A small, rural hospital is part of an Accountable Care Organization (ACO) and is designated as a Level 1 ACO. What is part of this designation?

Which patient should have pulmonary function testing as part of the presurgical exam?

The parents of Justin, aged 1 year, have been faithful in the past to give Justin his medications for various illnesses.  The advanced practice registered nurse has diagnosed Justin with bacterial otitis media and has ordered an injection of Rocephin.  The parents are concerned about the injection of medication into their child and the APRN is concerned about the long-standing effects of undertreated streptococcal infections in children. What ethical term best describes this?

Nikki, aged 28 years, reports for initial care at the clinic today.  She reports having a history of migraine headache for which she takes propranolol as preventive therapy.  She reports an increase in the frequency of her headaches in the last 3 months and does not understand why.  Nikki denies any lifestyle changes or added stressors.  What information should the nurse practitioner reinforce with Nikki before leaving the office?

An otherwise healthy, 49 year old white male presents with c/o sudden onset of low back pain after lifting heavy boxes at work yesterday. He describes the pain as “sharp” and says it radiates down into his right buttock and right leg and reports “tingling and numbness” in the right foot and lateral toes. With exam, you notice that there is a + straight leg exam at 20 degrees to both legs with decreased patellar reflexes. The patient reports that he takes no medications regularly and has only taken OTC Ibuprofen for the pain with some effect. Which of the following differential diagnosis is most probable? 

A patient prescribed a beta blocker medication is in your office with reports of syncope, shortness of breath, and hypotension. A cardiac monitor reveals a heart rate of 35 beats per minute. Which medication may be used to stabilize this patient?

An adolescent male has received an electrical injury from a high-voltage wire that was found lying on the ground. The adolescent is brought to your office by the family. Which diagnostic test is the priority while you wait for EMS?

During a clinical rotation, a nursing student at your clinic has accidentally splashed a chemical into his or her left eye. What intervention has priority while awaiting the arrival of the emergency medical service (EMS) personnel?

A provider attending a soccer match on a hot day is assisting a player who feels hot and appears dehydrated, but who is alert and oriented. What does the provider suspect?

Which cardiac arrhythmia in an unstable patient requires unsynchronized shocks, or defibrillation?