Nokea
A 74-year-old man who recently lost his spouse of 50 years in an auto accident tells the NP that "he has no purpose in this life":
- A. Have you told your family how you feel?
- B. Have you thought about hurting yourself?
- C. Are you taking your medication?
- D. Do you have any friends?
Correct Answer: B
Rationale: This is a key screening question to assess for suicidal ideation.
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A 78-year-old male was recently diagnosed with Alzheimer’s disease. He scored 23/30 on his Montreal Cognitive Assessment (MoCA) and his clinical presentation is consistent with mild disease. Which of the following is NOT a common side effect of donepezil?
- A. Thrombocytopenia
- B. Bradycardia
- C. Vivid dreams
- D. Gastrointestinal distress
Correct Answer: A
Rationale: Thrombocytopenia is not a common side effect of donepezil, while bradycardia, vivid dreams, and gastrointestinal distress are.
Randall Johnson, an 80-year-old man with a history of high blood pressure and hypothyroidism, presents with ongoing dizziness. What is the most likely cause of his dizziness?
- A. Orthostatic hypotension
- B. Benign positional paroxysmal vertigo
- C. Overcontrol of thyroid
- D. Ménière disease
Correct Answer: A
Rationale: Orthostatic hypotension is the most likely cause of dizziness in this patient with high blood pressure and hypothyroidism.
A 32-year-old woman presents with dull puffiness of the eyes, pronounced non-pitting periorbital edema. This finding is suggestive of:
- A. Nephrotic syndrome
- B. Myxedema
- C. Cushing syndrome
- D. Sinusitis
Correct Answer: B
Rationale: Myxedema, associated with hypothyroidism, causes puffiness and edema around the eyes.
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.
A pulsating mass may be an indication of...
- A. Strangulated hernia
- B. Incarcerated hernia
- C. AAA
- D. All of the above
Correct Answer: C
Rationale: A pulsating mass can indicate an abdominal aortic aneurysm (AAA), which is a critical condition.