Issues in Advanced Nursing Practice

Case Study

Gloria Smart is a 75-year-old female who presents to your office today for regular gyn care. You read her medical history and note she received a cardiac stent at age 55, has mild hypertension, and is on Zocor, Plavix, and lisinopril. Surgical history is remarkable for tonsils as a child and bunion surgery. She works full time, by choice, because it “makes me feel young.” She is up to date with colonoscopies. Gyn history normal pap history, last DXA within normal limits, normal mammogram. BMI is 26. First menses age 14 and menopause age 54. She works out at her local gym 5 days a week. Social history is negative for tobacco and recreational drugs. She has an occasional glass of wine. She has never married and has been with her current partner for 2 years and will be getting married in 2 months. She has never been pregnant, and her partner has never had a child.


1. What are your 3 differential diagnosis?

2. What is your primary diagnosis?

3. Why did you make this diagnosis decision?

4. What is your treatment plan?

5. What evidence-based research can you provide to support your decision (choice for differential diagnosis and plan/intervention)?

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