Match the type of cardiomyopathy with the description of the underlying issue

A patient is experiencing chest discomfort. What findings does the nurse see as concerning for a myocardial infarction (MI)?

An 88-year-old man with hypertension, type 2 diabetes, and osteoarthritis presents for routine follow-up. He reports increased fatigue but denies shortness of breath, dysuria, or lower extremity swelling.• Medications:   Lisinopril 10 mg daily   Metformin 1000 mg BID   Ibuprofen 400 mg TID for arthritis pain (started 6 months ago)• Physical Exam:   BP: 128/76 mmHg   HR: 78 bpm   Extremities: No edemaLaboratory Findings:• Serum Creatinine: Increased from 1.1 to 1.8 mg/dL (over 6 months)• BUN: Elevated at 32 mg/dL• GFR: Estimated at 45 mL/min• Potassium: 4.9 mEq/L• Glucose: Controlled at 120 mg/dL fastingWhat is the primary concern in this patient’s case?

A 35-year-old woman presents to the clinic with dysuria and urinary urgency for the past 2 days. She denies fever, chills, or flank pain. She also denies any history of recurrent UTIs or recent antibiotic use. She has a sulfa drug allergy. Her vitals are BP 120/78 mmHg, HR 78 bpm, Temp 98.6°F. On physical exam, she has no tenderness to her abdomen or CVA bilaterally but has suprapubic tenderness. A Point-of-Care Urinalysis was completed, which resulted in positive leukocyte esterase and nitrites with moderate bacteria. Based on the urinalysis findings and clinical presentation, what is the best initial treatment?

An 80-year-old woman is brought to the clinic by her daughter due to increasing confusion, dry mouth, and difficulty urinating over the past 3 days. She has also experienced new-onset constipation and blurry vision.• Medical History: Hypertension, overactive bladder, insomnia• Medications:   Amitriptyline 25 mg nightly (for neuropathic pain)   Oxybutynin 5 mg BID (for overactive bladder)   Diphenhydramine 50 mg nightly (for sleep)• Physical Exam:   BP: 128/76 mmHg, HR: 94 bpm   Pupils: Dilated and sluggish reaction to light   Mucous membranes: Dry   Bladder: Palpable, distendedWhich of the following is suspected as the underlying cause of this patient’s clinical presentation?

A 78-year-old man presents with fatigue, decreased appetite, and mild confusion for the past two weeks.Laboratory Results:• Creatinine: 2.9 mg/dL (baseline unknown)• BUN: 52 mg/dL• Potassium: 5.8 mEq/LPhysical Exam Findings:• Suprapubic fullness noted on palpation• Bladder scan shows post-void residual of 550 mLWhat is the most likely underlying cause of this patient’s renal insufficiency?

A 26-year-old woman with persistent asthma presents to urgent care with shortness of breath, wheezing, and chest tightness for the past 2 days. She has not been able to sleep and have been using her inhaler every 4 hours to minimal effect. Her current medications include Albuterol (PRN) and Fluticasone (low-dose ICS). Her v/s are BP: 110/70, P: 110, RR: 24/min, SpO₂: 92% on room air. On physical exam, the nurse practitioner observes accessory muscle use and auscultates diffuse expiratory wheezing. Using GINA guidelines, what is the best initial management?

A 29-year-old man presents to the health department clinic with complaints of a painless genital ulcer that appeared 1 week ago. He relayed that he had a new male partner with inconsistent condom use. He denies any dysuria or urethral discharge. On physical exam, the nurse practitioner notes a single, non-tender ulcer on the penis and palpates bilateral, non-tender inguinal lymphadenopathy. What is the most appropriate next step?

A 3-month-old infant presents with tachypnea, poor weight gain and difficulty feeding. On auscultation, a harsh holosystolic murmur is heard at the lower left sternal border. What is the most likely diagnosis?

A 22-year-old sexually active woman presents to the clinic for a well-woman exam. She does not use condoms consistently and has had two new partners in the past year. She has no new complaints, regular menstrual cycles every month, and unremarkable past medical history. On vaginal exam, the nurse practitioner notes no abnormal vaginal discharge or cervical motion tenderness. Based on CDC STI screening guidelines, what is the most appropriate next step in this patient’s care?