A 48 year old female patient presents to clinic with bilateral hand and finger pain. The patient also notes that her finger joints are swollen. She identifies that the pain is worst in the early morning and improves after about 2 hours when she “gets up and moving” for the day. Based on the patient’s presentation, you know which of the following is the most important to order?

A 49-year-old woman reports difficulty sleeping due to an uncomfortable, crawling sensation in her legs that improves when she walks. Symptoms are worse in the evening. Which additional finding would best support the diagnosis of restless legs syndrome?

A 20-year-old African American woman presents to the emergency department with severe, sudden-onset chest pain and shortness of breath. She also reports generalized fatigue and joint pain. She has a known history of chronic anemia but has not followed up with a primary care provider in over a year. On exam, she is tachycardic, tachypneic, and has mild scleral icterus. Oxygen saturation is 91% on room air. Laboratory studies show: Hemoglobin: 7.9 g/dL (low), Reticulocyte count: 10.2% (high), MCV: 96 fL (normal), LDH: elevated, Indirect bilirubin: elevated, Haptoglobin: undetectable. What is the most likely diagnosis?

A 19 year old patient reports to the urgent care with severe abdominal pain in the left upper quadrant after taking a hit to the abdomen during a soccer game. The patient notes that he has also been sick frequently over the past month beginning with a viral illness of fever and severe sore throat. The patient notes that he was seen and was told that his strep test was negative and that the viral illness would likely pass. You suspect the patient may have:

A nurse practitioner’s role on the interdisciplinary team includes which of the following responsibilities? (SELECT ALL THAT APPLY)

As a Nurse Practitioner in California, you are preparing to prescribe a Schedule II controlled substance for a new patient with chronic pain. Which of the following actions demonstrates responsible prescribing practices in accordance with state requirements?

A 68-year-old woman with a recent shingles outbreak reports persistent burning pain in a dermatomal distribution along her left rib cage that has continued several weeks after symptom onset. She finds clothing uncomfortable on the area. Which treatment is most appropriate to initiate?

A 56 year old male reports to clinic for a lab follow up after his annual physical. His PMH includes HLD (diet controlled), ACL status post surgical autograft repair, thyroidectomy, and prediabetes. His labs are as follows: Complete Metabolic Panel (CMP) Test Result Reference Range Sodium 139 mmol/L 135 – 145 mmol/L Potassium 4.2 mmol/L 3.5 – 5.1 mmol/L Chloride 102 mmol/L 98 – 107 mmol/L Bicarbonate (CO₂) 24 mmol/L 22 – 29 mmol/L BUN 13 mg/dL 7 – 20 mg/dL Creatinine 0.9 mg/dL 0.6 – 1.2 mg/dL Glucose (fasting) 89 mg/dL 70 – 99 mg/dL Calcium 7.1 mg/dL 8.5 – 10.5 mg/dL AST (SGOT) 20 U/L 10 – 40 U/L ALT (SGPT) 23 U/L 7 – 56 U/L ALP 72 U/L 40 – 129 U/L Total Protein 7.0 g/dL 6.0 – 8.3 g/dL Albumin 4.5 g/dL 3.4 – 5.4 g/dL Total Bilirubin 0.7 mg/dL 0.1 – 1.2 mg/dL Complete Blood Count (CBC) Test Result Reference Range WBC 6.2 x10⁹/L 4.0 – 10.5 x10⁹/L Hemoglobin 14.6 g/dL 13.5 – 17.5 g/dL (male) Hematocrit 44% 41 – 53% (male) MCV 90 fL 80 – 100 fL Platelets 250 x10⁹/L 150 – 450 x10⁹/L Neutrophils 58% 40 – 70% Lymphocytes 32% 20 – 45% Thyroid Panel Test Result Reference Range TSH 1.8 μIU/mL 0.4 – 4.5 μIU/mL Free T4 1.2 ng/dL 0.8 – 1.8 ng/dL Free T3 3.1 pg/mL 2.3 – 4.1 pg/mL Hemoglobin A1c Test Result Reference Range A1c 5.9%

Which similarity (distance) metric is commonly used in the K-Means clustering algorithm?

A 39 year old male patient reports deep shoulder pain that has gradually worsened over the past few months. He notes that over head motions and reaching behind his back worsen the pain. On physical examination, you note a positive lift-off and belly-press test. You suspect the patient has: