NSG6001 week 4 QUESTIONS AND SOLUTIONS

NSG6001 week 4 QUESTIONS AND SOLUTIONS The provider orders the oral phosphodiesterase type 5 inhibitor sildenafil to treat erectile dysfunction in a 65-year-old male patient. What will be included when teaching this patient about taking this medication. - ANSWER take on empty stomach medication may be taken once daily Which is true about hypoactive sexual desire in older male? - ANSWER Men with hypoactive sexual desire may have normal excitement and orgasm A young adult male reports a dull pain in the scrotum and the provider notes a bluish color showing through the skin on the affected side. Palpation reveals a "bag a worms" on the proximal spermatic cord. What is an important next step in managing this patient? - ANSWER Consideration of underlying causes of this finding An adolescent male reports severe pain in one testicle. The examiner notes edema and erythema of the scrotum on that side with a swollen, tender spermatic cord and absence of the cremasteric reflex. What is the most important intervention? - ANSWER Immediate referral to the ED A high school athlete is brought to the emergency department after collapsing during outdoor practice on a hot day. The patient is weak, irritable and confused. Serum Na 152 mEq/mL and has dry mucous membranes and tachycardia. What is the initial approach for rehydration in this patient? - ANSWER Intravenous fluid resuscitation with an isotonic solution An elderly patient who is taking thiazide diuretic has been ill with nausea and vomiting and is brought into the emergency department for evaluation. An assessment reveals oliguria, hypotension, and tachycardia and serum sodium is 118mEq/mL. What is the treatment - ANSWER Emergency volume repletion with 3% NaCl Which thyroid stimulating hormone level indicates hyperthyroidism? - ANSWER 0.2 Ulu/L A patient has thyroid nodules and the provider suspects thyroid cancer. To evaluate thyroid nodules for potential malignancy, which test is performed? - ANSWER Thyroid ultrasound What are some common goals of neuropsychiatric evaluation? - ANSWER to evaluate cognition when neuro-diagnostic tests are normal, to help identify rehabilitation goals in brain-injured patients monitor changes in symptoms over time A patient exhibits visual field defect, ataxia, and dysarthria and complains of a mild headache. A family member reports that the symptoms began several hours prior. An examination reveals normal range of motion in the neck. What type of cerebrovascular event is most likely? - ANSWER Ischemic stroke An elderly patient is brought to the emergency department after bein found on the floor after a fall. The patient has unilateral sagging of the face, marked slurring of the speech, and paralysis on one side of the body. The patient's blood pressure is 220/190 mmHg. What is the likely treatment for this patient. - ANSWER Neurosurgical consult What are initial approaches when managing delirium in a hospitalized patient who is agitated and confused? - ANSWER attend to hydration and toileting needs decrease stimulation discontinue any non-essential medications A previously lucid patient with early-stage Alzheimer's disease is hospitalized after a surgical procedure and exhibits distractibility and perceptual disturbances that occur only in the late afternoon - ANSWER Sundowner syndrome An elderly patient has symptoms of depression and the patient's daughter ask about possible Alzheimer's disease since there is a family history this disease. A screening evaluation shows no memory loss. What is the initial step in managing this patient? - ANSWER Prescribe a trial of an antidepressant medication A patient with dementia experiences agitation and visual hallucinations and is given haloperidol with subsequent worsening of symptoms. Based on this response what is the likely cause of the patient's symptoms? - ANSWER Lewy body dementia Which medication maybe useful in treating tension-type headache? - ANSWER antiemetics, muscle relaxants N-saids A patient has recurrent cluster headaches and ask about abortive therapy. Which therapy is effect for the majority of patients with cluster headaches - ANSWER Oxygen A patient with a seizure disorder has seizure which begin with eye twitching and occasionally visual hallucinations. Which site of the brain is the seizure focus - ANSWER Occipital A patient who has a seizure disorder and who takes levetiracetam is brought to an emergency dept with a seizure which has persisted for 15 minutes and which immediately followed another 15-minute seizure. What is the priority action for this patient - ANSWER Administer lorazepam and monitor cardio respiratory status Which drug is used to treat patient with focal epilepsy - ANSWER Carbarmazepine Begin prostate hypertrophy is a common finding as men age. Classically, this condition has many symptoms - ANSWER difficulty initiating urinary stream urinary hesitancy and urgency sensations of a full bladder and bladder spasms incontinence and post void dribbling A 63-year old presents to you with hematuria, hesitancy and dribbling. Digital rectal examination reveals a moderately enlarged prostate that is smooth. The client's prostate specific antigen is 1.2. What is the most appropriate management strategy for the provider to follow at this time? - ANSWER prescribe an alph adrenergic blocker A 15-year-old client comes in with acute abdominal pain. When taking his history the nurse practitioner finds that he fell off his bike this morning and has vomited. Upon closer examination the NP determines his pain is localized to the left groin and testicle. He is afebrile and reports no dysuria. the most likely differential diagnosis is - ANSWER testicular torsion A client is pregnant and has been taking the same levothyroxine medication for years. What might the provider expect to do with the levothyroxine medications - ANSWER increase the dosage while pregnant A TSH of 0.2 can lead to the following symptoms - ANSWER weight loss diarrhea Which of the following are causes of dementia in older adults that can be removed or reversed? - ANSWER Infections affecting the brain and polypharmacy An older male patient reports urinary frequency, back pain, and nocturia. A dipstick urinalysis reveals hematuria. What will the provider do next to evaluate this condition? - ANSWER PSA and perform a digital rectal exam An older male patient has a screening PSA which is 12 ng/ml. What does this value indicate? - ANSWER BPH A male patient reports nocturia and daytime urinary frequency and urgency without changes in the force of the urine stream. What is the likely cause of this? - ANSWER Lower urinary tract symptoms A 70-year-old male reports urinary hesitancy, post void dribbling, and a diminished urine stream. A digital rectal exam reveals and enlarged prostate gland that feels rubbery and smooth. Which tests will the primary care provider order based on these findings? - ANSWER Urinalysis and serum creatinine You see a 75-year old female in your clinic today complaining of urinary incontinence. She is otherwise healthy based upon her last visit. She states that her mother told her this would happen someday because it happens to every woman at some age. What would you tell this patient? - ANSWER This is not an expected condition related to aging. (Urinary incontinence is not an expected condition related to aging.) Spread of genital herpes only occurs during the time period with active lesions. Is this statement true or false? - ANSWER False (This is a false statement: spread of genital herpes only occurs during the time period with active lesions.)