Nokea
The nurse is caring for a client with dementia. Which intervention is most likely to reduce agitation in this client?
- A. Provide a calm environment with minimal stimulation.
- B. Increase social activities to promote interaction.
- C. Encourage frequent visitors to engage with the client.
- D. Provide a variety of activities to keep the client busy.
Correct Answer: A
Rationale: The correct answer is A: Provide a calm environment with minimal stimulation. This intervention is most likely to reduce agitation in a client with dementia because excessive stimulation can overwhelm and confuse them, leading to increased agitation. By creating a calm environment with minimal stimuli, the client can feel more relaxed and less agitated.
Summary:
B: Increasing social activities may actually worsen agitation as it can be overwhelming for a client with dementia.
C: While social engagement is important, too many visitors can increase agitation.
D: Providing a variety of activities may lead to confusion and frustration instead of reducing agitation.
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Which lesion is dark, raised, and asymmetric with an irregular border?
- A. Nevus
- B. Actinic keratosis
- C. Keratoacanthoma
- D. Melanoma
Correct Answer: D
Rationale: The correct answer is D, Melanoma. Melanoma is a type of skin cancer that typically presents as a dark, raised lesion with an irregular border and asymmetry. This is due to the abnormal growth of melanocytes, the pigment-producing cells in the skin. Nevus (A) is a common mole that is usually symmetrical and has a regular border. Actinic keratosis (B) is a precancerous lesion that is typically rough and scaly, not dark or raised. Keratoacanthoma (C) is a low-grade skin cancer that often appears as a dome-shaped lesion with a central crater, not necessarily dark or asymmetric.
The addition of benzoyl peroxide to erythromycin for the topical treatment of acne:
- A. Improve the efficacy of erythromycin
- B. Decrease the risk of desquamation
- C. Decreases the risk of resistance to erythromycin
- D. Increases the time the patient can be exposed to sunlight
Correct Answer: C
Rationale: Step-by-step rationale for why choice C is correct:
1. Benzoyl peroxide has antibacterial properties.
2. Combining benzoyl peroxide with erythromycin reduces bacterial resistance.
3. This combination therapy prevents the development of resistance to erythromycin.
4. Therefore, the risk of resistance to erythromycin is decreased.
Summary:
- Choice A is incorrect as benzoyl peroxide does not directly improve the efficacy of erythromycin.
- Choice B is incorrect as desquamation is not directly affected by the addition of benzoyl peroxide.
- Choice D is incorrect as there is no evidence to suggest that benzoyl peroxide increases the time a patient can be exposed to sunlight.
You want to start pharmacologic treatment for depression in an older patient who is taking numerous medications. Which of the following antidepressants is the least likely to cause drug-drug interactions?
- A. Citalopram
- B. Fluoxetine
- C. Paroxetine
- D. Venlafaxine
Correct Answer: E
Rationale: I believe you made a typo in listing the correct answer as "E" while there is no "E" option in the choices provided. Could you please confirm the correct answer choice so I can provide you with a detailed explanation and summary of why the correct answer is correct and why the other choices are incorrect?
Which one of the following is most true about the rule of fourths?
- A. One-fourth of geriatric problems are iatrogenic.
- B. Little can be done to prevent three-fourths of the problems of aging.
- C. For every medical complaint a patient presents with, a careful assessment can identify three other diagnoses.
- D. What used to be called normal aging can be largely explained by processes that are not normal.
Correct Answer: A
Rationale: Step 1: The rule of fourths states that one-fourth of geriatric problems are iatrogenic, meaning they are caused by medical treatment.
Step 2: This statement is true because iatrogenic problems in the elderly are common due to multiple medications, procedures, etc.
Step 3: A careful assessment can indeed identify iatrogenic issues, making this statement accurate.
Summary:
A is correct because it aligns with the concept of iatrogenic problems in the elderly.
B is incorrect because interventions can help prevent many problems of aging.
C is incorrect as it does not specifically address iatrogenic problems.
D is incorrect as it does not focus on the iatrogenic aspect of geriatric problems.
What clinical finding in a funduscopic examination is indicative of increased intracranial pressure?
- A. Pulsating veins
- B. Indistinct disk edge
- C. Clear disk edge
- D. Normal retinal appearance
Correct Answer: B
Rationale: The correct answer is B: Indistinct disk edge. Increased intracranial pressure causes papilledema, resulting in swelling and elevation of the optic disk. This leads to a blurred or indistinct disk edge. Pulsating veins (choice A) are seen in conditions like arteriovenous malformations, not specifically indicative of increased intracranial pressure. Clear disk edge (choice C) and normal retinal appearance (choice D) are not consistent with the findings associated with increased intracranial pressure.