A 26-year-old woman with no prior medical history presents to the emergency department (ED) with progressively worsening dyspnea for 1 week. Her symptoms are preceded by 3 days of fever, rigors, and nasal congestion. She is afebrile with HR of 116 beats/min and BP of 92/70 mmHg. Physical examination reveals bilateral rales, elevated jugular venous pressure, 2/6 systolic murmur at the left lower sternal border, cool extremities, and 2+ bilateral lower extremity edema. Echocardiogram reveals LVEF of 20%, nondilated LV (LV end-diastolic diameter of 3.4 cm), global hypokinesis, mild mitral regurgitation, and a normal right ventricular function. Labs are significant for creatinine of 1.6 mg/dL, aspartate aminotransferase (AST) of 385 U/L, alanine aminotransferase (ALT) of 413 U/L, troponin I of 4.8 ng/mL, and serum lactic acid of 2.8 mmol/L. Intravenous diuretics and dobutamine are initiated. Within 24 hours of admission, the patient develops hypotension and worsening heart failure refractory to inotropes and vasopressors. Urine output is 125 cc in the last 6 hours.  Which of the following is the best next step in her management to stabilize her?

During the patient interview prior to applying traction, a patient is evasive, seems confused, and is unable to communication understanding of the treatment. What is the most appropriate action of the PTA at this time?

A 65-year-old male patient is post-MI. Before the event, the patient had a history of hyperlipidemia but was not on any pharmacotherapy. The patient is started on beta blocker and statin therapy. Upon a chart review, you note the patient is consistently hypertensive and has a left ventricular ejection fraction (LVEF) of 40%. Which of the following medication classes would be most appropriate to add for this patient?

A PTA is using positional traction in sidelying. What therapeutic goals is the PTA trying to achieve?

Choose the correct letter in the box next to the part of the image that shows hydrogen bonding within the protein’s tertiary structure.

You assess a 55-year-old male patient who is a candidate for bariatric surgery. He is 175 cm, 120 kg and has arterial hypertension for which he takes ramipril. His wife tells you the patient snores during the night. His blood pressure (BP) is 125/75 mm Hg and pulse oximetry is 89% on room air. What is the MOST appropriate management of this patient?

A broker acting as a special agent of the seller may initial changes to the contract on behalf of his client.

7. A nurse is teaching about essential fatty acids. Which food is a good source?  

Jasmine Smith, sales associate with Oak Ridge Realty, is contacted by her college roommate, Chelsea Nguyen, whom she has not seen or spoken to in 12 years. Chelsea’s job has just relocated to town and she wants to purchase a condominium. If Jasmine acts as a subagent of the seller, which statement is true?

A 62-year-old male with past medical history significant for diabetes, hypertension, hyperlipidemia, and 60 pack year smoking history comes in with complaints of respiratory distress and flu-like symptoms for the past week. Vitals are HR 105 bpm, BP 170/91 mm Hg, SpO2 87% on 5 liters per minute of oxygen via nasal cannula. He is intermittently confused but is arousable and redirectable. His arterial blood gas shows pH of 7.26, PaO2 of 97 mm Hg, PaCO2 of 61 mm Hg and HCO3 of 30.Which is the appropriate next step in intervention?