A 29-year-old woman reports intense vulvar itching, thick wh…

A 29-year-old woman reports intense vulvar itching, thick white discharge, and external erythema that worsens after antibiotic use. She denies fever or pelvic pain. Exam confirms labial edema and adherent white plaques. The NP bases the plan of care on the knowledge that…

A 76-year-old woman in a nursing facility presents with mark…

A 76-year-old woman in a nursing facility presents with marked fatigue, exertional shortness of breath, brittle nails, pallor, craving ice, and reports a month of dark stools; exam reveals pale conjunctiva and a soft systolic murmur; labs show hemoglobin 8.8 g/dL (12–16), ferritin 7 ng/mL (15–200), positive stool guaiac, and MCV 79 fL (80–96); the NP bases the plan of care on the knowledge that…

A 58-year-old patient is evaluated for treatment-resistant h…

A 58-year-old patient is evaluated for treatment-resistant hypertension, new onset of renal insufficiency after starting an ACE inhibitor, and abdominal bruit on exam; labs show rising creatinine with otherwise normal urinalysis; the NP bases the plan of care on the knowledge that…

A 57-year-old patient undergoing treatment for chronic kidne…

A 57-year-old patient undergoing treatment for chronic kidney disease reports worsening fatigue, muscle twitching, and difficulty concentrating. Physical exam reveals normal hydration status. The NP bases care on the understanding that these symptoms MOST likely reflect:

A 69-year-old man presents with post-meal fullness, mild blo…

A 69-year-old man presents with post-meal fullness, mild bloating, and early satiety after large meals; he denies weight loss, vomiting, melena, or hematemesis; abdominal exam is normal and labs are unremarkable; the NP bases the plan of care on the knowledge that…