TEST BANK For Current Medical Diagnosis And Treatment 2024, 63rd

Current Medical Diagnosis & Treatment
K K K K




AKfemaleKpatient,KcurrentlyKatK26KweeksKgestation,KhasKexperiencedKaKslowKriseKofKherKblo
odKpressureKoverKtheKpastK2Kweeks.KHerKurineKspecimenKisKnegativeKforKprotein.KSheKhasK
reducedKherKsodiumKintakeKandKhasKbegunKaKwalkingKprogram.KTheKpatient'sKbloodKpress
ureKtodayKisK155/102,KwhichKisKconsistentKwithKherKreadingsKatKhome.KAssociatedKsympto
msKincludeKaKdullKheadache.KTheKnurseKpractitioner'sKbestKresponseKis:

a.K"TryKyogaKandKmeditationKtoKdecreaseKyourKbloodKpressure."
b.KStartKtheKpatientKonKmethyldopaK250KmgKpoKtwiceKdaily.
c.K"MonitorKyourKbloodKpressureKatKhomeKandKcallKtheKofficeKifKyouKhaveKswellingKorKaKpou
ndingKheadache."
d.KStartKtheKpatientKonKmetoprololK100mgKpoKtwiceKdaily.K-
K*b.KStartKtheKpatientKonKmethyldopaK250KmgKpoKtwiceKdaily.




Rationale:KMethyldopaKhasKtheKlongestKrecordKofKsafetyKatKaKstartingKdosageKofK250KmgKp
oKbidKorKtid.KTherapyKwithKbetaKblockersKorKcalciumKchannelKblockersKisKalsoKacceptable.K(
Papadakis&KMcPhee,K2015.KP.K801.)KMetoprololKisKaKCategoryKCKmedicationKandK100Kmg
KpoKbidKisKnotKtheKlowestKpossibleKstartingKdose.KTheKinitiationKofKanti-

hypertensiveKtherapyKinKpregnantKwomenKisKindicatedKifKtheKsustainedKbloodKpressureKisK
>K150/100KorKifKthereKisKevidenceKofKend-
organKdamageK(PapadakisK&McPhee,K2015,Kp.K801)

ResistantKhypertensionKmayKbeKcausedKbyKwhichKofKtheKfollowing?

a.KNSAIDs
b.KOralKContraceptives
c.KObesity
d.KAllKofKtheKaboveK-K*d.KAllKofKtheKabove


Rationale:KJNCK7KdefinesKresistantKhypertensionKasKtheKinabilityKtoKcontrolKbloodKpressur
eKinKthoseKpatientsKwhoKareKcompliantKwithKtheKappropriateKthree-
drugKregimen,KincludingKaKdiuretic.KCausesKofKresistantKhypertensionKlistedKinKtableK11-
11KincludeKnonadherence,KNSAIDs,KoralKcontraceptives,KadrenalKsteroids,Klicorice,Kobesit
y,KandKexcessiveKalcoholKintakeK(Sutters,K2015,Kp.458-459).

CholesterolKmedicationKthatKworksKbyKobstructingKtheKabsorptionKofKcholesterolKbyKblocki
ngKtheKpassageKofKcholesterolKacrossKtheKintestinalKwallKthroughKtheKinhibitionKofKaKcholes
terolKtransporterKisK?

a.KStatins
b.KFibricKAcid
c.KEzetimibe

,d.KBileKAcidK-K*c.KEzetimibeK(Zetia)K[CholesterolKabsorptionKinhibitor]



Rationale:K"EzetimibeKisKtheKlipidKlowerKdrugKthatKworksKbyKinhibitingKtheKintestinalKabsorp
tionKofKbiliaryKandKdietaryKcholesterolKbyKblockingKpassageKacrossKtheKintestinalKwallKbyKin
hibitingKaKcholesterolKtransporter.KStatinsKblockKtheKrate-
limitingKenzymeKinKtheKformationKofKcholesterol.KFibratesKareKperoxisomeKproliferative-
activatedKreceptor-
alphaKagonistsKthatKresultsKinKpotentKreductionsKofKplasmsKtriglyceridesKandKincreasesKinK
HDL.KBileKacidsKworkKbyKbindingKbileKacidKinKtheKintestine"K(Baron,K2015).

AK2KyearKgirlKarrivesKtoKyourKclinicKwithKaKhistoryKofKaKfeverKforK7Kdays,KcervicalKlymphaden
opathy,KedemaKandKdesquamationKofKextremities,Kbilateral,Knon-
exudativeKconjunctivitis,KandKpolymorphousKexanthema.KYouKcorrectlyKdiagnoseKtheKgirlK
withK:

a.KRheumaticKfever
b.KKawasakiKdisease
c.KLymeKdisease
d.KInfectiveKendocarditisK-K*b.KKawasakiKdisease


Rationale:KTheKdiagnosticKcriteriaKforKKawasakiKdiseaseKareKfeverKthatKlastsKforKgreaterKth
anK5KdaysKandKatKleastK4KofKtheKfollowingKotherKmanifestations:K(1)KcervicalKlymphadenop
athy,KusuallyKunilateralKandKgreatKthanKorKequalKtoK1.5KcmKinKdiameter,K(2)KextremityKchan
gesK(rednessKandKswellingKofKtheKhandsKandKfeetKwithKsubsequentKdesquamation),K(3)Kpo
lymorphousKexanthema,K(4)KoralKcavityKorKlipKchanges,K(suchKasKstrawberryKtongues,Kfiss
uringKandKcracking,KandKinflammationKofKtheKoralKmucosa),KandK(5)Kpainless,Kbilateral,Kno
n-
exudativeKconjunctivitis.KRheumaticKfeverKconsistsKofK2KmajorKcriteriaKsuchKasKcarditis,Ker
ythemaKmarginatum,KSydenhamKchorea,KorKpolyarthritis,KorK1KmajorKcriteriaKandK1KminorK
criteria,KsuchKasKpolyarthalgia,Kfever,KandKpreviousKrheumaticKheartKdiseaseKorKfever,Kplu
sKevidenceKtoKsupportKstreptococcalKinfection.KInfectiveKendocarditisKoftenKpresentsKwithK
weightKloss,Kmalaise,KandKfever.K(Darst,KCollins,K&KMiyamoto,K2014,Kp.K628).KLymeKdiseas
eKmayKdevelopKafterKaKtickKbite,KandKisKcharacterizedKbyKerythemaKchronicumKmigransK(O
gleK&KAnderson,K2014,Kp.K1350).

TheKMoroKReflex:
a.KDisappearsKbyKageK3Kmonths.
b.KDisappearsKbyKageK4Kmonths.
c.KDisappearsKbyKageK8Kmonths.
d.KDisappearsKbyKageK12KmonthsK-K*a.KDisappearsKbyKageK3Kmonths.
Rationale:K(pgK15)KTheKMoroK(startle)KreflexK-
KholdKtheKinfantKsupineKwhileKsupportingKtheKhead.KAllowKheadKtoKdropK1-

2KcmKsuddenly.KArmsKwillKabductKatKshoulderKandKextendKatKelbowKwithKspreadingKofKfing

,ers.KAdductionKwithKflexionKwillKfollow.KDevelopsKbyK28Kweeks'KgestationK(incomplete)Kand
KdisappearsKbyKageK3Kmonths.KTheKpalmarKgraspKdisappearsKbyKageK4Kmonths.KTheKtonic

KneckKreflexKdisappearsKbyKageK8Kmonths.

Rosenberg,KA.KA.,K&KGrover,KT.K(2014).KTheKnewbornKinfant.KInKW.KW.KHayKJr,KM.KJ.KLevin
,KR.KR.KDeterding,K&KM.KJ.KAbzug,KCurrentKdiagnosisK&KtreatmentK(22ndKed.,Kp.K15).KSanKF
rancisco,KCA:KMcGrawKHillKEducation.
*P.K568KSeidel-
infantKsupportedKinKsemisittingKposition,KallowKheadKandKtrunkKtoKdropback*

SignsKofKhypoglycemiaKinKtheKnewbornKinfantKincludeKallKofKtheKfollowingK*except:*
a.KLethargy
b.KApnea
c.KPoorKfeeding
d.KKernicterusK-K*d.KKernicterus
Rationale:K(pgK27)KSignsKofKhypoglycemiaKinKnewbornKinfantKmayKbeKnon-
specificKandKsubtle:Klethargy,KpoorKfeeding,Kirritability,Ktremors,Kjitteriness,Kapnea,Kseizure
s.
Rosenberg,KA.KA.,K&KGrover,KT.K(2014).KTheKnewbornKinfant.KInKW.KW.KHayKJr,KM.KJ.KLevin
,KR.KR.KDeterding,K&KM.KJ.KAbzug,KCurrentKdiagnosisK&KtreatmentK(22ndKed.,Kp.K27).KSanKF
rancisco,KCA:KMcGrawKHillKEducation.
*KernicterusKisKChronicKBilirubinKEncephalopathy-
irreversibleKbrainKinjuryKchar.KbyKcerebralKpalsyKandKhearingKimpairment*

AK7KmonthKoldKmaleKchildKisKinKyourKofficeKforKhisKcheckup.KTheKnurseKpractitionerKexpects
KtheKchildKtoKbeKableKtoKdoKwhichKofKtheKfollowing:




a.KStandsKalone.
b.KRollKfromKbackKtoKstomach.
c.KUsesKthumbKandKindexKfingerKtoKpickKupKcheerio.
d.KPointsKtoKnamedKobject.K-K*b.KRollKfromKbackKtoKstomach.

Rationale:K(pgK85)KAK&KCK-KStandingKaloneK9-11Kmonths.KDK-K24Kmos.
Goldson,KE.,K&KReynolds,KA.K(2014).KChildKdevelopmentK&Kbehavior.KInKW.KW.KHayKJr,KM.K
J.
Levin,KR.KR.KDeterding,K&KM.KJ.KAbzug,KCurrentKdiagnosisK&KtreatmentK(22ndKed.,Kp.K85).
SanKFrancisco,KCA:KMcGrawKHillKEducation.

MomKbringsKherK6-year-
oldKsonKinKforKepisodicKvisitKstatingKheKhasKstartedKhavingKbowelKmovementsKatKleastKtwoKt
imesKaKweekKinKhisKunderwearKatKschoolKforKaboutK9Kweeks.KSheKstatesKheKsaysKitKhurtsKw
henKheKhasKaKbowelKmovementKatKhome.KYouKsuspectKwhichKofKtheKfollowing:

a.KEnuresis
b.KEncopresis
c.KColic
d.KViralKgastroenteritisK-K*b.KEncopresis

, Rationale:K(p.K95)KEncopresisK-
KrepeatedKpassageKofKstool KintoKinappropriate KplacesKbyKchildKwhoKisKchronologicallyKorKd

evelopmentallyKolderKthanK4Kyears.K90%KofKcasesKresultKfromKconstipation
Goldson,KE.,K&KReynolds,KA.K(2014).KChildKdevelopmentK&Kbehavior.KInKW.KW.KHayKJr,KM.K
J.
Levin,KR.KR.KDeterding,K&KM.KJ.KAbzug,KCurrentKdiagnosisK&KtreatmentK(22ndKed.,Kp.K85).
SanKFrancisco,KCA:KMcGrawKHillKEducation.

TheKnurseKpractitionerKknowsKthatKtheKfollowingKisKtrueKofKbreastKcancerKinKmalesK*except:
*
a.KTheKaverageKageKofKoccurrenceKisK70KyearsKold.
b.KFirst-degreeKrelativesKofKmaleKwithKbreastKcancerKareKconsideredKtoKbeKatKhighKrisk.
c.KTheKprognosisKinKmalesKisKworseKthanKinKfemales.
d.KAKhistoryKofKprostateKcancerKreducesKtheKriskKofKbreastKcancer.K-
K*d.KAKhistoryKofKprostateKcancerKreducesKtheKriskKofKbreastKcancer.




Rationale:K(pgK743)KBreastKcancerKinKmalesKisKrare;KincidenceKisKonlyKaboutK1%KofKthatKinK
women.KAverageKageKofKoccurrenceKisK70Kyo.K*ThereKmayKbeKanKincreasedKincidenceKofK
breastKcancerKinKmenKwithKprostateKcancer.K*First-
degreeKrelativesKofKmenKwithKbreastKcancerKareKconsideredKtoKbeKhighKrisk.KMenKwithKbre
astKcancerKespeciallyKwithKaKhistoryKofKprostateKcancerKshouldKreceiveKgeneticKcounseling
.KTheKprognosis,KevenKinKstageKIKcases,KisKworseKinKmenKthanKinKwomen.

TheKnurseKpractitionerKisKeducatingKaK38KyearKoldKCaucasianKfemaleKaboutKfibrocysticKbre
astKcondition.KTheKNPKknowsKthatKwhichKofKtheKfollowingKisKtrueKaboutKfibrocysticKconditio
n:
a.KTheKmassesKareKalwaysKunilateral.
b.KItKisKtheKmostKfrequentKlesionKofKtheKbreast.
c.KTheKsizeKofKtheKmassesKremainKtheKsameKduringKtheKcourseKofKtheKcondition.
d.KPost-menopausalKwomenKnotKonKhormoneKtherapyKareKatKgreatestKrisk.K-
K*b.KItKisKtheKmostKfrequentKlesionKofKtheKbreast.




Rationale:K(pgK716)KFibrocysticKconditionKisKtheKmostKfrequentKlesionKofKtheKbreast.KTheK
massesKareKpainful,KoftenKmultiple,KusuallyKbilateralKmassesKinKtheKbreast.KRapidKfluctuati
onKinKtheKsizeKofKtheKmassesKisKcommon.KPainKoccursKorKworsensKandKsizeKincreasesKduri
ngKpremenstrualKphaseKof
cycle.KMostKcommonKageKisK30-
50.KRareKinKpostmenopausalKwomenKnotKreceivingKhormonalKreplacement.KGiuliano,KA.KE
.K&KHurvitz,KS.KA.K(2015).KBreastKdisorders.KInKM.KA.KPapadakis,K&KS.KJ.KMcPhee,KCurrentK
medicalKdiagnosisK&Ktreatment,Kp.K716-744).KSanKFrancisco,KCA:KMcGraw-HillKEducation.

AK75-year-
oldKmaleKcomesKintoKyourKofficeKcomplainingKofKhesitancy,Kurgency,Kfrequency,Knocturia,K
andKsensationKofKincompleteKbladderKemptying.KHeKdeniesKpainKorKhematuria.KWhatKmost
KlikelyKisKhisKdiagnosis?