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BB is a 55 yo male who presents to the clinic with complaints of failure to maintain an erection. He is evaluated for cardiovascular risk and found to be in general good health. He is prescribed Tadalafil (Cialis) for treatment. What is the mechanism of action of tadalafil? 

A patient has stage V chronic kidney disease, and his family explains he is becoming progressively confused. Uremic encephalopathy is suspected. What other manifestations would support this complication?

A 65-year-old man presents to the hospital complaining of left upper quadrant abdominal pain, and fatigue. He has no previous medical illnesses, and he is only on vitamin supplements that were started by his primary care provider for excessive tiredness. On examination, he looks slightly pale. On abdominal examination, there is massive splenomegaly. Laboratory investigations reveal, hemoglobin 10.8 g/dl, platelets 140000, and white cell count 140000 per microliter. His peripheral smear shows the left shift with promyelocytes, myelocytes, and metamyelocytes. It is decided to send a sample for cytogenetic analysis. What is it most likely to show?

The NP is working in urgent care when a child comes in with a rash. The NP is concerned the rash could be measles (rubeola). Which TWO of the following could be associated with such an infection? 

A client who is 2 weeks postpartum calls the obstetrician’s office and states that they have had a whitish vaginal discharge for 1 week, but today is “bleeding and saturating a pad about every half hour.” Which of the following is an appropriate response by the nurse?

Ethan is a 10-year-old boy who has recently been spending more time on his tablet and watching TV. His parents are concerned because he has become less active over the last year. He used to play outside with friends but now prefers sedentary activities. As a result, his physical fitness levels have decreased, and his weight has increased slightly. Ethan has also started showing signs of irritability and has difficulty focusing in school.  In your own words tell me at least 3 recomendations that would help Ethan’s parents establish better habits, routines, and perhaps behaviors.  *** In order to receive full credit you must provide 3 distinctive recommendations.

A client 4 weeks postpartum tells the nurse that they can’t cope any longer and is overwhelmed by the newborn. The baby has old formula on their cloths and under her neck. The patient doesn’t remember when they last bathed the baby. The nurse should encourage the physician to follow up with this patient immediately to be evaluated for:

Which of the following is the anatomical name for the “front of the elbow”?

The NP’s patient was admitted with bacteremia. The patient required intubation due to respiratory failure. The patient is requiring IV vasopressors for blood pressure support. The patient’s creatinine is elevated suggesting acute renal failure. The patient also has extremely elevated AST & ALT.  What role are cytokines playing in the above findings? 

Immediately after delivery, the client who was induced for severe preeclampsia begins having heavy vaginal bleeding and large clots. The nurse would anticipate which of the following medications to be ordered by the physician? Select all that apply.