Nokea
The National Institute of Neurologic Disorders and Stroke (NINDS) criteria for PD require a confirmatory autopsy but would rate as “probable” if three of the four primary clinical features were present. Which of the following lists three primary clinical features of PD?
- A. Fatigue, postural instability, gait dysfunction
- B. Rigidity, resting tremor, urinary urgency
- C. Rigidity, bradykinesia, resting tremor
- D. Freezing, sleep disturbance, arthralgias
Correct Answer: C
Rationale: The three primary features of PD are rigidity, bradykinesia, and resting tremor.
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What is an appropriate step in the initial management of the seven patients receiving atypical antipsychotics?
- A. No action is necessary, because one potential indication for atypical antipsychotic use is refractory behavioral disturbance in persons with significant dementia.
- B. Taper to discontinue the atypical antipsychotic; after a 2-week washout, begin therapy with zolpidem.
- C. Taper to discontinue the atypical antipsychotic, and create day programs that allow patients to develop a sleep deficit/need through the morning/afternoon/early evening.
- D. Start modafinil or a similar short-acting stimulant to minimize daytime sleepiness.
Correct Answer: C
Rationale: Creating day programs that help establish a sleep deficit and discontinuing antipsychotics is appropriate for managing the patients’ sleep issues.
Which of the following is a typical sign of diabetic ketoacidosis (DKA)?
- A. Excessive urination
- B. Ketone bodies in the urine
- C. High blood pressure
- D. Slow heart rate
Correct Answer: B
Rationale: Diabetic ketoacidosis often results in the presence of ketone bodies in the urine, along with hyperglycemia.
Snellen chart evaluation indicated that the patient vision is 20/30. What is the proper description of this result?
- A. At 20 feet, this patient can see what a person with normal vision can see at 30 feet
- B. At 30 feet, this patient can see what a person with normal vision can see at 20 feet
- C. At 20 feet, this patient can see what few people can see at 30 feet
- D. This patient has sight abilities that are worse than a patient with 20/40 vision
Correct Answer: A
Rationale: 20/30 means that at 20 feet, the patient can see what someone with normal vision sees at 30 feet.
A 42-year-old woman with a history of migraine headaches is requesting prophylactic medication treatment. Which medication should the Nurse Practitioner prescribe?
- A. Sumatriptan (Imitrex)
- B. Amitriptyline (Elavil)
- C. Verapamil (Verelan)
- D. Metoprolol (Lopressor)
Correct Answer: B
Rationale: Amitriptyline is used off-label for migraine prophylaxis.
A 40-year-old admits to multiple sex partners and presents with several lesions over his body. Findings reveal hemorrhagic vesiculopustular lesions over the hands and feet. These lesions are most likely associated with:
- A. Gonococcemia
- B. Infective endocarditis
- C. Hyperthyroidism
- D. Peripheral vascular disease
Correct Answer: A
Rationale: Hemorrhagic vesiculopustular lesions, particularly on the hands and feet, are associated with gonococcemia.