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34.  The nurse is assessing a client and finds an abnormal protrusion of the eyeballs related to an accumulation of fluid behind the eyeball.  The nurse will correctly document the presence of:

During an assessment of a 60-year-old male, you note a thickened, yellowish discoloration of his nails, along with separation of the nail from the nail bed and slight pain at the base. He reports a history of chronic fungal infections in the past. What is the most likely diagnosis?

A 68-year-old male with a history of diabetes and hypertension presents to the emergency department with complaints of worsening fatigue, fever, and a new rash on his legs and torso. On examination, he is febrile (101°F), tachycardic, and has patches of purpura and ecchymosis scattered over his lower legs, as well as areas of pale, cool skin. His blood pressure is 90/60 mmHg. Which of the following physical exam finding is the most concerning in this patient?

A 28-year-old female presents with a pruritic rash on her forearms that began as small red papules, which then developed into vesicles. The rash is distributed in a linear pattern along her forearms. She denies any new medications but mentions handling poison ivy last week. What is the most likely diagnosis?

Epidemiology Extra Credit Question (5 points possible)  Answer the Epidemiology questions based on the scenario below:  A small rural village is experiencing a disease outbreak. 32 people have become ill over the past week and are experiencing watery diarrhea, vomiting and dehydration. You investigate the area and find that they have been disposing of human waste upstream of their village. You collect a water sample and find high numbers of Vibrio cholera bacteria in the sample.     What is the incidence of the disease over the past week? (1 pt) What is the host? (1 pt) What is the etiologic agent? (1 pt) What would you do to prevent the spread of this disease and prevent another outbreak in the future? (2 pts) 

A 40-year-old female presents to the clinic with a 4-day history of progressive shortness of breath, fever, and productive cough with yellow-green sputum. She has a history of asthma but no other significant medical conditions. On examination, her vital signs show a temperature of 102°F (38.9°C), respiratory rate of 22 breaths per minute, and oxygen saturation of 93% on room air. You are suspecting this patient may have pneumonia. Which of the following is the most likely finding of your assessment in a patient with pneumonia?

A 32-year-old healthy adult presents with a persistent cough lasting for 3 weeks. Which of the following is the most appropriate next step in the management of this patient?

A 50-year-old female with a history of seasonal allergies presents to the clinic with a 2-week history of persistent cough, occasional wheezing, and clear sputum production. She denies fever, chest pain, or shortness of breath at rest. On physical examination, her vital signs are stable, and she appears otherwise well. On inspection you notice her breathing is shallow and tachypneic.  Lung auscultation reveals expiratory wheezing and prolonged occasional crackles throughout both lung fields. which clear slightly with coughing. Percussion is resonance, and there is no egophony or tactile fremitus. Based on these findings, which of the following is the most likely diagnosis?

A 5′ 6″ female patient was admitted for exacerbation of her reactive airway disease. When the practitioner arrived to assess her and was found to be obtunded with slow shallow respirations. The following arterial blood gas was obtained on a 5L NC:   pH – 7.22 PaCO2 – 68 torr PaO2 – 78 torr HCO3 – 25 mEq/L BE – +1   The physician decided to intubate. What initial vent settings should the patient be placed on?

A/C volume control ventilation can be defined as [word1] and [word2] triggered, [word3] limited, and [word4] cycled.