Ms. Carson is a 71-year-old female who presents with significant pleuritic-type

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Ms. Carson is a 71-year-old female who presents with significant pleuritic-type

chest pain. She has no known cardiopulmonary history and does not smoke cigarettes. Her history is significant only for an upper endoscopy this morning for evaluation of severe gastroesophageal reflux disease (GERD). She tolerated the procedure well and was discharged home. Over the afternoon she developed worsening pain on the left side of her chest and finally had to come to the emergency department. Her vital signs are as follows: temperature 100.0°F, pulse 116 bpm, respiratory rate 22 breaths per minute, and blood pressure 96/60 mm Hg. The AGACNP orders which of the following diagnostic studies to confirm the suspected diagnosis?

A.Chest radiograph          B. 12-lead ECG          C. Upper endoscopy          D.Esophagram

 
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88 Jeff Z. is a 49-year-old male who is on the heart transplant

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88 Jeff Z. is a 49-year-old male who is on the heart transplant list due to

myocarditis-related end stage congestive heart failure. While counseling Jeff about bridge devices that allow him to be discharged from the hospital, the AGACNP tells Jeff that the most frequently used device is:

A.Ideal for smaller-framed patients        B. Implanted below the diaphragm                                         C. Independent of external power for up to 24 hours            D.Good for up to 2 years

 
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Mr. Mettenberger is being discharged following his hospitalization

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Mr. Mettenberger is being discharged following his hospitalization for

reexpansion of his second spontaneous pneumothorax this year. He has stopped smoking and does not appear to have any overt risk factors. While doing his discharge teaching, the AGACNP advises Mr. Mettenberger that his current risk for another pneumothorax is:

A. < 10%     B. 25-50%     C. 50-75%     D. > 90

 
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Cameron and his family hosted a big party for the Superbowl

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Cameron and his family hosted a big party for the Superbowl with a large

spread of different food. He made his famous hot chicken wings and ranch dip for the big game that were placed out early for a pre-game get together. After the game and once everyone left, Cameron noticed there were some leftovers of both remaining, so Cameron place them into the refrigerator. Cameron finished off both of them for lunch then next day. Three days later, Cameron started to have a headache followed by stomach pain and severe diarrhea. Cameron noticed that there was blood in his stool, so he scheduled an appointment with his family doctor. The doctor collected a stool sample and identified a Gram negative helical shaped bacteria. The doctor then sent the sample off for further culture-independent diagnostic testing.

1. What microorganism causes this disease? Make sure to give the name of the bacteria in proper binomial nomenclature and discuss any virulence factors or specific traits of this bacteria that influences the disease.

2. What is your diagnosis (i.e. what is the disease), and what specific features within the case were critical to your diagnosis of this disease?

3. How is this disease transmitted?

4. How is the disease treated? Make sure to be specific on types of treatments used and timing of treatment needed.

5. What symptoms might the patient develop if the disease is not treated?

6. What is the prognosis with treatment?

 
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