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Which is a true statement about varicose veins?
- A. They are due to congenital valve deformities
- B. They are usually diagnosed on clinical presentation
- C. They are not affected by pregnancy
- D. They are more symptomatic during ovulation
Correct Answer: B
Rationale: The correct answer is B because varicose veins are usually diagnosed based on clinical presentation, such as visible, bulging veins and symptoms like pain or swelling. This is because varicose veins are often easily visible and cause noticeable symptoms.
A: Varicose veins are not typically due to congenital valve deformities but rather develop over time due to weakened vein walls and valves.
C: Varicose veins can be affected by pregnancy due to hormonal changes and increased pressure on the veins.
D: Varicose veins may not necessarily be more symptomatic during ovulation; symptoms can vary based on individual factors.
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When treating a patient with asthma who is experiencing acute wheezing, which medication should be given to relieve the symptoms?
- A. Short acting bronchodilator
- B. Long acting bronchodilator
- C. Inhaled corticosteroid
- D. Combination of methylxanthine and long acting bronchodilator
Correct Answer: A
Rationale: The correct answer is A: Short acting bronchodilator. During an acute asthma attack, a short-acting bronchodilator (such as albuterol) is the preferred medication to relieve symptoms quickly by dilating the airways. This medication acts rapidly to open up the airways and provide immediate relief of wheezing and shortness of breath. Long-acting bronchodilators (choice B) are not recommended for acute symptom relief. Inhaled corticosteroids (choice C) are used for long-term control of asthma symptoms and not for immediate relief during an acute attack. Combining methylxanthine and long-acting bronchodilator (choice D) is not the standard treatment for acute wheezing in asthma.
The nurse is teaching an older client with hypertension about lifestyle changes. Which of the following is most effective in managing high blood pressure?
- A. Reducing sodium intake
- B. Increasing intake of fatty foods
- C. Limiting physical activity
- D. Reducing fiber in the diet
Correct Answer: A
Rationale: The correct answer is A: Reducing sodium intake. High sodium intake can lead to fluid retention and increased blood pressure. By reducing sodium intake, blood pressure can be effectively managed. Increasing intake of fatty foods (B) can contribute to heart disease and worsen hypertension. Limiting physical activity (C) can lead to weight gain and higher blood pressure. Reducing fiber in the diet (D) can negatively impact overall health and increase the risk of hypertension.
Even though older adults are less likely to get counseled for smoking cessation, they have which one of the following?
- A. The same quit rates as younger individuals
- B. Approximately 50% better quit rates than younger individuals
- C. Approximately 25% better quit rates than younger individuals
- D. Much lower quit rates than younger individuals
Correct Answer: C
Rationale: The correct answer is C: Approximately 25% better quit rates than younger individuals. Older adults tend to have higher quit rates compared to younger individuals due to factors like increased motivation, life experience, and health concerns. Older adults often have more resources and support systems in place to help them quit smoking successfully. Choice A is incorrect because older adults do not necessarily have the same quit rates as younger individuals. Choice B is also incorrect as the difference in quit rates is not as high as 50%. Choice D is incorrect as older adults do not generally have much lower quit rates than younger individuals.
The earliest clinical manifestation of diabetic nephropathy is:
- A. An elevation in blood urea nitrogen (BUN)
- B. An elevation in blood urea nitrogen (BUN) and creatinine (CR)
- C. A decreased glomerular filtration rate
- D. Microalbuminuria
Correct Answer: D
Rationale: The correct answer is D: Microalbuminuria. In diabetic nephropathy, the earliest clinical manifestation is the presence of microalbuminuria, which indicates early kidney damage. This occurs before significant changes in BUN, creatinine, or glomerular filtration rate are observed. Microalbuminuria is a key indicator for monitoring and early intervention in diabetic nephropathy.
Incorrect Options:
A: An elevation in blood urea nitrogen (BUN) - BUN levels may rise in later stages of kidney damage.
B: An elevation in blood urea nitrogen (BUN) and creatinine (CR) - These markers typically increase as kidney function declines, not in the early stages.
C: A decreased glomerular filtration rate - GFR decreases as kidney function worsens, not typically an early sign in diabetic nephropathy.
A 19-year-old college student, Todd, is brought to your clinic by his mother. She is concerned that there is something seriously wrong with him. She states for the past 6 months his behavior has become peculiar and he has flunked out of college. Todd denies any recent illness or injuries. His past medical history is remarkable only for a broken foot. His parents are both healthy. He has a paternal uncle who had similar symptoms in college. The patient admits to smoking cigarettes and drinking alcohol. He also admits to marijuana use but none in the last week. He denies using any other substances. He denies any feelings of depression or anxiety. While speaking with Todd and his mother you do a complete physical examination, which is essentially normal. When you question him on how he is feeling, he says that he is very worried that Microsoft has stolen his software for creating a better browser. He tells you he has seen a black van in his neighborhood at night and he is sure that it is full of computer tech workers stealing his work through special gamma waves. You ask him why he believes they are trying to steal his programs. He replies that the technicians have been telepathing their intents directly into his head. He says he hears these conversations at night so he knows this is happening. Todd's mother then tells you, "See, I told you . . . he's crazy. What do I do about it?" While arranging for a psychiatry consult, what psychotic disorder do you think Todd has?
- A. Schizoaffective disorder
- B. Psychotic disorder due to a medical illness
- C. Substance-induced psychotic disorder
- D. Schizophrenia
Correct Answer: D
Rationale: The correct answer is D: Schizophrenia. Todd presents with a history of peculiar behavior, academic decline, paranoid delusions, and auditory hallucinations. These are classic symptoms of schizophrenia, a chronic and severe mental disorder. Schizoaffective disorder (A) involves a mix of schizophrenia symptoms and mood disturbances, but Todd does not exhibit significant mood symptoms. Psychotic disorder due to a medical illness (B) would require evidence of a medical condition causing Todd's symptoms, which is not present. Substance-induced psychotic disorder (C) would require Todd's symptoms to be solely due to substance use, but his symptoms persist despite marijuana abstinence. Therefore, based on Todd's symptoms and history, the most likely diagnosis is schizophrenia.