A 24-year-old man presented to the hematology clinic for follow-up after a recent hospitalization for excessive bleeding from an accidental knife cut. The patient reported a history of prolonged bleeding after tooth extraction, an upper gastrointestinal bleed 3 years previously, and excessive bruising since childhood. He denied hemarthroses but reported chronic pain in his ankles […]
Susan is nearing the end of her life and lives in a nursing facility for older people. Her family comes to visit often. She enjoys this for the most part. Sometimes when her son comes to visit, he brings legal paperwork for her to sign. She is not sure why she is signing these documents […]
A 22-year-old woman presents with an acute onset of decreased sensation in her right hand. A history of present illness reveals that her father had a myocardial infarction yesterday and died before she could take him to the hospital. Her past medical history is unremarkable. Her vital signs are blood pressure 120/80 mm Hg, heart […]
A 65-year-old patient with severe behavioral and psychological symptoms of dementia (BPSD) has been readmitted to a geropsychiatry unit due to recurrent aggressive behaviors that have caused injuries and resulted in discharge from long term care facilities. In addition to non-pharmacological interventions and pain management, he has not benefited from either citalopram or sertraline, nor […]
A 22-year-old male presents for an evaluation. His history is significant for opioid use disorder. The patient uses one gram of heroin intravenously daily. The last dose of heroin was two hours ago. The patient denies any restlessness, nausea, vomiting, or diarrhea. His vital signs include blood pressure 120/80 mmHg, pulse 72bpm, respiratory rate 18/min, […]
A 26-year-old female presents with fatigue, numbness and tingling in her bilateral upper extremities and feeling like she has difficulty maintaining her balance when walking. Upon further questions, she reports that she scheduled an appointment with optometry for an exam because of blurry vision. Which of the following should the primary care nurse practitioner consider […]