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In the late stages of dementia, a phenomenon called "sun downing" occurs, in which cognitive
disturbances tend to :
a. peak mid-day
b. becomes worse toward the evening
c. improves as the day goes on
d. fluctuates during the course of the day
b. becomes worse toward the evening
The proposed mechanism by which diphenhydramine caused delerium is:
a. anticholinergic effects
b. dopaminergic effects
c. gabanergic effectis
d. serotinergic effects
a. anticholinergic effects
According to the Palliative Care Presentation, palliative care may be provided to
a. only cancer patients
b. anyone regardless of their life expectancy or disease progression
c. those with a life expectancy > 6 months
d. those with a life expectancy< 6 months
b. anyone regardless of their life expectancy or disease progression
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,The highest level of evidence with the use of adjuvant analgesics is with
a. therapeutic trials before discontinuing drugs
b. patients with fibromyalgia are candidates for adjuvant analgesics
c. tricyclic antidepressants avoided due to high adverse affects
d. neuropathic pain patients are candidates for adjuvant analgesia
d. neuropathic pain patients are candidates for adjuvant analgesia
According o the Sexuality presentation, the biggest barrier to appropriate sexual evaluation in
the older patient
a. older people dont talk about sex
b. most elderly patients are not interested in sex
c. ageist attitudes
d. female post menopausal changes
c. ageist attitudes
The patient with BPH is seen for follow-up.. He has been taking finasteride (Proscar) for 6
months. The clinician should assess this patient for which of these side effects?
a. headache
b. urinary incontinence
c. hypotensionn
d. impotence
d. impotence
Which of the following statements is true regarding pain?
a. all of the above
b. if a patient complains of pain but has no physical signs, he or she is most likely exhibiting
drug-seeking behavior
c. pain is a subjective experience related to actual or potential tissue damage
d. acute pain is more intense and severe than chronic pain
c. pain is a subjective experience related to actual or potential tissue damage
The highest level of evidence to support interventions at the end of life is with
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,a. hycosamine for respiratory secretions
b. stimulant laxatives for treating constipation
c. opioids for pain control
d. opioids for dyspnea
d. opioids for dyspnea
The comorbid psychiatric problem with the highest frequency in dementia is:
a. depression
b,, agitation and aggression
c. psychosis
d. anxiety
a. depression
According to the World Health Orginazition's analgesic ladder, which drug would be most
appropriate in opiate-niave patient who presents with moderate pain
a. naproxen/morphine
b. asprin/fentanyl
c. acetaminophen/hydrocodone
d. ibuprofen/impraminen
c. acetaminophen/hydrocodone
K B age 54 presents to your office. her husband has just died suddenly and she states she
cannot function. She is crying all the time, cant seem to focus and she has so much she needs to
do to plan the funeral service and get through the next few days. YOu decide to prescribe a
benzodiazepine. Please choose the correct treatment decision statements below.
a. benzodiazepines are safe to prescribe long term
b. benzodiazepines should not be stopped abruptly if taken for > 1 month
c. benzodiazepines are first line treatment for anxiety in the elderly
d. benzodiazepines should be prescribed at the highest dose tolerated for the best effect
b. benzodiazepines should not be stopped abruptly if taken for > 1 month
Mrs. L, a 66 year old Asian female, presented for her yearly physical last week. A review of her
chart reveals she smokes 2 packs of cigarettes a day, and drinks 2 beers every evening since she
retired. She stopped walkingn two years ago when she started having knee pain. As part of
heallth maintenance, a DEXA was ordered. You have received the results, a T score of -2.5. The
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, score is consistant with
a. normal result
b. osteoporosis
b. osteoporosis
According to the American College of Cardiology 2017 Guidelines for High blood pressure in
adults, hypertension stage 2 is defined as
a. >150 or >90 mmHG
b. >140 or >90 mmHG
c. 120-129/<80 mmHg
d. 130-139 or 80-89 mm HG
b. >140 or >90 mmHG
A 58 year old male presents to the clinic with complaints of increasing SOB. The NP suspects HF.
The NP examines the CXR film. The NP knows diagnosis can be made with a high degree of
accuracy if two of the following criteria are met:
1. signs of interstitial edema (Kerley Bs)
2. upper zone redistribution of pulmonary blood flow (cephalization)
3. abnormally enlarged retrosternal apace
4. flattening of the diaphragm with blunting of the costrophrenic angle on PA film
a. 1 & 2
b2&4
c. 1 & 3
d. 2 & 3
a. 1 & 2
Which obstructive lung disease is classified as reversible?
a. Asthma
b. Chronic bronchitis
c. Emphysema
d. COPD
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