NSG 6001 Week 4

• 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 UTI

• A 70 year old male reports urinary hesitancy, post void dribbling, and a diminished

urine stream. A digital rectal exam reveals an 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

• 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? Select all that apply.:

Answer Take on an empty stomach The medication effects may last for 24-36 hours Medication may be taken once daily

6. Which is true about hypoactive sexual desire in older men?:

Answer Hypoactive sexual desire in older men is related to sexual aversion.

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• 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 of worms" on the proximal spermatic cord. What is an important next step in managing this patient?:

Answer Referral to an emergency department for surgical consultation.

• 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 Doppler ultrasound to assess testicular blood flow.

• A high school athlete is brought to the emergency department after col- lapsing during

outdoor practice on a hot day. The patient is weak, irritable, and confused. Serum NA is 152 mEq/ml and has dry mucous membranes and tachycardia. What is the initial approach

for rehydration in this patient?:

Answer Intra- venous 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, hypertension, and tachycardia and serum sodium is 118 mEq/ml. What is

the treatment?:

Answer Emergency volume repletion with 3% NaCl.

11. 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.

13. What are some common goals of neuropsychiatric evaluation?:

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Answer To evaluate cognition when neuro-diagnostic tests are normal.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 being found on the

floor after a fall. The patient has unilateral sagging to the face, marked slurring of 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? Select all that apply.:

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 asks about

possible Alzheimer's disease since there is a family history of this disease. A screening evaluation shows no memory loss. What is the initial step in managing this patient?:

Answer Order brain imaging studies

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• 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

20. Which medication maybe useful in treating tension-type headaches?:

Answer Muscle relaxants

NSAIDS

• A patient has recurrent cluster headaches and asks about abortive therapy. Which therapy

is effective for the majority of patients with cluster headaches.-

Answer Oxygen

• A patient with a seizure disorder has seizures 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 department 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 cardiorespiratory status.

24. Which drug is used to treat patients with focal epilepsy?:

Answer Carbarmazepine.

• Benign prostate hypertrophy is a common finding as men age. Classically, this

condition has many symptoms.:

Answer Difficulty initiating urine stream.