A 48-year-old male presents with complaints of chest pain, shortness of breath, and coughing up frothy sputum for the past 2 days. The patient was discharged 1 week ago with STEMI and cardiac catheterization with stenting in the left anterior descending artery. The patient’s chest x-ray shows blunting of the costophrenic angles. The decubitus chest x-ray shows free-flowing fluid collection greater than 1 cm. What is the AG-ACNP’s priority action for this patient?

A 56-year-old male with 30-pack year smoking history, CAD, and advanced liver disease due to alcoholic cirrhosis is being evaluated for a liver transplantation. He complains of worsening shortness of breath. His heart rate is 110/min, blood pressure is 97/64 mm Hg, respiratory rate is 32/min, and saturation 90% on 5 L/min nasal cannula. When asked to sit up in bed, the patient states that he “usually breathes better” when lying supine.  Which of the following is the MOST likely pathophysiology behind the diagnosis?

A 65-year-old male with a history of COPD and active tobacco use with no prior intubations presented to the emergency department with increased work of breathing and increased wheezing. In the emergency department, he was given stacked nebulizers and IV steroids and initiated on BIPAP. His initial blood gas demonstrated pH 7.2/ pCO2 75/ pO2 65. Following intubation, he was placed on volume control ventilation. His initial peak pressure (peak inspiratory pressure ) was 45 cm H2O, and his plateau pressure (Pplat) was 35 cm H2O. He was placed on a respiratory rate of 30, PEEP 15, FiO2 0.40 and his SpO2 was 90%. Two hours after arrival to the ICU, his ventilator starts to alarm for high pressures. His peak pressures have increased to 65 cm H2O, and his plateau pressure has increased to 55 cm H2O. His heart rate increases from 80 beats per minutes to 110, and his blood pressure drops from 110/70 to 80/50 mm Hg. His SpO2 drops to 75%. His examination is notable for continual wheezing and slight deviation of the trachea toward the left.What is the most likely cause for this acute change?

A 45-year-old male with morbid obesity (BMI 55) presents to the ED at 6 AM with right leg pain, and cellulitis that has kept him awake all night. He is admitted to the ward and his fevers and skin examination are improved with antibiotics during the first 16 hours of hospitalization. At 2 AM you are called to evaluate the patient for ICU admission because of somnolence and hypoxemia (SpO2 falling to high 70s on 2LNC). The rapid response team had difficulty waking the patient and ABG was performed before your arrival in the patient’s room: 7.29/74/52. Following arterial puncture, the patient woke up and by your arrival he is able to converse but remains sleepy with eyes closed, denying dyspnea, with SpO2 now 92% on 2LNC, and normal work of breathing. Medication history was reviewed, and no opiates have been administered. The ward team is requesting ICU transfer because of acute hypercarbic respiratory failure and initiation of BiPAP. You review recent laboratory test results and note that serum bicarbonate has been 38 to 40 over the last 6 months.Which of the following statements is true?

Which of the following is a potential complication of untreated OSA?

Identify the following m-mode structures and cardiac timing events. You must spell out the structure name AND include a comma between the two words.                Example: PV, IVCT The structure and timing event labeled #1 is the_______ during, ________ _______ .The structure and timing event labeled #2 is the the_______ during, ________ _______ .The structure between the red double-head arrow and timing event labeled #3 is the_______ during, ________ _______ .                                                                                                                                                                                                     

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?

When optimizing color Doppler, in what order should the controls be utilized?

A 68-year-old female is admitted to the hospital with an acute exacerbation of chronic obstructive lung disease. She is intubated for worsening hypercarbia and transferred to the medical ICU. On day 8 of her ICU stay, she is felt to be clinically improving and close to extubation readiness when she develops intermittent desaturation and increased tracheal secretions. A portable chest radiograph demonstrates a new right lower lobe infiltrate. A tracheal aspiration is obtained for culture.  Which of the following would be appropriate intravenous antibiotic regimen?

This vessel flow pattern is commonly known as the tango step. What part of the cardiac cycle is identified at the arrow?