Which best describes the classic symptoms of Parkinson’s Disease?

Nathan is a 20-year-old college student who lives in the dorm on campus.  He presents to clinic with complaints of an itchy rash that is spreading and more noticeable at night.  He has tried some steroid cream he uses for his dermatitis, but it is not helping.  On exam, Nathan has an erythematous, papular rash with a few linear lesions noted.  The rash is present in Nathan’s axillary folds, elbows, and finger webs.  As the APRN, what would be the best treatment plan for Nathan?

Craig is a 44-year-old who presents with the following skin lesion.  What is this lesion?  Image courtesy of wikimedia.org

When speaking to patients about bariatric surgery, it is important to provide education on all aspects of the post-op journey. What are the potential short- and long-term risks specific to post bariatric surgery? Select all that apply.

The next patient in clinic is being seen for a yearly physical exam and to assess if he would be a candidate for bariatric surgery. Select the medical history and/or lab results that would exclude the patient from being a bariatric surgical candidate.

Sharon is a 40-year-old with a PMH of obesity, hypertension, hyperlipidemia, and Type 2 DM. Her medications include losartan 50 mg, atorvastatin 20 mg, and empagliflozin 10 mg. Her BMI is 42 kg/m2. She informs you she is ready to lose weight and would like to lose about 80 pounds over the next two years. Which medication would provide the best repsonse for this scenario?

Jenna is a 21-year-old female who presents to clinic with complaints of a painful, burning bump on her left labia majora.  On exam, the APRN notes an abraided blister at the posterior fourchette and an ulceration on her left labia majora.  What would be the best treatment recommendation for Jenna?    

Kristy is a 26-year-old who presents to your office with complaints of daily headache.  She has 5 children under the age of 11, the oldest has cerebral palsy with significant physical and mental disability, and children 3 and 4 have ADD and oppositional defiant disorder.  She describes the headaches as being “all over” without visual disturbance.  She does have nausea sometimes, but has never had emesis. Light and sound seem to make them worse on a lot of days.   “They’re just getting worse and worse.  They occur all the time now”.  She has tried OTC ibuprofen, naprosyn and acetaminophen without relief, taking at least one dose daily and often twice daily.  You have met her significant other one time when you helped her take the kids to the car after an appointment.  He was “sleeping” in the passengers seat reeking of alcohol.  He would arouse, so you new he wasn’t dead, but was definitely not of any help.  What type of headache does Kristy have?

Emily is a 19-year-old who presents to clinic with complaints of unilateral headache associated with photophobia, phonophobia and nausea.  She tells you that she has never had a headache like this previously.  Denies head trauma or visual change.  Her exam is completely normal including neurological exam.  What is your plan of care for Emily?

You suspect your patient has hyperthyroidism. Which signs or symptoms may be present during your assessment? Select all that apply.