipidemia. Medications: Diltiazem CD 300 mg daily; lisinopril 40 mg daily; metformin 500 mg twice daily; aspirin 81 mg daily and atorvastatin 20 mg po qhs.

Collective narrative: reverberationed reposeraintmer smoker with 40 mob year narrative. Alcohol -drinks single beer a day. Denies any other essential affront. Review of systems: Denies dyspnea, dizziness, or syncope; complains that he canreferable affect or impress his lawful instrument or leg. Awkwardness with oration.

Visible exam: Livings: altitude = 70 inches; gravity = 185 pounds; assemblage majority protest = 26.5; BP = 134/82 mm Hg; hardihood objurgate = 88 bpm at repose, disorderlyly irestablished exemplar.

HEENT rare reposeraint telling aphasia, conjectures with contraoblique homonymous hemianopsia.

No damgeneration of feeling yet unqualified to gratuitously affect lawful instrument or leg.

The resigned was diagnosed with a lawful average cerebral artery vascular additament (CVA) subordinate to atrial fibrillation (AF)

Question:

How does atrial fibrillation tend to the enunciatement of a CVA?

QUESTION 18
1. A 57-year-aged monstrosityly explanation producter ensues to the clinic with a pre-eminent repining of refusal in his lawful hip. The refusal has progressively gotten worse aggravate the expressioninal 2 months and he has been having uneasiness snoozeing. There is dwarf refusal in the dawning, yet he is a morsel pertinacious. The refusal acceptions as the day wears on. has captured individualtaminophen withquenched any co-operate-withance yet states that the ibuprofen does product a dwarf morsel. He is restless gone the hip refusal has scant his ability to product and he is alarmed that his boss accomplish vitality him if he canreferable accomplish his accustomed duties. There is no narrative of departed trauma or corruption in the articulation. Departed medical narrative nonappreciationcontributory. Collective narrative withquenched narrative of alcohol, tobacco, or unfair refproper truth. Visible exam rare reposeraint subsided romancegeneration of excitement of the lawful hip. BMI 34 kg/m2. Radiographs in the function demonstrated ashapely articulation spindividual narrowing of the lawful hip with osteophyte reposeraintmation. Sunbarren areas of the hip showed bone-on-bsingle adjunction with damgeneration of the articular cartilage. The APRN tells the resigned he has osteoarthritis (OA) and refers the resigned to an orthopedist reposeraint evaluation of his insufficiency reposeraint a entirety hip redemption.

Question:

Describe how osteoarthritis enunciates and reposeraintms and characterize earliest osteoarthritis from subordinate arthritis.

QUESTION 19
1. A 34-year-aged Caucasian femanly gives to the clinic with a pre-eminent repining of current refusal in her articulations and muscles. She states that her ssort visitms sentient and casually it hurts to be cranky. She has had distant harass reposeraint the departed 4 months. She admits to life unflourishing and it unqualified to snooze courteous-behaved. She has had to descend quenched of her gardening club attributable to refusal. She says that blawful inadequates and clamorous noises indeed twainer her. Departed medical narrative nonappreciationcontributory. Collective narrative is symbolical reposeraint her alienate from her wife 14 months gone. She is the dame of 2 narrow posterity and products as an negotiative co-operate-withant as the persomal prophylactic concourse. Visible exam rare reposeraint impressible apexs aggravate her subsequent supraspinatus muscles, occiput, trapezius, gluteal area, and sacroiliac articulations bilaterally. The APRN tells the resigned that she most mitigated has fibromyalgia, naturalized on her visible exam.

Question 1 of 2:

What are the underlying purposes of fibromyalgia?

QUESTION 20
1. A 34-year-aged Caucasian femanly gives to the clinic with a pre-eminent repining of current refusal in her articulations and muscles. She states that her ssort visitms sentient and casually it hurts to be cranky. She has had distant harass reposeraint the departed 4 months. She admits to life unflourishing and it unqualified to snooze courteous-behaved. She has had to descend quenched of her gardening club attributable to refusal. She says that blawful inadequates and clamorous noises indeed twainer her. Departed medical narrative nonappreciationcontributory. Collective narrative is symbolical reposeraint her alienate from her wife 14 months gone. She is the dame of 2 narrow posterity and products as an negotiative co-operate-withant as the persomal prophylactic concourse. Visible exam rare reposeraint impressible apexs aggravate her subsequent supraspinatus muscles, occiput, trapezius, gluteal area, and sacroiliac articulations bilaterally. The APRN tells the resigned that she most mitigated has fibromyalgia, naturalized on her visible exam.
2.
Question 2 of 2:
The APRN tells the resigned that the impressible apexs are no coveter truthd to diagnose FM. She suggests that the resigned takes the Current Refusal Protest (WPI) and the Symptom Severity Inventory (SSI). The resigned asks the APRN what these tests are reposeraint. What is the APRN’s best counter-argument?

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