Nokea
A woman is 11 weeks pregnant and has a maternity history of one full term vaginal delivery, a set of premature triplets delivered vaginally, and a first trimester abortion. Using her TPAL system to document her maternal status:
- A. Gravida 4 para 1114
- B. Gravida 4, para 1314
- C. Gravida 3, para 1114
- D. Gravida 3, para 1112
Correct Answer: A
Rationale: TPAL system: Gravida (pregnancies), Para (full-term, preterm, abortions, living children).
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Desmopressin acetate (DDAVP) nasal spray has been found to be useful in the management of enuresis in children. In which of the following situations is the drug especially beneficial?
- A. Daytime incontinence
- B. Hypertensive children with enuresis
- C. Secondary enuresis
- D. Sleepovers
Correct Answer: D
Rationale: DDAVP is especially beneficial for primary nocturnal enuresis, and may be used during situations like sleepovers.
An 82-year-old woman with a history of hypertension and type 2 diabetes mellitus presents after collapsing at home. What diagnostic test should be done first?
- A. Complete blood count and basic metabolic panel
- B. A STAT noncontrast head computed tomography (CT)
- C. A two-dimensional echocardiogram
- D. Urinalysis
Correct Answer: B
Rationale: Noncontrast CT is essential for evaluating potential stroke.
Which one of the following is most true about aging changes?
- A. Stage 3 and 4 sleep decreases.
- B. Renal perfusion is not reduced, but renal function is reduced.
- C. Hearing acuity declines beginning in middle age.
- D. Prostatic enlargement occurs only in a minority of men.
Correct Answer: A
Rationale: Aging leads to a decrease in the deeper stages of sleep (Stage 3 and 4).
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.
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.