A patient in the Medical Intensive Care Unit (MICU) is diagnosed with sepsis and severe hypoxemia. After 17 days in the MICU, his condition has not improved, and a repeat chest X-ray shows significant changes in lung architecture with worsening gas exchange. Which of the following pathophysiological changes is most likely contributing to his ongoing hypoxemia at this stage?

A 52-year-old male with a 40-pack-year smoking history presents to the clinic with a chronic cough, unexplained weight loss, and recent onset of digital clubbing. His oxygen saturation is 88% on room air. A chest X-ray reveals a suspicious mass in the right upper lobe. Which of the following is the most likely underlying condition causing the patient’s clubbing?

A patient with right-sided heart failure presents with ascites, and a yellow-tinted appearance to their skin and eyes. They are also embarrassed to report that their stool is now a different color than normal (clay-colored). What condition, which is common in right-sided heart failure, do you suspect? 

An acute care nurse practitioner working in the emergency room is treating a child under 2 years old who has been diagnosed with bronchiolitis. The nurse practitioner knows that the most likely pathogen responsible for this condition is:

A 25-year-old woman reports episodes where she wakes up during the night, feeling unable to move or speak. She is fully aware of her surroundings and can recall the event in detail the next day. During which sleep stage does this type of parasomnia occur?

A 68-year-old patient presents with confusion, cold and clammy skin, and a systolic blood pressure of 85 mmHg. The patient’s mean arterial pressure (MAP) is calculated to be 60 mmHg. Which of the following is the most appropriate initial clinical concern for this patient?

Prolonged high blood pressure can damage the endothelial cells that line arteries. Which of the following conditions is most likely to occur because of this damage? 

Which of the following best describes the role of GABA as an inhibitory neurotransmitter in the spinal cord?

A 55-year-old man presents with the sudden onset of flashes of light and a “curtain-like” shadow over his vision. Ophthalmic examination reveals a retinal tear with fluid accumulation beneath the retina. What is the most likely diagnosis?

Four hours after mechanical ventilation is initiated, a patient’s arterial blood gas (ABG) results include a pH of 7.51, PaO2 of 88 mm Hg, PaCO2 of 26 mm Hg, and HCO3− of 23 mEq/L (23 mmol/L). What change should the nurse anticipate to the ventilator settings to fix the acid-base imbalance?