Nokea
A 42-year-old woman with a history of migraine headaches is requesting prophylactic medication treatment. Which medication should the Nurse Practitioner prescribe?
- A. Sumatriptan (Imitrex)
- B. Amitriptyline (Elavil)
- C. Verapamil (Verelan)
- D. Metoprolol (Lopressor)
Correct Answer: B
Rationale: Amitriptyline is used off-label for migraine prophylaxis.
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Rapid Human Immunodeficiency virus (HIV) testing would be appropriate for a patient with complaints of:
- A. Painful bowel movement, anal itching, and painful or swollen testicles or abnormal menstrual bleeding
- B. Painful urination, dyspareunia, and vaginal or penile discharge
- C. Fever, headache, and lymphadenopathy
- D. None of the above
Correct Answer: C
Rationale: Acute HIV symptoms may include fever, headache, sore throat, and lymphadenopathy.
When interpreting a complete blood count (CBC) lab report, which of the following results describes the size of the RBCs?
- A. Hemoglobin
- B. Mean corpuscular volume (MCV)
- C. Red cell distribution width (RDW)
- D. Hematocrit
Correct Answer: B
Rationale: MCV measures the average size of red blood cells.
During a physical examination, a patient presents with swollen lymph nodes. How should you adjust your palpation technique based on the findings?
- A. Increase the pressure to assess for tenderness
- B. Use a firmer grip to ensure you can feel the nodes
- C. Continue using soft finger pads but apply a more vigorous motion
- D. Maintain the light circular motion but focus on the areas of swelling
Correct Answer: A
Rationale: Increased pressure helps assess tenderness and the degree of swelling or possible infection in swollen lymph nodes.
A 70-year-old man has bothersome lower urinary tract syndrome (LUTS) associated with benign prostatic hyperplasia (BPH). His symptoms are no longer well managed with lifestyle modifications. He is interested in medication to reduce his urinary symptoms but is concerned about possible side effects. He notes that he is recently married and sexual activity is very important to him. Which of the following medications would be most appropriate for this patient?
- A. Alfuzosin
- B. Ditropan
- C. Dutasteride
- D. Tamsulosin
Correct Answer: D
Rationale: Tamsulosin is an alpha-1 blocker that helps alleviate urinary symptoms without significantly impacting sexual function.
A 72-year-old man with colonic diverticulosis was admitted to the hospital with gastrointestinal bleeding and abdominal pain. The following day, the patient was positive on the Confusion Assessment Method (CAM) performed by geriatric consultation services. Which of the following is NOT predisposed by delirium in this patient?
- A. Higher risk of institutionalization
- B. Increased risk of dementia
- C. Shorter length of stay in the hospital
- D. Increased mortality
Correct Answer: C
Rationale: Delirium is associated with increased mortality and risk of dementia, but it generally leads to longer hospital stays.