A patient with an obstructing ureteral stone develops progressive dilation of the renal pelvis and calyces on imaging. The affected renal parenchyma is becoming thinner. The NP bases the plan of care on the understanding that…

A 75-year-old patient has progressive hand stiffness and knee pain that worsen with use. Morning stiffness is brief, and joint involvement is not strongly symmetrical. Another patient of the same age has prolonged morning stiffness, bilateral small-joint swelling, and symmetric involvement. The NP bases the plan of care on

A 76-year-old patient with chronic kidney disease reports progressive fatigue, recurrent respiratory infections, and increasing bruising. Hemoglobin is 8.8 g/dL (normal 12–16 g/dL), WBC is 3,100/mm³ (normal 5,000–10,000/mm³), and platelets are 78,000/mm³ (normal 150,000–450,000/mm³). MCV is 106 fL (normal 80–100 fL). Vitamin B12 and folate levels are normal. Bone marrow examination demonstrates abnormal maturation of multiple myeloid cell lines rather than an absence of hematopoietic precursors. The NP bases the plan of care on

A 62-year-old patient with no current gastrointestinal complaints is hesitant to undergo recommended colorectal cancer screening because there is no abdominal pain, bleeding, or change in bowel habits. The NP bases the plan of care on the understanding that…

A patient with sickle cell disease develops fever, dehydration, severe diffuse bone pain, and increasing dyspnea following a respiratory illness. Hemoglobin is decreased from baseline and reticulocytes are elevated. The NP bases the plan of care on

A patient with malignant disease has cells demonstrating sustained proliferation, angiogenesis, genomic instability, and resistance to programmed cell death. The NP bases the plan of care on the knowledge that:

A 53-year-old patient has episodic vertigo lasting hours, unilateral hearing loss, tinnitus, nausea, and a sense of fullness in one ear. Neurologic examination between episodes is normal. The NP bases the plan of care on

A patient presents with a rapidly enlarging region of painful erythema, warmth, and edema involving the lower leg. The abnormality extends beyond individual hair follicles, and examination suggests involvement of dermis and subcutaneous tissue. The NP bases the plan of care on the understanding that…

A 70-year-old patient with severe hypothyroidism becomes progressively lethargic during a respiratory infection. The patient is hypothermic, bradycardic, and minimally responsive. Family members state that increasing fatigue and slowed cognition had been attributed to depression for several months. The NP bases the plan of care on

A 73-year-old patient reports progressive dysphagia, unintentional weight loss, and a sensation of food sticking after swallowing. Symptoms have become steadily worse over several months. The NP bases the plan of care on the understanding that…