Nokea
Which of the following is false about the Veterans Health Administration?
- A. It is an integrated network of service providers across the United States.
- B. It serves a population with an average age of nearly 65 years.
- C. It provides care management only for individuals with disabilities that are service-related.
- D. It can provide older adults home-based primary care, geriatric assessment, and long-term care.
Correct Answer: C
Rationale: The Veterans Health Administration provides care to all veterans, regardless of whether their disabilities are service-related.
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A common cause of decreased libido in men is due to:
- A. Decreased blood flow in the hypogastric arterial system
- B. Endocrine dysfunction
- C. Neurologic deficit
- D. Impaired neural innervation
Correct Answer: B
Rationale: Endocrine dysfunction, particularly low testosterone, is a common cause of decreased libido in men.
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.
Papilledema is a cause for concern because it is suggestive of:
- A. Optic atrophy
- B. Microaneurysms
- C. Increased intracranial pressure
- D. Retinal hemorrhage
Correct Answer: C
Rationale: Papilledema is caused by increased intracranial pressure, leading to swelling of the optic disc.
A nurse practitioner examines the skin of an elderly patient. Which finding below is NOT a benign lesion associated with the aging process?
- A. Xerosis
- B. Cherry angiomas and senile purpura
- C. Senile keratosis and senile lentigines
- D. Dermatophytosis
Correct Answer: D
Rationale: Dermatophytosis is a fungal infection and is not a normal aging change.
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.