Nokea
On examination, a patient is noted to have a "mask-like" face with decreased blinking and a characteristic stare. These features may be characteristic of:
- A. Nephrotic syndrome
- B. Myxedema
- C. Cushing’s syndrome
- D. Parkinson disease
Correct Answer: D
Rationale: A "mask-like" face is a classic feature of Parkinson’s disease.
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Joyce Mitchell is a 73-year-old frail female with a history of frequent falls, presenting with nausea, vomiting, sweating, and horizontal nystagmus. She is diagnosed with vestibular neuritis. What is the best initial course of treatment?
- A. Vestibular rehabilitation
- B. Supportive care with anti-nausea and anti-vertigo medication
- C. Fluids
- D. Epley maneuver
Correct Answer: B
Rationale: Supportive care with anti-nausea and anti-vertigo medication is appropriate for vestibular neuritis.
An 80-year-old man is being evaluated for recent episodes of incontinence and confusion. His family states that he is usually independent with no altered mental issues but has become forgetful within the last 2 weeks. Which medication is most likely associated with these symptoms?
- A. Cimetidine (Tagamet)
- B. Warfarin (Coumadin)
- C. Ramipril (Altace)
- D. Vitamin B12
Correct Answer: A
Rationale: Cimetidine can cause confusion and altered mental status in the elderly.
During an acute attack of gout, the nurse practitioner knows NOT to prescribe:
- A. Colchicine (Colcrys)
- B. Allopurinol (Zyloprim)
- C. Steroids
- D. NSAIDs
Correct Answer: B
Rationale: Allopurinol should not be used during an acute gout attack as it may worsen symptoms.
What specific part of the eye is primarily examined using an ophthalmoscope?
- A. Cornea
- B. Lens
- C. Retina
- D. Iris
Correct Answer: C
Rationale: An ophthalmoscope is used to examine the retina, which includes the optic disc and blood vessels.
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.