Harmony, a 33 year- old G1 P0 comes into see the nurse. Harmony is 29 weeks pregnant and she had only one previous prenatal visit at 18 weeks.  She has declined vaccines and most blood work, so her rubella status, blood type, HIV status are unknown   Harmony has failed to keep previous appointments which were scheduled at 22 weeks and 26 weeks. Harmony states that she has not been taking iron preparations nor her folic acid supplement as prescribed. She lives with her boyfriend outside of town on 2 acres and they raise chickens. Harmony shared that she treated her morning sickness with herbs from her garden.  How would you ask the questions while maintaining a non-judgmental attitude and respect for the patient preference?

Daniel is a 52-year-old male with a history of obesity and diabetes. He had gastric bypass surgery 6 years ago and has been maintaining normal blood glucose levels and a BMI of 25 for the last 4 years. Daniel was able to stop taking medication for his diabetes but still takes a daily multivitamin. He has had symptoms of Irritable Bowel Syndrome intermittently for 6 months, including abdominal pain and constipation. Within the last week, he has developed new symptoms that are more severe than the abdominal pain in the past. Daniel’s pain radiates into his groin and interior to the ribs on his right side. The pain fluctuates in intensity but is so severe that it’s debilitating at times. This morning, his pain was accompanied by nausea and vomiting, so he decided to seek emergency care. Which parts of Daniel’s history contribute to his risk for kidney stones?

Anaphylactic shock O Is a severe complication during pregnancy in which seizures occur O Occurs in pregnant women who smoke O Is a common side-effect seen in newborns with fetal alcohol syndrome O Is a life-threatening whole-body reaction to an offending substance, such as an allergen

A 5-year-old Gabriel is a multiracial male weighing 48 lbs with an allergy to penicillin arrives in the emergency room, no cultural considerations identified. You are handed the following notes on the patient that read: He arrived in ER with his mother after falling out of bed after jerking movement activity as witnessed by his older brother while sleeping. Right-upper extremity appears with deformity. Mother and child speak English. Child has no significant medical history. Mother reports incontinent of urine during episode. Your Assessment Vital Signs: T 102.9, P 135, R 24, BP 118/60, O2 sat 100% RA General Appearance: appears drowsy; face flushed, quiet Neuro: oriented X3 Cardiovascular: unremarkable Respiratory: lungs clear Integumentary: very warm, dry GI/GU: abdomen normal Physician Orders Complete Blood Count (CBC) Complete Metabolic Panel (CMP) Urinalysis with culture and sensitivity (U/A C&S) Blood Cultures x 2 X-rays kidneys, Influenza screening Acetaminophen 15 mg/kg PO…

Section A – Answer ALL questions A 1 month old baby is failing to thrive, with poor feeding and growth, and frequent irritability. After becoming ill with a severe cold, he is admitted to hospital with abdominal tenderness and yellowing of the whites of the eyes, and is diagnosed with jaundice. Clinical investigation reveals elevated serum bilirubin, splenomegaly, and a low level of haemoglobin.   Whole blood extract containing 200mg of red blood cells were resuspended in 1mL saline stabilised with 1,8-beta-mercaptoethanol and EDTA. The activity of “enzyme X” was measured in the sample by adding 100µL of this suspension to 0.9 mL of Tris-HCl EDTA buffer (pH 8.0) containing 0.1M MgCl2, 2.0mM NADH, 50mM phosphoenolpyruvate (PEP), 30mM ADP and lactate dehydrogenase at 60units/mL.   The decrease in absorbance at 340nm was followed over a period of 10 minutes and compared with a blank sample containing all components except the ADP. The results are shown in the table below:   Time/min…

Harmony, a 33 year- old G1 P0 comes into see the nurse. Harmony is 29 weeks pregnant and she had only one previous prenatal visit at 18 weeks.  She has declined vaccines and most blood work, so her rubella status, blood type, HIV status are unknown   Harmony has failed to keep previous appointments which were scheduled at 22 weeks and 26 weeks. Harmony states that she has not been taking iron preparations nor her folic acid supplement as prescribed. She lives with her boyfriend outside of town on 2 acres and they raise chickens. Harmony shared that she treated her morning sickness with herbs from her garden.  What education would you offer the client?

A 50 year old male is experiencing fatigue, dizziness, and headaches with a rapid decline in his visual acuity. He treats his hypertension and type 2 diabetes with medications. His brow and jaw are enlarged (proganthism), his hands and feet and fingers are wide. His wedding ring no longer fits on his finger. He is obese and has a deep voice. -His lab tests show high blood glucose, high GH, high IGF1, normal prolactin, and low testosterone.There was a pituitary mass seen on his CT scan.   What is the diagnosis that best matches this patients conditions? a.) gigantism b.) crushing's c.) acromegaly d.) hypopituitarism

A woman is pregnant for the third time and there is some concern for the safety of her fetus. Medical records indicating Rh factors in the family have been lost. For this reason, blood samples were taken from each child and from the mother. Determine the Rh factors for each to ensure the safety of the pregnancy.The mother is rh negative, how will her 3 children be?

Daniel is a 52-year-old male with a history of obesity and diabetes. He had gastric bypass surgery 6 years ago and has been maintaining normal blood glucose levels and a BMI of 25 for the last 4 years. Daniel was able to stop taking medication for his diabetes but still takes a daily multivitamin. He has had symptoms of Irritable Bowel Syndrome intermittently for 6 months, including abdominal pain and constipation. Within the last week, he has developed new symptoms that are more severe than the abdominal pain in the past. Daniel’s pain radiates into his groin and interior to the ribs on his right side. The pain fluctuates in intensity but is so severe that it’s debilitating at times. This morning, his pain was accompanied by nausea and vomiting, so he decided to seek emergency care.Why might Daniel’s doctor ask him about his diet? Briefly explain how his diet might be related to his condition.

A 50 year old male is experiencing fatigue, dizziness, and headaches with a rapid decline in his visual acuity. He treats his hypertension and type 2 diabetes with medications. His brow and jaw are enlarged (proganthism), his hands and feet and fingers are wide. His wedding ring no longer fits on his finger. He is obese and has a deep voice. -His lab tests show high blood glucose, high GH, high IGF1, normal prolactin, and low testosterone.There was a pituitary mass seen on his CT scan. What accounts for the patients proganthism? a.) High growth hormone levels after epiphyseal plate closure cause thickening of bone structure b.) low testosterone leads to increased bone growth and density c.) normal bone growth with aging d.) Low IGF=-1 stimulates bone growth