Nokea
A 78-year-old male was recently diagnosed with Alzheimer’s disease. He scored 23/30 on his Montreal Cognitive Assessment (MoCA) and his clinical presentation is consistent with mild disease. Which of the following is NOT a common side effect of donepezil?
- A. Thrombocytopenia
- B. Bradycardia
- C. Vivid dreams
- D. Gastrointestinal distress
Correct Answer: A
Rationale: Thrombocytopenia is not a common side effect of donepezil, while bradycardia, vivid dreams, and gastrointestinal distress are.
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A 74-year-old man who recently lost his spouse of 50 years in an auto accident tells the NP that "he has no purpose in this life":
- A. Have you told your family how you feel?
- B. Have you thought about hurting yourself?
- C. Are you taking your medication?
- D. Do you have any friends?
Correct Answer: B
Rationale: This is a key screening question to assess for suicidal ideation.
Which of the following is NOT a common safety concern for adult patients?
- A. Physical health risks
- B. Occupational safety
- C. Substance abuse
- D. Childhood vaccinations
Correct Answer: D
Rationale: Childhood vaccinations are not a common safety concern for adult patients.
A 67-year-old female with a history of congestive heart failure and myocardial infarction is admitted to the hospital because of increasing altered mental status and decreased arousal over the last week. Which one of the following features best distinguishes delirium from depression or dementia?
- A. Irritability
- B. Inattention
- C. Paranoia
- D. Aggressiveness
Correct Answer: B
Rationale: Inattention and waxing and waning of alertness are key features distinguishing delirium from depression or dementia.
Why is it important to consider intracranial hemorrhage when a patient presents with epistaxis?
- A. It indicates a possible allergic reaction.
- B. It may suggest a more serious underlying condition.
- C. It is a common cause of nasal congestion.
- D. It usually resolves without treatment.
Correct Answer: B
Rationale: Epistaxis can be a symptom of intracranial hemorrhage, especially if the bleeding is sudden or severe.
Ophthalmoscopic examination of a 40-year-old carpenter reveals a triangular thickening of the bulbar conjunctiva across the outer surface of the cornea. This condition is termed:
- A. Corneal arcus
- B. Corneal scar
- C. Pterygium
- D. Cataract
Correct Answer: C
Rationale: A pterygium is a growth of the conjunctiva over the cornea.