Author: Anonymous

A 65-year-old patient with a history of malignancy develops increasing headache, vomiting, reduced level of consciousness, blood pressure 188/74 mm Hg, and pulse 48/min. The NP bases the plan of care on

A patient with sickle cell disease develops fever, dehydration, severe diffuse bone pain, and increasing dyspnea following a respiratory illness. Hemoglobin is decreased from baseline and reticulocytes are elevated. The NP bases the plan of care on

A 66-year-old patient with chronic lymphocytic leukemia is evaluated because of increasing fatigue and recurrent respiratory infections. The WBC count is markedly elevated, yet the patient has experienced three bacterial infections in four months. The NP bases the plan of care on

A 34-year-old patient has recurrent bloody diarrhea, urgency, and abdominal cramping. Colonoscopy demonstrates continuous inflammation beginning in the rectum and involving the colonic mucosa. The NP bases the plan of care on the understanding that…

A 25-year-old reports pelvic pain, dyspareunia, abnormal vaginal discharge, and postcoital bleeding. Temperature is 38.3°C, and pelvic examination demonstrates significant lower abdominal tenderness. The NP bases the plan of care on the understanding that…

A 42-year-old patient develops generalized edema and frothy urine. Urinalysis demonstrates heavy proteinuria, while serum albumin is markedly reduced. Blood pressure is mildly elevated. The NP bases the plan of care on the understanding that…

A 74-year-old patient with chronic back pain develops sudden severe thoracic pain while lifting a light grocery bag. There was no fall. The patient has lost 5 cm of height over several years and recently completed prolonged glucocorticoid therapy. Neurologic examination is normal. The NP bases the plan of care on

A 31-year-old patient has infertility, irregular menses, acne, and increasing terminal hair growth. Metabolic evaluation demonstrates insulin resistance, and imaging shows enlarged ovaries with multiple follicles. The NP bases the plan of care on the understanding that…

A 32-year-old woman has dysuria, urinary frequency, suprapubic discomfort, and cloudy urine without fever or flank pain. Urinalysis supports bacterial infection. The NP bases the plan of care on the understanding that…

A 62-year-old patient with chronic hypoxemic lung disease has elevated hemoglobin and hematocrit. Erythropoietin is increased. The patient reports headaches but has no splenomegaly or known JAK2 mutation. The NP bases the plan of care on