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You are seeing a 42 year old female patient with a past medical history that includes hypertension, elevated body mass index and gastric bypass surgery 5 years ago. She stopped taking all of her medications 3 years ago due to a combination of the cost of the medications and her financial situation.  Physical exam findings include BP 100/50 mmHg, HR 88 beats per minute, HEENT exam:  conjunctival pallor (paleness of conjuntiva), cheilosis (inflammatory lesion at the corner of her mouth) and glossitis (inflammation of the tongue).  Her neuro exam revealed loss of proprioception.  What is most likely the cause of this patient’s symptoms?

According to the ACC/AHA Guideline criteria for “Treatment of Hyperlipidemia with Statin Therapy to Reduce Atherosclerotic Cardiovascular Risk” which of the following patient categories would NOT be included in the guidelines for primary prevention.

You prescribed ferrous sulfate, PO, 325 mg TID X 90 days for the diagnosis of iron deficiency anemia. Which of the following statements would NOT be included in patient and family education?

The next 3 questions pertain to this patient.Your next patient is a 26-year old female patient who presents to clinic for a health maintenance exam.  A CBC is obtained with the following results: Complete Blood Count Results  CBC Value Reference Range WBC 5.5 4-11 X 103/ul RBC 4.33 4.0-5 X106/uL Hgb 10.5 12.0-16 g/dL HCT 30.3 36-46% MCV 71 80-100 fl MCH 24.2 28-34 pg MCHC 28.6 32-36 g/dL RDW 15.4 12-14.6% PLT 258 150-450 X 103 u/l  What type of anemia does this patient have?

The list of potential causes for a pleural effusion is long. Which of the following statements is NOT true regarding pleural effusions?

A young, healthy 26-year-old female patient without a previous history of lung disease has an increased respiratory rate and reports a feeling of “not getting enough air.” This patient does not have any signs of a pulmonary infection (no fever, cough, sputum production). The APRN auscultates clear breath sounds bilaterally and notes that she does not have any pulmonary signs for increased respiratory effort. Which diagnostic test will the APRN perform initially?

Your next patient is 73-year-old female with progressive right hip pain. She has been having symptoms for months. She has noticed the beginning signs of limited mobility, especially over the past 3-4 week. As you consider your patient’s age, hip anatomy, and previous history, you know the following:

A patient has a gradually enlarging nodule on one lower eyelid and reports that the lesion is painful. On examination, the lesion appears warm, erythematous, edematous and painful to touch.  The APRN knows that this is likely to be which type of lesion?

 There is a reference to Healthy People 2030 the Buttaro textbook. What is NOT a goal of the Healthy People initiative?

Your last patient is a 48 year-old female who comes to you with right shoulder pain and weakness.  This is her first visit to any health care provider regarding this pain.  She denies any trauma or injury, but is a large art piece sculptor and she does almost daily repetitive work using her arms overhead.  She is right dominant and this is impacting her ability to do her usual activities and her art work. You completed a physical exam with muscle/tendon testing and suspect a rotator cuff injury.  What is the appropriate treatment plan at this time?