One of the challenges to a patient-centric architecture approach to health information infrastructure is obtaining patient consent to access their healthcare data.

A 62 year old female with a history of hypertension presents to the office for follow-up after feeling short of breath. Her CXR shows congestion without any evidence of pneumonia or COPD.  Her echocardiogram shows an EF of 45% and EKG shows LVH.  She reports that she is out of breath after walking up 1 flight of stairs. She has no allergies. What are the appropriate medications for this patient?

A 48 year old female presents to the office for fever, chills, cough and congestion for the past 2 weeks. She notes that she feels short of breath and also has a decreased appetite. She has a PMH of hypertension, diabetes, a recent broken leg and takes losartan and glucophage. She is allergic to penicillin and clarithromycin medications.  A CXR shows a right lower lobe consolidation. How would you treat her?

When starting a patient on statin therapy the NP needs to consider that

A 67 year old female presents to your office with a 25 year history of poorly controlled hypertension.  Which combination of physical findings would indicate target organ damage that is commonly seen in hypertensive patients?

A 19 year old male presents to the office for occasional shortness of breath. He indicates that it occurs every few weeks and it accompanies wheezing. You send him for PFT’s and it shows that he has asthma. What treatment would you start him on?

A 62 year old male complains of chest pain that occured while shoveling snow.  The pain stopped after 5 minutes of rest.  In the office an EKG and vital signs are normal. His LDL is 169 and HDL is 23. His vital signs show the following: BP 155/90, HR 92, RR 12, O2 Sat 100%. Based on this information, what medications would you make sure that he was taking before leaving your office?

A 43 year old white male presents to the office for follow-up to hypertension. He has been taking HCTZ 25 mg for 3months. His blood pressure in the office today is 150/80 in the office. What do you recommend? 

A 42 year old male with no medical history presents to the office complaining of pain in his left great toe starting 2 days ago. He indicates that he is unable to walk and is in a wheelchair. He denies any trauma to the toe or foot. The toe is red, swollen, exquisitely tender and he is unable to extend it. You review his chart and note that he has been married for 20 years, works as a auto salesman and drinks a 6 pack of beer daily. Select the best treatment from the options listed below. 

A young adult female presents to your office with acute onset of shortness of breath.  Her history reveals recent long distance air travel. She denies a history of asthma, is a non smoker and is currently taking melatonin for sleep and oral contraceptives which she has been taking for 8 years without any problems. Assuming you had access to all stat labs and diagnostic studies, what is the next best step for this patient?