Nokea
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.
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The medication that blocks the transportation of glucose across the intestines into the bloodstream to target prandial blood glucose is:
- A. Metformin (Glucophage XR)
- B. Acarbose (Precose)
- C. Rosiglitazone (Avandia)
- D. Glipizide (Glucotrol XL)
Correct Answer: B
Rationale: The correct answer is B: Acarbose (Precose). Acarbose is an alpha-glucosidase inhibitor that blocks the breakdown of carbohydrates into glucose in the intestines, reducing glucose absorption and lowering postprandial blood glucose levels. Metformin (A) works by decreasing glucose production in the liver. Rosiglitazone (C) is a thiazolidinedione that improves insulin sensitivity. Glipizide (D) is a sulfonylurea that stimulates insulin release from the pancreas. Acarbose specifically targets postprandial blood glucose by blocking glucose absorption in the intestines.
A 28-year-old patient comes to the office for evaluation of a rash. At first there was only one large patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. On physical examination, you note that the pattern of eruption is like a Christmas tree and that there are a variety of erythematous papules and macules on the cleavage lines of the back. Based on this description, what is the most likely diagnosis?
- A. Pityriasis rosea
- B. Tinea versicolor
- C. Psoriasis
- D. Atopic eczema
Correct Answer: A
Rationale: The correct answer is A: Pityriasis rosea. The key features that point towards this diagnosis include the sudden eruption of lesions in a Christmas tree pattern on the back and torso, along with itching. Pityriasis rosea commonly presents with a single large patch followed by smaller lesions in a distinct pattern. Other choices can be ruled out based on the description provided. Tinea versicolor typically presents with hypo- or hyperpigmented patches, not the erythematous papules and macules described. Psoriasis usually presents with thick, silvery scales, not erythematous lesions in a Christmas tree pattern. Atopic eczema may present with erythematous papules, but the Christmas tree pattern and acute onset described are not typical.
A 78-year-old woman with cardiovascular disease declines creating an advance directive. Which characteristic is necessary for a healthcare agent?
- A. Geographic proximity to the patient’s home
- B. Knows how the patient defines quality of life
- C. Is a member of the patient’s immediate family
- D. Has medical training or experience
Correct Answer: B
Rationale: The correct answer is B because knowing how the patient defines quality of life is crucial for making healthcare decisions aligned with the patient's values and preferences. This ensures the healthcare agent can advocate for the patient's wishes effectively. Geographic proximity (A) is not necessary as communication can be maintained remotely. Being a family member (C) may create biases, and medical training (D) is not essential for understanding the patient's values.
Which form of urinary incontinence is present in a patient with Alzheimer’s disease who is unable to reach the toilet in time?
- A. Functional incontinence
- B. Overflow incontinence
- C. Urge incontinence
- D. Stress incontinence
Correct Answer: A
Rationale: Functional incontinence is the correct answer. This occurs when a person has physical or cognitive impairments that prevent them from reaching the toilet in time. In Alzheimer's disease, the patient's cognitive decline may impede their ability to recognize the need to urinate or navigate to the restroom. Overflow incontinence is due to bladder overdistention, urge incontinence is characterized by a sudden and overwhelming urge to urinate, and stress incontinence is associated with physical activities that increase intra-abdominal pressure. Hence, in this scenario, functional incontinence aligns with the patient's inability to reach the toilet promptly due to their Alzheimer's disease-related cognitive limitations.
What is the most common cause of erectile dysfunction in older men?
- A. Psychological stress
- B. Adverse drug reaction
- C. Atherosclerosis
- D. Autonomic neuropathy
Correct Answer: C
Rationale: The correct answer is C: Atherosclerosis. Atherosclerosis is the most common cause of erectile dysfunction in older men as it leads to reduced blood flow to the penis, affecting the ability to achieve and maintain an erection. Psychological stress (A) can contribute to erectile dysfunction but is not the primary cause. Adverse drug reactions (B) can also lead to erectile dysfunction, but it is not as common as atherosclerosis. Autonomic neuropathy (D) can affect nerve impulses in the penis but is not as prevalent as atherosclerosis in causing erectile dysfunction in older men.