Kaplan University - MN 568 - MN568 unit 10 final. A+ Guide.

Question 1 2 / 2 points Which statement about confusion is true? Question options: a) Confusion is a disease process. b) Confusion is always temporary. c) Age is a reliable predictor of confusion. d) ...

Question 1 2 / 2 points Which statement about confusion is true? Question options: a) Confusion is a disease process. b) Confusion is always temporary. c) Age is a reliable predictor of confusion. d) Polypharmacy is a major contributor to confusion in older adults. Question 2 2 / 2 points Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear? Question options: a) Meclizine b) Diphenhydramine c) Diamox d) Promethazine Question 3 2 / 2 points The hallmark of an absence seizure is: Question options: a) No activity at all b) A blank stare c) Urine is usually voided involuntarily d) The attack usually lasts several minutes Question 4 2 / 2 points How often should drug levels be monitored when a seizure medication has controlled the seizures, and the drug level is adequate? Question options: a) Every 3 months b) Every 6 months c) Annually d) Whenever there is a problem Question 5 2 / 2 points Which of the following persons fits the classic description of a patient with multiple sclerosis (MS)? Question options: a) A teenage male b) A 65-year-old male c) A 25-year-old female d) A 60-year-old female Question 6 2 / 2 points Which of the following is a specific test to MS? Question options: a) Magnetic resonance imaging (MRI) b) Computed tomography (CT) scan c) A lumbar puncture d) There is no specific test. Question 7 2 / 2 points Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis? Question options: a) Cholinesterase inhibitors b) Anxiolytics c) Antidepressants d) Atypical antipsychotics Question 8 2 / 2 points Which hematoma occurs along the temporal cranial wall and results from tears in the middle meningeal artery? Question options: a) Epidural hematoma b) Subdural hematoma c) Subarachnoid hematoma d) Intraparenchymal hemorrhage Question 9 2 / 2 points Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing? Question options: a) CN V b) CN VII c) CN IX d) CN X Question 10 2 / 2 points Which statement best describes a carotid bruit? Question options: a) It is felt with the middle three fingers over the carotid artery. b) A bruit becomes audible when the lumen is narrowed to 1 mm or less. c) A low-pitched bruit is a medical emergency. d) The higher the pitch of the bruit, the higher the degree of stenosis. Question 11 2 / 2 points Which patient is more likely to have a cluster headache? Question options: a) A female in her reproductive years b) A 40-year-old African American male c) A 55-year-old female who drinks 10 cups of coffee daily d) A 45-year-old male awakened at night Question 12 2 / 2 points Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of? Question options: a) Dementia b) Alzheimer’s disease c) Parkinson’s disease d) Delirium Question 13 2 / 2 points Which type of meningitis is more benign, self-limiting, and caused primarily by a virus? Question options: a) Purulent meningitis b) Chronic meningitis c) Aseptic meningitis d) Herpes meningitis Question 14 2 / 2 points Which is the most sensitive neuroimaging test to evaluate patients with encephalitis? Question options: a) MRI b) CT c) Electroencephalogram (EEG) d) An initial lumbar puncture Question 15 2 / 2 points What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster? Question options: a) A stabbing pain on one small area of the body b) A vesicular skin lesion on one side of the body c) A pain that is worse upon awakening d) A lesion on the exterior ear canal Question 16 1 / 1 point Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her? Question options: a) “Most patients have complete recovery in 3 to 6 months.” b) “Unfortunately, you’ll probably have a small amount of residual damage.” c) “Don’t worry, I’ll take care of everything.” d) “You may have a few more episodes over the course of your lifetime but no permanent damage.” Question 17 2 / 2 points Sam, aged 65, is started on L-dopa for his Parkinson’s disease (PD). He asks why this is necessary. You tell him: Question options: a) “L-dopa is neuroprotective.” b) “The primary goal of therapy is to replace depleted stores of dopamine.” c) “This is the only drug that can provide symptomatic benefit.” d) “This is the initial monotherapy drug.” Question 18 2 / 2 points Which of the following signs is seen in a patient with more advanced PD? Question options: a) Resting tremor b) Bradykinesia c) Rigidity d) Postural instability Question 19 2 / 2 points Which of the following is the most commonly experienced symptom of migraine? Question options: a) Light sensitivity b) Pulsatile pain c) Sound sensitivity d) Experiencing an aura Question 20 2 / 2 points Which of the following characteristics differentiates peripheral vertigo from central vertigo? Question options: a) The duration of central vertigo is shorter than that of peripheral vertigo. b) There is an auditory-associated symptom with peripheral vertigo and a visual-associated symptom with central vertigo. c) Central vertigo is positional, and peripheral vertigo is not. d) The onset of central vertigo is more sudden than that of peripheral vertigo. Question 21 2 / 2 points Carotid endarterectomy should be considered only for symptomatic patients with greater than what percentage of stenosis? Question options: a) Greater than 25% b) Greater than 50% c) Greater than 75% d) Only for 100% occlusion Question 22 2 / 2 points What antiplatelet agent is most widely used for secondary prevention of stroke? Question options: a) Aspirin b) Ticlopidine c) Clopidogrel d) Aspirin and clopidogrel Question 23 2 / 2 points Which adjunctive diagnostic test should be used in the work-up of a patient with suspected Creutzfeldt-Jakob disease or transient epileptic amnesia? Question options: a) MRI b) CT c) Cerebrospinal fluid analysis d) EEG Question 24 2 / 2 points Which herbal preparation may cause delirium and should be avoided in an elderly patient? Question options: a) Sam-e b) Saint John’s Wort c) Melatonin d) Saw Palmetto Question 25 0 / 2 points Which of the following activities is part of the functional activities questionnaire? Question options: a) Asking the patient to unravel a Rubik’s cube b) Determining if the patient can drive on the highway c) Asking the patient about a news event from the current week d) Seeing if the patient can keep his or her home clean Question 26 2 / 2 points About 90% of all headaches are? Question options: a) Tension b) Migraine c) Cluster d) Without pathological cause Question 27 2 / 2 points Which statement is true regarding driving and patients with a seizure disorder? Question options: a) Once diagnosed with a seizure disorder, patients must never drive again. b) After being seizure free for 6 months, patients may drive. c) Each state has different laws governing driving for individuals with a seizure disorder. d) These persons may drive but never alone. Question 28 2 / 2 points Julie has relapsing-remitting muscular sclerosis. She has not had a good response to interferon. Which medication might help given intravenously once a month? Question options: a) Glatiramer acetate b) Natalizumab c) Fingolimod d) Glucocorticoids Question 29 2 / 2 points The ‘freezing phenomenon’ is a cardinal feature of? Question options: a) Parkinson’s disease b) Alzheimer’s disease c) A CVA d) Bell’s palsy Question 30 2 / 2 points A ratchet-like rhythmic contraction, especially in the hand, during passive stretching is known as? Question options: a) Spinothalamic dysfunction b) Ratcheting c) Cogwheeling d) Hand tremors Question 31 2 / 2 points Clinical features of insidious onset, slow progression, and a lack of other findings to explain the symptoms are fairly diagnostic of which condition? Question options: a) Guillain-Barré syndrome b) Parkinson’s disease c) Alzheimer’s disease d) Huntington’s disease Question 32 1 / 1 point Which condition is characterized by the impaired ability to learn new information along with either a cognitive disturbance in language, function, or perception? Question options: a) Guillain-Barré syndrome b) Parkinson’s disease c) Alzheimer’s disease d) Delirium Question 33 2 / 2 points A score of 20 to 25 on this test indicates early-stage Alzheimer’s disease: Question options: a) SLUMS b) MoCA c) FAST d) MMSE Question 34 2 / 2 points Intravenous thrombolytic therapy following an ischemic CVA should be given within how many hours of symptom onset? Question options: a) 1 hour b) 3 hours c) 6 hours d) 12 hours Question 35 2 / 2 points When administered at the beginning of an attack, oxygen therapy may help this kind of headache? Question options: a) Tension b) Migraine c) Cluster d) Stress Question 36 2 / 2 points The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety? Question options: a) Acetylcholine b) Gamma-aminobutyric acid (GABA) c) Dopamine d) Serotonin Question 37 2 / 2 points The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least: Question options: a) 1 month b) 3 months c) 6 months d) 12 months Question 38 1 / 1 point A patient presents to the clinician after experiencing four episodes in the last month of sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes. The patient is now becoming very fearful of future events and has been reluctant to leave the house. The clinician suspects panic disorder but wants to rule out any possible medical causes. Which of the following medical conditions can mimic the symptoms of a panic attack? Question options: a) Pheochromocytoma b) Hyperthyroidism c) Cardiac arrhythmias d) All of the above Question 39 2 / 2 points Which of the following is considered first-line treatment for panic disorders? Question options: a) Benzodiazepines b) Selective serotonin reuptake inhibitors (SSRIs) c) Tricyclic antidepressants d) Cognitive behavioral therapy Question 40 1 / 1 point Which of the following symptoms is not part of the diagnostic criteria for post-traumatic stress disorder (PTSD)? Question options: a) Hypersomnolence b) Blunted feelings c) Loss of interest in significant activities d) Intrusive recurrent recollections of the event Question 41 2 / 2 points Which of the following neuroendocrine abnormalities is implicated in depression? Question options: a) Decrease in adrenal size b) Increased cortisol and corticotrophin-releasing hormone c) An exaggerated response of thyrotropin (TRH) to infusion of thyroid-releasing hormone d) Increased inhibitory response of glucocorticoids to dexamethasone Question 42 2 / 2 points The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants? Question options: a) SSRIs are more effective than TCAs. b) SSRIs take less time to work than TCAs. c) SSRIs have a more favorable side-effect profile than TCAs. d) SSRIs are not lethal in overdose. Question 43 2 / 2 points After discontinuing fluoxetine, how long must a person wait before starting a monoamine oxidase inhibitor? Question options: a) 2 weeks b) 3 weeks c) 4 weeks d) 5 weeks Question 44 2 / 2 points It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is especially true during which time period? Question options: a) Before the initiation of treatment b) 1 to 2 weeks after the initiation of treatment c) When switching to a different medication d) 1 to 2 weeks after tapering off medications Question 45 2 / 2 points A patient is experiencing extrapyramidal side effects from his antipsychotic medications. The clinician would most likely take which of the following approaches to treating these side effects? Question options: a) Give the patient a “drug holiday” until the symptoms resolve and then restart the medication. b) Switch the patient to a different antipsychotic. c) Treat the patient with anticholinergics. d) Treat the patient with anticonvulsants. Question 46 1 / 1 point According to Kübler-Ross, the stages of grief occur in which order? Question options: a) Anger, denial, depression, bargaining, acceptance b) Anger, denial, bargaining, acceptance, depression c) Denial, anger, depression, bargaining, acceptance d) Denial, anger, bargaining, depression, acceptance Question 47 1 / 1 point The clinician is educating a patient about the effects of marijuana. The patient stated she has been smoking for years and believes the use does not interfere with her life. What is a significant long-term sequelae of marijuana use that the clinician should educate this patient about? Question options: a) Memory impairment b) Sexual dysfunction c) Dry mouth d) There are no long-term consequences of marijuana use. Question 48 2 / 2 points Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter? Question options: a) GABA b) Acetylcholine c) Dopamine d) Serotonin Question 49 2 / 2 points What blood alcohol level corresponds with the signs of stupor and confusion? Question options: a) 0.05 b) 0.1 c) 0.2 d) 0.3 Question 50 2 / 2 points Rapid eye movement (REM) sleep occurs how frequently during non-REM sleep? Question options: a) Every 30 minutes b) Every 60 minutes c) Every 90 minutes d) Every 180 minutes Question 51 2 / 2 points Which of the following is a laboratory finding commonly found in patients with anorexia nervosa? Question options: a) Hypercholesterolemia b) Hypermagnesmia c) Leukocytosis d) Decreased TRH Question 52 2 / 2 points Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration? Question options: a) Sertraline b) Fluoxetine c) Citoprolam d) Imipramine Question 53 2 / 2 points Which of the following would be important to monitor in a child receiving methylphenidate for treatment of attention deficit-hyperactivity disorder (ADHD)? Question options: a) Liver function b) Vision c) Growth parameters d) Renal function Question 54 2 / 2 points It is important for the clinician to discuss the long-term effects of sexual assault with survivors. Which of the following is the most common long-term effect of sexual assault? Question options: a) Depression b) Obsessive-compulsive disorder c) Substance abuse d) PTSD Question 55 2 / 2 points Women are at the highest risk for developing postpartum depression for up to how long after childbirth? Question options: a) 2 weeks b) 1 month c) 3 months d) 6 months Question 56 2 / 2 points Which is the most prevalent psychiatric condition in the United States? Question options: a) Depression b) Anxiety c) Substance-related addictions d) Gambling Question 57 1 / 1 point What is recorded as clinical category two of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision)? Question options: a) Clinical disorder or focus of clinical attention b) Personality or environmental problems c) Environmental and psychosocial stressors d) Global assessment of functioning Question 58 2 / 2 points Which of the following may be used to evaluate a person’s suicide risk? Question options: a) CAGE b) SANE c) SAD PERSONAS d) DIGFAST Question 59 2 / 2 points Assessing for adherence with prescribed medications and developing a plan for what to do if they are stopped is a major treatment issue for which of the following diagnostic groups? Question options: a) ADHD b) Bipolar c) Depression d) Anxiety Question 60 1 / 1 point Bipolar disorder requires differential diagnosis from all of the following except? Question options: a) Substance abuse and medication effects b) Medical and neurological disorders c) Cluster B personality disorders and depression d) Obsessive-compulsive disorder Question 61 1 / 1 point The use of benzodiazepines in the patient with generalized anxiety disorder and comorbid depression can exacerbate depressive symptoms. Question options: a) True b) False Question 62 1 / 1 point Depressive episodes associated with bipolar disorder are treated the same as major depressive disorder. Question options: a) True b) False Question 63 1 / 1 point Women in abusive relationships have a greater chance of being killed by their batterers when they leave the relationship than women who stay. Question options: a) True b) False Question 64 1 / 1 point Adults must show childhood onset of symptoms to receive a diagnosis of ADHD. Question options: a) True b) False Question 65 1 / 1 point Parkinson’s disease and dementing illnesses may commonly manifest depressive symptoms. Question options: a) True b) False Question 66 1 / 1 point The best predictor of suicide risk is a history of suicide attempts. Question options: a) True b) False Question 67 1 / 1 point A no-suicide contract can prevent a suicide attempt. Question options: a) True b) False Question 68 1 / 1 point Depression is the most chronic disabling and economically catastrophic medical disorder of the severe mental illnesses. Question options: a) True b) False Question 69 1 / 1 point Clozapine (Clozaril) requires laboratory monitoring at specified frequencies with results reported to a national registry. Question options: a) True b) False Question 70 1 / 1 point When combined with certain other medications, serotonin-specific antidepressants can have significant liver P450-interaction effects. Question options: a) True b) False Question 71 1 / 1 point A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination? Question options: a) Human papillomavirus (HPV) b) Endometrial hyperplasia c) Vagismus d) Polycystic ovarian syndrome Question 72 2 / 2 points A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea? Question options: a) Ceftriaxone b) Doxycycline c) Acyclovir d) Metronidazole Question 73 1 / 1 point A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease has she most probably been exposed to? Question options: a) Gonorrhea b) HPV c) Chlamydia d) Trichomonas Question 74 1 / 1 point A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding? Question options: a) Trichomonas b) Bacterial vaginosis c) HPV d) Herpes simplex virus Question 75 2 / 2 points Which of the following medications is the treatment of choice for trichomonas? Question options: a) Metronidazole b) Ceftriaxone c) Diflucan d) Doxycycline Question 76 1 / 1 point A 36-year-old woman is seen with complaints of vaginal itching, burning, and discharge. On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae. Which of the following treatments would be appropriate? Question options: a) Fluconazole b) Estrogen vaginal cream c) Metronidazole d) Doxycycline Question 77 2 / 2 points Mandy presents with a cauliflower-like wart in her anogenital region. You suspect it was sexually transmitted and document this as a: Question options: a) Filiform/digitate wart b) Dysplastic cervical lesion c) Condyloma acuminata d) Koilocytosis Question 78 2 / 2 points During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? Question options: a) An enlarged rubbery gland b) A hard irregular gland c) A tender gland d) A boggy gland Question 79 2 / 2 points Of the following types of cellulitis, which is a streptococcal infection of the superficial layers of the skin that does not involve the subcutaneous layers? Question options: a) Necrotizing fasciitis b) Periorbital cellulitis c) Erysipelas d) “Flesh-eating” cellulitis Question 80 2 / 2 points The forced vital capacity is decreased in: Question options: a) Asthma b) Chronic bronchitis c) Emphysema d) Restrictive disease Question 81 2 / 2 points The most common cause of CAP is? Question options: a) Streptococcus pneumoniae b) Klebsiella pneumoniae c) Legionella pneumoniae d) Pseudomonas aeruginosa Question 82 2 / 2 points Which of the following is a possible consequence of sleep apnea? Question options: a) Asthma b) Increased white blood cells c) Insulin resistance d) Hyperactivity Question 83 2 / 2 points The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection? Question options: a) IgA b) IgE c) IgG d) IgM Question 84 2 / 2 points A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find? Question options: a) The scrotum will be dark. b) The scrotum will appear light pink or yellow. c) The scrotum will appear milky white. d) The internal structures will be clearly visible. Question 85 2 / 2 points During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? Question options: a) An enlarged rubbery gland b) A hard irregular gland c) A tender gland d) A boggy gland Question 86 2 / 2 points A 78-year-old man is diagnosed with C2 prostate cancer, and he asks the clinician what that means. In order to answer the patient, the clinician must have which of these understandings of the Jewett rating system? Question options: a) The cancer involves the seminal vesicles. b) There is metastatic disease to regional lymph nodes. c) The cancer is confined to the capsule. d) There is metastasis to distant organs. Question 87 1 / 1 point A 58-year-old patient has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the patient about which of these side effects? Question options: a) Risk of osteoporosis b) May have hot flushes c) May have impotence d) All of the above Question 88 1 / 1 point A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE). Which of the following should be included in the list of differential diagnoses? Question options: a) Testicular cancer b) Inguinal hernia c) Varicocele d) All of the above Question 89 1 / 1 point What is the treatment of choice for a patient diagnosed with testicular cancer? Question options: a) Radical orchidectomy b) Lumpectomy c) Radiation implants d) All of the above Question 90 1 / 1 point A patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan? Question options: a) Every month b) Every 3 to 4 months c) Every 6 to 12 months d) Every year Question 91 2 / 2 points Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause? Question options: a) “You must be under a lot of stress lately.” b) “It is hereditary. Did your father experience this also?” c) “The cause is unknown, but we suspect it is due to an immunologic mechanism.” d) “We’ll have to do some tests.” Question 92 2 / 2 points Which of the following is “a linear crack extending from the epidermis to the dermis?” Question options: a) An ulcer b) A fissure c) Lichenification d) An excoriation Question 93 2 / 2 points A bulla is: Question options: a) A vesicle larger than 1 cm in diameter b) An elevated solid mass with a hard texture; the shape and borders can be regular or irregular c) A superficial elevated lesion filled with purulent fluid d) Thinning of the skin (epidermis and dermis) that appears white or translucent Question 94 1 / 1 point A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do? Question options: a) Make an immediate referral for an orthopedic evaluation without further assessment. b) Tell her that it takes time for these bruises to improve, so she should be patient. c) Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint. d) Send her to the emergency room for reduction of this obvious wrist fracture. Question 95 1 / 1 point Osteoarthritis is primarily a noninflammatory condition. Question options: a) True b) False Question 96 1 / 1 point The presence of a positive rheumatoid factor is always indicative of rheumatoid arthritis. Question options: a) True b) False Question 97 2 / 2 points Which of the following medications can cause hyperglycemia? Question options: a) Prednisone b) Metformin c) Synthroid d) Cephalexin Question 98 2 / 2 points Which of the following is diagnostic for diabetes mellitus? Question options: a) A1C 7.0 on one occasion b) Fasting blood sugar (FBS) of 100 mg/dL on two occasions c) Random glucose of 200 mg/dL on two occasions d) Two-hour post-load plasma glucose of 300 mg/dL on one occasion Question 99 2 / 2 points Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy? Question options: a) Insulin b) Metformin c) Glucotrol d) Precose Question 100 1 / 1 point A 35-year-old woman presents with symptoms of hypoglycemia. There is no history of diabetes mellitus. Which of the following should be included in the differential diagnosis? Question options: a) Anxiety disorder b) Pheochromocytoma c) Psychosis d) All of the above