Nokea
A patient with bulimia is likely to be:
- A. Very overweight
- B. Very underweight
- C. Of average weight
- D. Not concerned with weight
Correct Answer: C
Rationale: The correct answer is C: Of average weight. Patients with bulimia often maintain a normal weight or fluctuate between weight extremes due to their binge-eating and compensatory behaviors. They may engage in purging to counteract the effects of binge eating, preventing significant weight gain. Choice A is incorrect as bulimia is not typically associated with being very overweight. Choice B is incorrect as individuals with bulimia can have a normal or slightly underweight body weight. Choice D is incorrect as individuals with bulimia are often preoccupied with weight and body image.
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You want to start pharmacologic treatment for depression in an older patient who is taking numerous medications. Which of the following antidepressants is the least likely to cause drug-drug interactions?
- A. Citalopram
- B. Fluoxetine
- C. Paroxetine
- D. Venlafaxine
Correct Answer: E
Rationale: I believe you made a typo in listing the correct answer as "E" while there is no "E" option in the choices provided. Could you please confirm the correct answer choice so I can provide you with a detailed explanation and summary of why the correct answer is correct and why the other choices are incorrect?
The most appropriate medication indicated for reversing the anticoagulated effects of dabigatran etexilate (Pradaxa) is:
- A. Idarucizumab (Praxbind)
- B. Vitamin K
- C. Protamine sulfate
- D. Fondaparinux (Arixtra)
Correct Answer: A
Rationale: Step-by-step rationale:
1. Idarucizumab is a specific reversal agent for dabigatran, directly binding to dabigatran to neutralize its anticoagulant effects.
2. Vitamin K is ineffective for dabigatran reversal, as it mainly works on reversing the effects of vitamin K antagonist anticoagulants like warfarin.
3. Protamine sulfate is used for heparin reversal, not for direct thrombin inhibitor reversal like dabigatran.
4. Fondaparinux is a factor Xa inhibitor and not effective for reversing the effects of dabigatran.
You are at your family reunion playing football when your uncle takes a hit to his right lateral thorax and is in pain. He asks you if you think he has a rib fracture. You are in a very remote area. What would your next step be?
- A. Call a medevac helicopter
- B. Drive him to the city (4 hours away)
- C. Press on his sternum and spine simultaneously
- D. Examine him for tenderness over the injured area
Correct Answer: D
Rationale: The correct answer is D: Examine him for tenderness over the injured area.
Rationale:
1. Start with a physical examination to assess for tenderness directly over the injured area.
2. Rib fractures often present with localized tenderness upon palpation.
3. If tenderness is present, suspect a rib fracture and advise immobilization.
4. Advise against unnecessary movement to prevent further injury.
Summary:
- Choice A: Calling a medevac helicopter is premature without assessing the severity of the injury.
- Choice B: Driving him 4 hours away could worsen his condition without proper assessment.
- Choice C: Pressing on the sternum and spine simultaneously is not recommended as it can cause further harm.
Which is a true statement about varicose veins?
- A. They are due to congenital valve deformities
- B. They are usually diagnosed on clinical presentation
- C. They are not affected by pregnancy
- D. They are more symptomatic during ovulation
Correct Answer: B
Rationale: The correct answer is B because varicose veins are usually diagnosed based on clinical presentation, such as visible, bulging veins and symptoms like pain or swelling. This is because varicose veins are often easily visible and cause noticeable symptoms.
A: Varicose veins are not typically due to congenital valve deformities but rather develop over time due to weakened vein walls and valves.
C: Varicose veins can be affected by pregnancy due to hormonal changes and increased pressure on the veins.
D: Varicose veins may not necessarily be more symptomatic during ovulation; symptoms can vary based on individual factors.
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.