Author: Anonymous

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

A 71-year-old patient with diabetes and hypertension has chronic gait instability and numbness in both feet. Today the patient suddenly develops facial asymmetry and inability to move the left arm. The NP bases the plan of care on

A 36-year-old patient has amenorrhea, galactorrhea, infertility, and progressive headaches. Visual testing identifies peripheral field abnormalities. The NP bases the plan of care on

A 72-year-old patient with metastatic malignancy develops progressive confusion, weakness, and an unwitnessed seizure. Serum sodium is 119 mEq/L (normal 135–145 mEq/L). The patient has no peripheral edema, and the family reports no excessive water intake. The neurologic examination reveals no persistent focal deficit. The NP bases the plan of care on

A 73-year-old patient has progressive painless loss of peripheral vision over several years. The patient denies flashes, floaters, severe pain, nausea, or acute visual changes. The NP bases the plan of care on