Norma is a 67-year-old female patient that presents to clinic with a painful rash on her torso that started yesterday.  She states she cannot wear a bra because it rubs on the rash and is tender.  The physical exam reveals an erythematous, papular rash that starts below her left axilla and travels around her rib cage to just under her left scapula.  There are a few vesicles present.  Based on this exam, the APRN comes up with a diagnosis and recommends Norma to 

Lisa is a 54-year-old woman who presents for her annual exam.  She wants to know what to do with this skin lesion she has had for several months.  What is your best plan of care?

Emma is an 87-year-old female who lives in a rural area approximately 20 miles from your clinic. She frequently has difficulty finding rides to get her shopping done as well as attend to her healthcare appointments. She lives alone, has no children, and is financially dependent upon her monthly Social Security checks. She is able to care for herself and is fiercely independent. PMH: Hypertension, Hyperlipidemia, and Hypothyroidism. Medications include Lisinopril 10 mg po daily, Crestor 20 mg po daily, and levothyroxine 88 mcg po daily. Her wieght is 55 kg. Today she expresses that she has been unable to afford her medications the past six months though now has enough money to purchase them, but needs a prescription renewal. What dose of levothyroxine would you start Emma on initially?  

Ryan is a 30-year-old patient that presents to clinic with complaints of a rash.  He appears ill and tells you that four days ago he began to feel fatigued and just wasn’t hungry.  He then developed fever that has ranged from 103 to 104 degrees and persists. He has also had a bit of runny nose, cough, and he has bilateral conjunctivitis as well as a very sore throat. He reports he can’t stand the light and has done nothing but lay in his dark bedroom for the last 3 days.  The rash started last night and he first noticed it to his face but decided to be seen today when it spread to his neck and upper chest and back.   On exam you note he has bilateral conjunctivitis, has photophobia, and an extremely erythematous pharynx. The rash is maculopapular and blanches with a few areas that have a petechial appearance.   Given these exam findings, you suspect that Ryan has contracted what infectious disease? 

Samantha is a 27-year-old female with a history of seizure disorder that is controlled with phenytoin (Dilantin).  She has questions for you regarding contraception.  What is the best advice you can give her?

[CHAPTER 11 – Alternatives to Fossil Fuels]  How much carbon dioxide is produced alongside electricity in a nuclear power plant compared to burning coal?

[CHAPTER 9 – Conventional Energy: Fossil Fuels] In West Virginia, coal reserves are expected to last for at least another _____ years.  

[CHAPTER 2 – Ecology ] Under what conditions might we see exponential population growth?

[CHAPTER 7 – Geological and Land Resources ] E-waste that can contain valuable metals and also toxic chemicals include _______

[CHAPTER 10 – Air Quality and Climate Change] Why are sea levels rising due to climate change?