All smokers should be counseled on the benefits of smoking cessation because by the time symptoms develop, the patient’s FEV1 will have reduced by approximately 50%.  

Haidt (R11) discusses a conversation with a taxi driver in which the driver says “We will return to Jordan because I never want to hear my son say ‘f*** you’ to me.”  According to Haidt, the driver’s concern deals with which moral foundation?

A tall, thin 21-year-old male has sudden sharp pain in the chest and dyspnea. What differential diagnosis is most likely? 

A 64 year old woman presents with a 3-month history of upper abdominal pain. She describes the discomfort as an intermittent, centrally located “burning feeling” in the upper abdomen, most often occurs with meals and accompanied by mild nausea. Use of an over the counter antacid provides partial symptom relief. She also uses naproxen sodium on a regular basis for the control of osteoarthritis pain. Her clinical presentation is consistent with: 

A 48-year-old woman calls 911 and is brought to the emergency room complaining of a sudden onset of dyspnea. She reports she was standing in the kitchen making dinner, when she suddenly felt as if she could not get enough air, her heart started racing, she became lightheaded and felt as if she would faint. She denied chest pain or cough. Her medical history is significant for gallstones, for which she underwent a cholecystectomy 2 weeks ago. The procedure was complicated by a wound infection, requiring her to stay in the hospital for 8 days. She takes no medications regularly, only acetaminophen as needed for pain at her abdominal incision site. On examination, she is tachypneic with a respiratory rate of 28 breaths per minute, oxygen saturation is 84% on room air, heart rate 124, and blood pressure 118/89 mm Hg. She appears uncomfortable, diaphoretic, and frightened. Her oral mucosa is slightly cyanotic, her jugular venous pressure is elevated, and her chest is clear to auscultation. Her apical heart rhythm is tachycardic but regular rhythm with a loud S2 in the pulmonic area, no gallop or murmur. Her abdominal examination is benign. Incision site is normal without signs of infection. Her right leg is moderately swollen from mid-thigh to her feet, and her thigh and calf are mildly tender to palpation. Laboratory studies including cardiac enzymes are normal, her electrocardiogram (ECG) reveals sinus tachycardia, and her chest X-ray is interpreted as normal.  What is your next step? 

A male client presents with complaints of blood in his urine. It is painless and he has no difficulty with voiding. The nurse practitioner obtains a urinalysis which confirms the presence of red blood cells. Leukocytes are negative. What is the priority diagnosis that must be ruled out on this client?  

Which of the following is most consistent with the presentation of a patient with diverticulosis? 

Iron deficiency anemia is an example of which type of anemia?  

A 37-year-old man presents to your office with the complaint of cough. The cough began approximately 3 months prior to this appointment, and it has become more annoying to the patient. The cough is nonproductive and worse at night, and after exercise. He has had a sedentary lifestyle but recently started an exercise program, including jogging, and says he is having a much harder time with the exertion. He just runs out of breath earlier than he used to previously, and he coughs a great deal. He has not had any fever, blood-tinged sputum, or weight loss. He denies nasal congestion and headaches. He does not smoke and has no significant medical history. His examination is notable for a blood pressure of 134/78 mm Hg and lungs that are clear to auscultation bilaterally, except for an occasional expiratory wheeze on forced expiration. A chest radiograph is read as normal.  What test would you do? 

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