Nokea
A 40-year-old female, the overall texture of the breast is soft, with an uneven contour bilaterally. The NP informs the patient that:
- A. Warrants a mammogram
- B. Is considered normal
- C. May be suggestive of fibroadenoma
- D. May indicate cystic breast
Correct Answer: B
Rationale: Step-by-step rationale:
1. The patient is 40 years old, which is within the age range for routine screening mammograms.
2. The description of soft, uneven breasts is typical of normal breast tissue variations.
3. Given the patient's age and the benign characteristics described, no further investigation is needed.
Summary of other choices:
A: Warrants a mammogram - Not necessary as the breast characteristics described are normal for the patient's age.
C: May be suggestive of fibroadenoma - Fibroadenomas typically present as firm, well-defined lumps, not soft and uneven breasts.
D: May indicate cystic breast - Cystic breasts may feel lumpy or tender, but the overall texture is not described as soft and uneven.
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A 69-year-old female presents to your office for routine primary care. Her elder sister was recently diagnosed with Alzheimer's disease, and she wonders what steps she can take to reduce her own risk of developing dementia. Which of the following statements is true about the prevention of dementia?
- A. There is moderate quality evidence to support daily use of vitamin B12 and fish oil to prevent cognitive decline.
- B. Risk of dementia is modulated by non-modifiable risk factors, such as genetics, family history, and educational attainment, and there are no behavioral interventions that can reduce the risk of dementia.
- C. There is moderate quality evidence to suggest control of cardiovascular and metabolic risk factors, such as blood pressure, weight, and blood sugar, may reduce risk of dementia.
- D. There is moderate to low quality evidence supporting cannabinoids may reduce rates of progression from mild cognitive impairment to dementia.
Correct Answer: C
Rationale: The correct answer is C: There is moderate quality evidence to suggest control of cardiovascular and metabolic risk factors, such as blood pressure, weight, and blood sugar, may reduce the risk of dementia. This statement is true because studies have shown that managing cardiovascular and metabolic risk factors can help reduce the risk of developing dementia. High blood pressure, obesity, and diabetes have been linked to an increased risk of cognitive decline and dementia. By controlling these risk factors through lifestyle changes or medication, individuals can potentially lower their risk of developing dementia.
Choice A is incorrect because while vitamin B12 and fish oil may have some benefits for cognitive health, the evidence supporting their use in preventing dementia is not strong.
Choice B is incorrect because while genetics and family history play a role in dementia risk, there are behavioral interventions, such as maintaining a healthy lifestyle and managing risk factors, that can help reduce the risk of dementia.
Choice D is incorrect because there is not enough strong evidence to support the claim that cannabinoids can reduce rates
An 18-year-old college freshman presents to the clinic for evaluation of gastroenteritis. You measure the patient's temperature and it is 104 degrees Fahrenheit. What type of pulse would you expect to feel during his initial examination?
- A. Large amplitude, forceful
- B. Small amplitude, weak
- C. Normal
- D. Bigeminal
Correct Answer: A
Rationale: The correct answer is A: Large amplitude, forceful. A high fever, like 104 degrees Fahrenheit, typically leads to an increased heart rate and stronger pulse. This is the body's way of compensating for the fever and increased metabolic demands. A pulse with large amplitude and forceful quality indicates a higher cardiac output to support the body's needs during the fever. Choices B and C are incorrect because a small amplitude, weak pulse is unlikely with a high fever, and a normal pulse may not be expected in this scenario. Choice D, bigeminal, refers to an abnormal heart rhythm pattern characterized by every other beat being premature and is unrelated to the patient's fever.
A 50-year-old male has a non-tender, enlarged scrotum. The nurse practitioner suspects which of the following conditions:
- A. Orchitis
- B. Epididymitis
- C. Hydrocele
- D. Prostatitis
Correct Answer: C
Rationale: The correct answer is C: Hydrocele. A hydrocele is a fluid-filled sac surrounding the testicle, causing scrotal enlargement without tenderness. Orchitis (A) is inflammation of the testicle, presenting with pain and tenderness. Epididymitis (B) is inflammation of the epididymis, also causing tenderness. Prostatitis (D) involves inflammation of the prostate gland, not related to scrotal enlargement. In this case, the lack of tenderness and presence of scrotal enlargement point towards a hydrocele as the likely condition.
The nurse is teaching an older client with hypertension about lifestyle changes. Which of the following is most effective in managing high blood pressure?
- A. Reducing sodium intake
- B. Increasing intake of fatty foods
- C. Limiting physical activity
- D. Reducing fiber in the diet
Correct Answer: A
Rationale: The correct answer is A: Reducing sodium intake. High sodium intake can lead to fluid retention and increased blood pressure. By reducing sodium intake, blood pressure can be effectively managed. Increasing intake of fatty foods (B) can contribute to heart disease and worsen hypertension. Limiting physical activity (C) can lead to weight gain and higher blood pressure. Reducing fiber in the diet (D) can negatively impact overall health and increase the risk of hypertension.
The following information is recorded in the health history: "Patient denies chest pain, palpitations, orthopnea, and paroxysmal nocturnal dyspnea." Which category does it belong to?
- A. Chief complaint
- B. Present illness
- C. Personal and social history
- D. Review of systems
Correct Answer: D
Rationale: The correct answer is D: Review of systems. In this case, the information provided pertains to specific symptoms related to the cardiovascular system. The review of systems involves asking about symptoms in various body systems to identify any potential issues. This information helps in identifying any underlying health concerns that the patient may not have mentioned as their main complaint.
Summary of why other choices are incorrect:
A: Chief complaint - This is the main reason for the patient's visit or primary concern, not a list of symptoms.
B: Present illness - Focuses on the details of the current medical issue, not a general review of symptoms.
C: Personal and social history - Pertains to the patient's lifestyle, habits, and social support, not specific symptoms related to body systems.