Nokea
A 70-year-old man walks 20 minutes most days of the week. He has begun to complain of pain in his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 20-minute walks without stopping to rest. What choice best describes the pain associated with peripheral artery disease?
- A. A sharp, stabbing pain
- B. A dull pain and cramp
- C. An electric shock
- D. A pulsating pain
Correct Answer: B
Rationale: Claudication pain due to peripheral artery disease is typically dull and cramp-like during exercise.
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A 27-year-old male patient presents with a painless chancre on the shaft of his penis and regional lymphadenopathy. He is diagnosed with primary syphilis. The best initial treatment is:
- A. Ceftriaxone (Rocephin)
- B. Clindamycin (Cleocin)
- C. Metronidazole (Flagyl)
- D. Benzathine penicillin G (Bicillin L.A)
Correct Answer: D
Rationale: Benzathine penicillin G is the first-line treatment for primary syphilis.
How many chains of lymph nodes should be assessed during a clinical examination?
- A. Five chains
- B. Seven chains
- C. Nine chains
- D. Eleven chains
Correct Answer: B
Rationale: Seven chains of lymph nodes are typically assessed during a clinical examination, including cervical, axillary, and inguinal regions.
Headaches with symptoms of nausea and vomiting may be associated with all of the following, EXCEPT:
- A. Migraine headache
- B. Brain tumors
- C. Subarachnoid hemorrhage
- D. Tension headache
Correct Answer: D
Rationale: Tension headaches typically do not present with nausea and vomiting.
Risk factors for elder mistreatment include all except:
- A. Physical disability of patient
- B. Dementia of patient
- C. Caregiver burden
- D. Substance abuse of caregiver
Correct Answer: E
Rationale: Financial independence of the caregiver is not a recognized risk factor for elder mistreatment.
A 75-year-old man presents with the chief concern, “I may have a bladder infection.” Further questioning reveals for several months he has been needing to void every couple of hours (can’t sit through a whole ball game), feels he must go as soon as he feels the urge (he tried putting it off and had urinary leakage), and is getting up two to three times at night to void. He denies delay in voiding or straining to initiate voiding, slow stream, feeling of incomplete emptying, or dribbling after completion of urination. He also denies dysuria and abdominal pain. Which of the following best describes the category or type of his lower urinary tract symptoms?
- A. Prostatism
- B. Overactive bladder
- C. Postmicturition
- D. Storage (irritative)
Correct Answer: D
Rationale: Storage symptoms (irritative) include urgency, frequency, and nocturia, which are characteristic of overactive bladder.