A 28-year-old female arrives via EMS after collapsing at a restaurant following ingestion of shellfish. She reports throat tightness and difficulty breathing. Vital signs: BP 78/42 mmHg, HR 128 bpm, RR 26 breaths/min, SpO2 88% on room air. Assessment reveals generalized urticaria, audible stridor, and diffuse wheezing.

A 67-year-old male with type 2 diabetes presents to the emergency department confused and diaphoretic after his wife found him unresponsive at home. He takes glipizide and metformin. Vital signs: BP 102/64 mmHg, HR 112 bpm, RR 18 breaths/min, Temp 36.8 degrees Celsius. Point-of-care glucose is 38 mg/dL. The client is unable to swallow safely.

A 72-year-old male with hypertension and atrial fibrillation presents to the emergency department with sudden-onset right-sided weakness and expressive aphasia that began 45 minutes ago. Vital signs: BP 188/104 mmHg, HR 82 bpm (irregular), RR 16 breaths/min, SpO2 97% on room air. CT scan of the head without contrast is negative for hemorrhage. NIHSS score is 14.

A 19-year-old male who sustained a traumatic brain injury in a motor vehicle collision is in the neurological ICU. He is intubated and sedated. Vital signs: BP 168/92 mmHg, HR 54 bpm, RR 12 breaths/min (ventilator-controlled). The nurse notes that the client's pupils are unequal: right pupil is 6 mm and non-reactive, left is 3 mm and brisk. ICP monitor reads 28 mmHg.

A 54-year-old female with a history of sepsis secondary to pneumonia is on day 3 of mechanical ventilation in the ICU. Vital signs: BP 94/58 mmHg, HR 118 bpm, RR 28 breaths/min (above set rate), Temp 38.9 degrees Celsius. ABG results show PaO2 54 mmHg on FiO2 of 0.80 and PEEP of 12 cmH2O. Bilateral patchy infiltrates are visible on chest X-ray.

A 41-year-old female with a known history of Addison disease presents to the emergency department after 3 days of vomiting and diarrhea. She ran out of her hydrocortisone prescription 5 days ago. Vital signs: BP 78/46 mmHg, HR 124 bpm, RR 22 breaths/min, Temp 38.3 degrees Celsius. Laboratory results reveal sodium 124 mEq/L, potassium 6.2 mEq/L, glucose 52 mg/dL, and cortisol less than 2 mcg/dL.

A 68-year-old male with a history of diabetes and chronic kidney disease presents to the emergency department with fever of 39.8 degrees Celsius, heart rate 118 bpm, blood pressure 88/54 mmHg, respiratory rate 24 breaths per minute, and SpO2 94% on room air. He is confused and diaphoretic. Urine output has been less than 20 mL per hour for the past 3 hours. Blood cultures and a urinalysis have been collected, and lactate level is 4.2 mmol per liter.

A 72-year-old female with a history of chronic heart failure presents with progressive dyspnea over 3 days, orthopnea, and bilateral lower extremity edema to the knees. Vital signs: blood pressure 158/96 mmHg, heart rate 102 bpm, respiratory rate 26 breaths per minute, SpO2 88% on room air. Chest auscultation reveals bibasilar crackles and an S3 gallop. She reports a 4 kg weight gain over the past week.

A 28-year-old female with type 1 diabetes presents to the emergency department with a 2-day history of nausea, vomiting, polyuria, and polydipsia. She has not taken her insulin for 3 days. Vital signs: blood pressure 102/68 mmHg, heart rate 114 bpm, respiratory rate 28 breaths per minute with deep, labored breathing, and temperature 37.0 degrees Celsius. Blood glucose is 498 mg per dL. Arterial blood gas shows pH 7.18, bicarbonate 10 mEq per liter, and her breath has a fruity odor.

A 55-year-old male who recently returned from a long-haul flight presents with sudden onset right-sided pleuritic chest pain and moderate dyspnea. He reports right calf pain and swelling for 2 days. Vital signs: blood pressure 118/76 mmHg, heart rate 108 bpm, respiratory rate 22 breaths per minute, SpO2 91% on room air, and temperature 37.2 degrees Celsius. ECG shows sinus tachycardia with a new right bundle branch block. D-dimer is markedly elevated.

A 61-year-old male presents to the emergency department with sudden onset severe headache, left-sided facial droop, left arm weakness, and slurred speech that began 45 minutes ago. He has a history of hypertension and atrial fibrillation but admits to missing his anticoagulation medications for the past 2 weeks. Vital signs: blood pressure 186/102 mmHg, heart rate 88 bpm, respiratory rate 18 breaths per minute, SpO2 96% on room air. Blood glucose is 108 mg per dL.

A 34-year-old female with no significant past medical history is brought to the emergency department by ambulance after receiving a penicillin injection at an urgent care clinic approximately 10 minutes ago. She presents with generalized urticaria, angioedema of the lips and tongue, audible stridor, and severe dyspnea. Vital signs: blood pressure 76/42 mmHg, heart rate 132 bpm, respiratory rate 32 breaths per minute, SpO2 86% on room air. She is anxious and having difficulty speaking.