Nokea
In which conflict did the US military first utilize X-ray technology for medical purposes?
- A. World War I
- B. Spanish-American War
- C. World War II
- D. Korean War
Correct Answer: A
Rationale: X-ray technology was first utilized for medical purposes during World War I to diagnose injuries and illnesses.
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Which of the following is the most appropriate description of “personhood” as it relates to people with dementia?
- A. Personhood is a universal concept that is defined the same way in all cultures.
- B. The ability to relate to others as people, rather than preserving cognitive independence, is an important aspect of “personhood.”
- C. The ability to recognize family members by name is an important aspect of “personhood.”
- D. A deterioration in cognitive function demonstrates the decreasing value of older adults in society.
Correct Answer: B
Rationale: Personhood focuses on maintaining human connections, even when cognitive decline occurs.
Two years later Mr. Hunter reports progression of his urinary symptoms and desires “a pill to make this better.” His current IPSS is 17, with a bother score of 3 indicating moderate voiding symptoms with moderate impact on his quality of life. On review of systems he notes that his vision has worsened, especially in his left eye. His ophthalmologist has recommended cataract surgery. For which of the following medications would initiation of therapy be delayed until after cataract surgery?
- A. Finasteride
- B. Tamsulosin
- C. Tadalafil
- D. Oxybutynin
Correct Answer: B
Rationale: Tamsulosin may cause intraoperative floppy iris syndrome, so it is often delayed until after cataract surgery.
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.
During an abdominal examination, the NP percusses the bulging area of the abdomen. Which sounds suggest the presence?
- A. Tympanic
- B. Dullness
- C. Hyperresonant sounds
- D. Normal resonance
Correct Answer: B
Rationale: Dullness suggests the presence of fluid or a solid mass in the abdomen, indicating conditions like ascites or tumors.
What further diagnostic steps are required for the seven patients receiving atypical antipsychotics?
- A. All patients should receive 1 week of actigraphy monitoring both on and off their current antipsychotic.
- B. All patients should be immediately referred for cognitive behavioral therapy for insomnia (CBTI).
- C. All patients should receive referral to both psychiatry and neurology, neuroimaging, and screening polysomnography to identify underlying sleep disorder.
- D. Unless there is an underlying suspicion of obstructive sleep apnea (OSA) or other sleep disorder, these patients already meet criteria for irregular sleep-wake phase disorder, and no further diagnostic steps are required.
Correct Answer: C
Rationale: Comprehensive diagnostic steps involving psychiatry, neurology, and neuroimaging are necessary to assess underlying conditions and ensure proper management.