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The nurse practitioner notes severe renal injury in a patient using an NSAID, ACE inhibitor, and diuretic. The underlying mechanism is best described as:

According to the Lecture Schedule, when is homework section 11.1 due in MyLab? 

The nurse practitoner prescribing a GLP-1 receptor agonist educates the patient on how it improves post-prandial glucose levels. Which of the following statements is most appropriate?

A 64-year-old man is admitted to the medical floor with acute-on-chronic dyspnea and productive cough with dark sputum for the past week. He reports progressively worsening shortness of breath over the past 5 years. His occupational history includes 38 years working in coal mining in West Virginia. He has a 20 pack-year smoking history but quit 10 years ago. Vital signs: BP 142/86, HR 102, RR 26, temperature 38.3°C (101°F), SpO2 88% on room air. Physical examination reveals use of accessory muscles, decreased breath sounds throughout with coarse crackles in the upper lung fields bilaterally, and dullness to percussion at the right base. Laboratory Results: Test Value Reference Range Complete Blood Count WBC 14,500/μL 4,500-11,000/μL Hemoglobin 16.8 g/dL 13.5-17.5 g/dL Hematocrit 52% 38.5-50% Platelets 285,000/μL 150,000-400,000/μL Basic Metabolic Panel Sodium 138 mEq/L 136-145 mEq/L Potassium 4.2 mEq/L 3.5-5.0 mEq/L Chloride 100 mEq/L 98-106 mEq/L Bicarbonate 32 mEq/L 22-28 mEq/L BUN 22 mg/dL 7-20 mg/dL Creatinine 1.1 mg/dL 0.6-1.2 mg/dL Arterial Blood Gas (Room Air) pH 7.38 7.35-7.45 PaCO2 48 mmHg 35-45 mmHg PaO2 56 mmHg 80-100 mmHg HCO3 28 mEq/L 22-26 mEq/L Additional Labs Procalcitonin 2.8 ng/mL

When prescribing levothyroxine therapy, the nurse practitioner knows that drugs that induce the CYP450 system will:

The nurse practitioner is evaluating four patients seeking contraception. In which patient would combined oral contraceptives be contraindicated?

A 56-year-old man is admitted to the medical floor for management of acute decompensated heart failure. His wife mentions that he snores loudly at night and she frequently observes him stop breathing for 10-20 seconds, followed by gasping or choking sounds. The patient reports chronic daytime fatigue and falling asleep frequently during the day. His medical history includes hypertension, type 2 diabetes, obesity (BMI 36 kg/m²), and atrial fibrillation. Neck circumference 19 inches. Cardiovascular exam reveals an irregular rhythm and 2+ pitting edema bilaterally. Retrognathia is noted. Oropharyngeal exam shows a crowded airway with enlarged tonsils and low-lying soft palate (Mallampati class IV).  Chest x-ray showing small pleural effusions, otherwise clear lungs. The AGACNP is concerned for repetitive dynamic collapse of the upper airway during sleep. What action by the AGACNP is most appropriate? 

A 56-year-old with 35% TBSA burns is in the ICU on day 6. Over 12 hours he develops progressive tachycardia, progressive tachypnea, new feeding intolerance, and platelet count drops from 190,000 to 85,000. The wound shows new dark discoloration with rapid conversion of previously viable partial-thickness areas to necrosis. Blood pressure becomes refractory to fluids. What is the most appropriate management strategy?

A 52-year-old male with a history of hypertension, hyperlipidemia, and type II diabetes presents to the emergency room with a 2-day history of right lower leg pain, redness, and swelling. He reports the symptoms began suddenly and have progressively worsened. He denies any recent trauma but mentions he had a small scratch on his leg from gardening about 5 days ago. He denies any recent long care rides or recent sedentary activity.  Vital signs: temperature 38.3°C (101°F), blood pressure 128/82 mmHg, heart rate 92 bpm, and respiratory rate 16/min on room air. Physical examination reveals a poorly demarcated area of erythema and edema on the right lower leg that is warm and tender to palpation. There is no streaking erythema. The left lower leg appears normal. The affected area is not exquisitely tender, and there is no crepitus or bullae formation. (Tintinalli’s Emergency Medicine) What is the most likely diagnosis?

The nurse practitioner is counseling a 42-year-old woman with hypertension and migraine with aura about contraception. Which option is most appropriate?