Knowlege check

1. CC: “I possess been having fearful chest and arm trouble for the departed 2 hours and I fancy I am having a character invasion.”HPI: Mr. Hammond is a 57-year-old African American manly who presents to the Emergency Department delay a exaltedest remonstrance of chest trouble that radiates down his left arm. He states that he agoing having trouble sundry hours ago and says the trouble “it feels love an elephant is sitting on my chest”. He rates the trouble as 8/10. Nothing has made the trouble ameliorate or worse. He denies any antecedent issue of chest trouble. Denies loathing, dyspnea, or lightheadedness. He was ardent 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the trouble.Lipid panel reveals Entirety Cholesterol 324 mg/dl, exalted inobservance lipoprotein (HDL) 31 mg/dl, Low Inobservance Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dlHis distinction is an clever supplemental deference myocardial infarction.1 of 2 Questions:Why is HDL considered the “good” cholesterol?

QUESTION 21. CC: “I possess been having fearful chest and arm trouble for the departed 2 hours and I fancy I am having a character invasion.”HPI: Mr. Hammond is a 57-year-old African American manly who presents to the Emergency Department delay a exaltedest remonstrance of chest trouble that radiates down his left arm. He states that he agoing having trouble sundry hours ago and says the trouble “it feels love an elephant is sitting on my chest”. He rates the trouble as 8/10. Nothing has made the trouble ameliorate or worse. He denies any antecedent issue of chest trouble. Denies loathing, dyspnea, or lightheadedness. He was ardent 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the trouble.Lipid panel reveals Entirety Cholesterol 324 mg/dl, exalted inobservance lipoprotein (HDL) 31 mg/dl, Low Inobservance Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dlHis distinction is an clever supplemental deference myocardial infarction.2 of 2 Questions:Explain the role inflammation has in the outgrowth of atherosclerosis.

QUESTION 31. A 45-year-old dowager delay a narrative of systemic lupus erythematosus (SLE) presents to the Emergency Capability (ER) delay remonstrances of eager retrosternal chest trouble that worsens delay innatty bdestroy or mendacious down. She reports a 3-day narrative of low-grade heat, listlessness and says she feels love she had the flu. Corporeal exam reveals tachycardia and a pleural attrition rub. She was diagnosed delay clever pericarditis.
Question:
What does the Advanced Practice Registered Protect (APRN) own as the outend of the pleural attrition rub?

1 points   QUESTION 41. A 15-year-old boyish manly ends to the clinic delay his parents delay a exaltedest remonstrance of heat, loathing, vomiting, out-of-sorts localized abdominal trouble, arthralgias, and “swollen lymph nodes”. States he has felt “lousy” for a foreigner weeks. The heats possess been as exalted as 102 F. His parents sentiment he had the flu and took him to an Urgent Care Center. He was ardent Tamiflu® and sent abode. He says the Tamiflu didn’t look to result. States had a scorn sore throat a foreigner weeks ago and attributed it to the flu. Corporeal exam orthodox attenuated immature man who appears to be forlorn but not cleverly ill. Subsequent pharynx reddened and tonsils 3+ delayout exudate. + preliminary and subsequent cervical lymphadenopathy. Tachycardic and a new aggression 2/6 exalted-pitched, crescendo-decrescendo systolic eviction rumbling auscultated at the left sternal verge. Rapid strep +. The resigned was diagnosed delay clever rheumatic character disorder (RHD).
Question:
Explain how a unequivocal strep criterion has objectd the resigned’s symptoms.

QUESTION 51. The APRN sees a 74-year-old obese femanly resigned who is 2 days shaft-op succeeding undergoing left allty hip re-establishment. The resigned has had cutting shaft op loathing and vomiting and has been unfitted to go to corporeal therapy. Her mucus membranes are dry. The resigned says she feels love the skin on her left leg is too compact. Exam reveals a swollen, natty, and red colored calf. The resigned has a duplex ultrasound which reveals the nearness of a innatty venous thrombosis (DVT).Question:Describe the factors that could possess contributed to the outgrowth of a DVT in this resigned decipher how each of the factors could object DVT.

QUESTION 61. A 45-year-old dowager is 10 days condition shaft inequitable trivial bowel resection for Crohn Disorder and has been recuperating at abode. She suddenly develops cutting lack of exhalation, becomes pointless, and her race constraining drops to 80/40 mmHg (antecedent readings ~130/80s mmHg). The pulse oximetry is 89% on capability air. The APRN suspects the resigned conversant a colossal pulmonary embolus.
Question:
Explain why a enlightened pulmonary embolus interferes delay oxygenation.
  QUESTION 71. A 45-year-old dowager is 10 days condition shaft inequitable trivial bowel resection for Crohn Disorder and has been recuperating at abode. She suddenly develops cutting lack of exhalation, becomes pointless, and her race constraining drops to 80/40 mmHg (antecedent readings ~130/80s mmHg). The pulse oximetry is 89% on capability air. While waiting for the Emergency Medical Service (EMS) to end-to, the APRN places EKG leads and the EKG demonstrates upupproper ventricular force.
Question:
Explain why a enlightened pulmonary embolism objects upupproper ventricular force.
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QUESTION 81. A 12-year-old spinster is brought to the Emergency Capability (ER) by her dowager delay remonstrances of lack of exhalation, wheezing, tachypnea, tachycardia, and a non-productive cough. The dowager states they had exact end from a decline carouse where the all nobility enjoyed a hayride. The symptoms began soon succeeding they left the carouse but got ameliorate a foreigner hours succeeding they returned abode. The symptoms began manyly encircling 6 hours delayedr and look to be worse. The dowager states there is no narrative of allergies or many respiratory infectious. The offshoot is up to duration on all vaccinations. The offshoot was diagnosed delay asthma. The protect practitioner deciphered to the dowager that her offshoot was exhibiting symptoms of asthma, and probably had an forthcoming asthmatic rejoinder and a delayed asthmatic rejoinder.
Question 1 of 2:
Explain forthcoming asthmatic rejoinders and the cells under obligation for the rejoinders.

QUESTION 91. A 12-year-old spinster is brought to the Emergency Capability (ER) by her dowager delay remonstrances of lack of exhalation, wheezing, tachypnea, tachycardia, and a non-productive cough. The dowager states they had exact end from a decline carouse where the all nobility enjoyed a hayride. The symptoms began soon succeeding they left the carouse but got ameliorate a foreigner hours succeeding they returned abode. The symptoms began manyly encircling 6 hours delayedr and look to be worse. The dowager states there is no narrative of allergies or many respiratory infectious. The offshoot is up to duration on all vaccinations. The offshoot was diagnosed delay asthma. The protect practitioner deciphered to the dowager that her offshoot was exhibiting symptoms of asthma, and probably had an forthcoming asthmatic rejoinder and a delayed asthmatic rejoinder.Question 2 of 2:Explain delayed asthmatic rejoinders and the cells under obligation for the rejoinders.

QUESTION 101. A 64-year-old man delay a 40 pack/year narrative of cigarette smoking has been diagnosed delay emphysema.  He asks the APRN if this media he has COPD.Question 1 of 2:Explain the pathophysiology of emphysema and how it relates to COPD.

QUESTION 111. A 64-year-old man delay a 40 pack/year narrative of cigarette smoking has been diagnosed delay emphysema.  He asks the APRN if this media he has COPD.Question 2 of 2:Explain the pathophysiology of continuous bronchitis and how it relates to COPD.

QUESTION 121. Mr. Jones is a 78-year-old master who presents to the clinic delay a exaltedest remonstrance of heat, chills and cough. He too reports some dyspnea. He has a narrative of upupproper edged CVA, COPD, dyslipidemia, and HTN. Current medications conceive atorvastatin 40 mg po qhs, lisinopril, and fluticasone/salmeterol. He reports over use of his albuterol liberate inhaler.
Vital signs Temp 101.8 F, pulse 108, respirations 21. PaO2 on capability air 86% and on O2 4 L nasal canula 94%. CMP WNL, WBC 18.4. Corporeal exam reveals attenuated, restless master delay soft hemiparesis on left edge due to CVA. HEENT WNL exclude for adulterated gag reflex and obstructed altitude of the uvula, CV-HR 108 RRR delayout rumblings, rubs, or click, no bruits. Resp-coarse rhonchi throughout lung fields. CXR reveals combination in upupproper inferior lobe. He was diagnosed delay aggregation acquired pneumonia (CAP).Question:
Patient was hypoxic as evidenced by the low PaO2. Decipher the pathologic processes that objectd this resigned’s hypoxemia.

1 points   QUESTION 131. A 64-year-old dowager delay tolerably cutting COPD ends to the pulmonary clinic for her quarterly checkup. The APRN reviewing the chart notes that the resigned has lost 5% of her organization ponderosity past her terminal investigate. The APRN questions the resigned and resigned admits to not having plenteous of an passion and she too admits to detriment some meals beobject it “takes too plenteous result” to misinterpret and assimilate dinner.
Question:
The APRN owns that COPD has a noxious chattels on resigneds. Decipher why resigneds delay COPD are at destroy for malnutrition.

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