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Racial disparities have been a part of US healthcare for many decades. How might this impact the expectations of older Black Americans?
- A. Reluctance to participate in medical research because of unethical studies in the past
- B. Underrepresentation of Black physicians in the geriatric workforce
- C. Cumulative effects of differences in access to healthcare providers
- D. All of these
Correct Answer: D
Rationale: The correct answer is D because each of the choices addresses a different aspect of how racial disparities in healthcare can impact the expectations of older Black Americans. A is correct because unethical studies in the past can lead to reluctance to participate in medical research. B is correct because the underrepresentation of Black physicians may affect the quality of care older Black Americans receive. C is correct because differences in access to healthcare providers can result in cumulative negative effects on health outcomes for older Black Americans. Therefore, the combination of these factors can significantly impact the expectations and experiences of older Black Americans in healthcare.
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Which of the following anatomic landmark associations is correct?
- A. 2nd intercostal space for needle insertion in tension pneumothorax
- B. T6 for lower margin of endotracheal tube
- C. Sternal angle marks the 4th rib
- D. 5th intercostal space for chest tube insertion
Correct Answer: D
Rationale: The correct answer is D because the 5th intercostal space is the recommended location for chest tube insertion to drain the pleural space effectively. This space is ideal as it allows for adequate drainage without causing injury to vital structures.
A: The 2nd intercostal space is actually used for needle decompression in tension pneumothorax.
B: T6 is the level at which the tip of the endotracheal tube should ideally lie to ensure proper placement and ventilation.
C: The sternal angle corresponds to the 2nd rib, not the 4th rib, making this association incorrect.
In summary, choice D is correct as it aligns with the standard practice for chest tube insertion, while choices A, B, and C are incorrect due to their association with different anatomic landmarks and procedures.
The following information is recorded in the health history: "Patient denies chest pain, palpitations, orthopnea, and paroxysmal nocturnal dyspnea." Which category does it belong to?
- A. Chief complaint
- B. Present illness
- C. Personal and social history
- D. Review of systems
Correct Answer: D
Rationale: The correct answer is D: Review of systems. In this case, the information provided pertains to specific symptoms related to the cardiovascular system. The review of systems involves asking about symptoms in various body systems to identify any potential issues. This information helps in identifying any underlying health concerns that the patient may not have mentioned as their main complaint.
Summary of why other choices are incorrect:
A: Chief complaint - This is the main reason for the patient's visit or primary concern, not a list of symptoms.
B: Present illness - Focuses on the details of the current medical issue, not a general review of symptoms.
C: Personal and social history - Pertains to the patient's lifestyle, habits, and social support, not specific symptoms related to body systems.
You are obtaining an arterial blood gas in the radial artery on a retired cab driver who has been hospitalized in the intensive care unit for a stroke. You are concerned about the possibility of arterial insufficiency. You perform the Allen test. This means that you:
- A. Checked for patency of the radial artery
- B. Checked for patency of the brachial artery
- C. Checked for patency of the ulnar artery
- D. Checked for patency of the femoral artery
Correct Answer: C
Rationale: The Allen test assesses collateral circulation by checking for patency of the ulnar artery. This is important before obtaining an arterial blood gas from the radial artery to ensure adequate blood flow and prevent ischemia. If the ulnar artery is not patent, using the radial artery could lead to arterial insufficiency. Checking the radial artery's patency (Choice A) is not the purpose of the Allen test. Checking the patency of the brachial artery (Choice B) or the femoral artery (Choice D) is not relevant in this context. The correct answer is C because ensuring ulnar artery patency is crucial for arterial blood gas sampling from the radial artery.
Which of the following medications is commonly prescribed for patients with hypertension and chronic kidney disease?
- A. Lisinopril
- B. Furosemide
- C. Metoprolol
- D. Spironolactone
Correct Answer: A
Rationale: The correct answer is A: Lisinopril. Lisinopril is an ACE inhibitor commonly prescribed for patients with hypertension and chronic kidney disease. It helps to reduce blood pressure and protect the kidneys by dilating blood vessels and improving blood flow. Furosemide (B) is a diuretic used to treat fluid retention but not specifically indicated for chronic kidney disease. Metoprolol (C) is a beta-blocker primarily used for heart conditions. Spironolactone (D) is a potassium-sparing diuretic and is not the first-line treatment for hypertension in patients with chronic kidney disease.
A 28-year-old patient comes to the office for evaluation of a rash. At first there was only one large patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. On physical examination, you note that the pattern of eruption is like a Christmas tree and that there are a variety of erythematous papules and macules on the cleavage lines of the back. Based on this description, what is the most likely diagnosis?
- A. Pityriasis rosea
- B. Tinea versicolor
- C. Psoriasis
- D. Atopic eczema
Correct Answer: A
Rationale: The correct answer is A: Pityriasis rosea. The key features that point towards this diagnosis include the sudden eruption of lesions in a Christmas tree pattern on the back and torso, along with itching. Pityriasis rosea commonly presents with a single large patch followed by smaller lesions in a distinct pattern. Other choices can be ruled out based on the description provided. Tinea versicolor typically presents with hypo- or hyperpigmented patches, not the erythematous papules and macules described. Psoriasis usually presents with thick, silvery scales, not erythematous lesions in a Christmas tree pattern. Atopic eczema may present with erythematous papules, but the Christmas tree pattern and acute onset described are not typical.