Nokea
Mr. B is an 82-year-old enrolled in your primary care clinic panel. His wife is his primary caregiver and feels stressed and overwhelmed. What option would be appropriate for Mr. B except:
- A. Adult day program
- B. Assisted living
- C. Skilled nursing facility
- D. In-home paid care provider
Correct Answer: C
Rationale: Skilled nursing facilities are typically for patients who require higher levels of medical care, which may not be needed for Mr. B.
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Explain why late inspiratory crackles in the lower third of the chest are indicative of heart failure rather than other respiratory conditions.
- A. They indicate airway obstruction typical of asthma.
- B. They suggest fluid accumulation in the alveoli due to heart failure.
- C. They are a sign of chronic bronchial inflammation.
- D. They are associated with hyperinflation of the lungs in COPD.
Correct Answer: B
Rationale: Late inspiratory crackles indicate fluid in the alveoli, a hallmark of heart failure.
A 70-year-old man has bothersome lower urinary tract syndrome (LUTS) associated with benign prostatic hyperplasia (BPH). His symptoms are no longer well managed with lifestyle modifications. He is interested in medication to reduce his urinary symptoms but is concerned about possible side effects. He notes that he is recently married and sexual activity is very important to him. Which of the following medications would be most appropriate for this patient?
- A. Alfuzosin
- B. Ditropan
- C. Dutasteride
- D. Tamsulosin
Correct Answer: D
Rationale: Tamsulosin is an alpha-1 blocker that helps alleviate urinary symptoms without significantly impacting sexual function.
The remission rate of depressed patients who are 65 years and older to initial antidepressant treatment is:
- A. 30%
- B. 40%
- C. 70%
- D. 80%
Correct Answer: C
Rationale: Older adults have a higher remission rate from antidepressant treatment compared to younger populations.
Which of the following statements is true?
- A. Decision-making capacity can be determined only by a psychiatrist.
- B. A diagnosis of dementia precludes competent decision making.
- C. Lack of decision-making capacity should not be presumed if the patient goes against medical advice.
- D. Expression of a choice is sufficient to indicate decision-making capacity.
Correct Answer: C
Rationale: A patient's decision-making capacity cannot be assumed to be absent solely based on their refusal of medical advice.
Examination of the hair reveals a fine silky appearance. This finding may be seen in patients that have:
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Type 2 diabetes
- D. Celiac disease
Correct Answer: B
Rationale: Hyperthyroidism can lead to fine, silky hair due to the effects of thyroid hormones.