Nokea
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.
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Which of the following is NOT a safety issue commonly faced by older adults?
- A. Falls
- B. Medication safety
- C. Cognitive impairment
- D. Increased physical activity
Correct Answer: D
Rationale: Older adults face safety issues related to falls, medication safety, and cognitive impairment, but increased physical activity is generally a benefit.
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).
On admission to the hospital, an 85-year-old woman was found to have a fungating mass on her right breast. The mass is 9 cm in diameter, partially ulcerated, and associated with edema of the arm and obvious pain. The patient has no children and had lived alone until recently, when a neighbor became concerned for what appeared to be a progressive loss of memory and neglect of the house. A nephew living in another city eventually came to take care of the situation and arranged for the admission. The patient appears confused and withdrawn; her appearance is disheveled, but she seems to be independent in her ADLs. The medical history is negative for any serious illnesses. She was able to drive her own car until shortly before this admission. The nephew does not wish to authorize hospice “right now.” A positron-emission tomography scan was negative for metastatic disease. In addition to determining the cause of her delirium, which of the following is the best way to address the breast mass?
- A. Tamoxifen should be initiated immediately. If no response is seen in 3 months, the patient should receive chemotherapy.
- B. The mass should be biopsied to study hormone receptor and HER2/neu antigen status.
- C. The patient should undergo surgery as initial treatment.
- D. The initial treatment should be radiation therapy.
Correct Answer: E
Rationale: Given the patient's age and condition, the best approach is to avoid aggressive treatment and focus on symptom management.
A 7-year-old child has been diagnosed with acute sinusitis. The drug class that should be avoided is:
- A. Antihistamines
- B. Expectorants
- C. Decongestants
- D. Nasal steroids
Correct Answer: A
Rationale: Antihistamines should be avoided in children with sinusitis, as they can dry secretions and worsen symptoms.
What is the primary function of the hypothalamus in the human body?
- A. Regulating blood sugar levels
- B. Maintaining body temperature
- C. Producing hormones that control the pituitary gland
- D. Processing sensory information
Correct Answer: C
Rationale: The hypothalamus plays a key role in regulating the endocrine system, particularly through its control of the pituitary gland.