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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.
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This contagious disease causes fever, headache, stiff neck, photophobia, nausea, vomiting, and altered mental status. What immunization prevents this?
- A. Meningococcal vaccine
- B. Pneumococcal vaccine
- C. Measles, Mumps, and Rubella (MMR) vaccine
- D. Varicella vaccine
Correct Answer: A
Rationale: The meningococcal vaccine prevents infections that cause meningitis.
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).
A 67-year-old female with a history of congestive heart failure and myocardial infarction is admitted to the hospital because of increasing altered mental status and decreased arousal over the last week. Which one of the following features best distinguishes delirium from depression or dementia?
- A. Irritability
- B. Inattention
- C. Paranoia
- D. Aggressiveness
Correct Answer: B
Rationale: Inattention and waxing and waning of alertness are key features distinguishing delirium from depression or dementia.
During an abdominal examination, the NP percusses the bulging area of the abdomen. Which sounds suggest the presence?
- A. Tympanic
- B. Dullness
- C. Hyperresonant sounds
- D. Normal resonance
Correct Answer: B
Rationale: Dullness suggests the presence of fluid or a solid mass in the abdomen, indicating conditions like ascites or tumors.
All of the statements about Medicaid are true except:
- A. Medicaid is jointly funded by federal and state governments.
- B. Medicaid provides coverage for low-income people of all ages.
- C. The coverage provided under Medicaid is the same in every state.
- D. Long-term care for elderly and disabled people accounts for the largest proportion of Medicaid spending.
Correct Answer: C
Rationale: Medicaid coverage varies by state and is not the same in every state.