A patient with cluster head aches: - answershould eliminate triggers like nicotine and alcohol
An elderly patient has an audible carotid bruit. He has
... [Show More] a history of hypertension Hyperlipidemia and and MI 5 years ago. The finding of a bruit indicates that the patient: - answeris more likely to die from cardiovascular disease than cerebrovascular disease
Mini mental status exam helps identify patients who have symptoms of - answercognitive impairment
A 26 year old patient with a long history of chronic sinusitis presents today with temperature of 103.2F, headache and stiff neck. Which finding below should make the NP suspect meningitis? - answerPositive Kerning and Brudinski
fever nucal rigidity headaches and altered mental status characterize acute bacterial meningitis.
84 year old with advanced dementia symptoms. What is NOT in the differential?
Tumor
Cerebral Hemorrhage
Cerebral Infarct
Normal aging process - answerChanges in cognition are NOT associated with the aging process although 50% of patients over 90 have some form of dementia. All patients should have some type of imaging done to rule out tumor infection hemorrhage infarct, ect. Experts are unable to agree on which studies are the most valuable.
A family member of a newly diagnosed Alzheimer's disease patient asks how long the patient will have to take Donepezil, and acetylcholinesterase inhibitor, before learning weather it is beneficial or not. You reply: - answer6-12 months
The evaluation should include caregiver feedback, repeat mental status assessments ability to perform ado healthcare provider assessment side effects and cost. If stopped it can be restarted at a later date.
An elderly patient with organic brain syndrome is at increased risk for elder abuse because: - answerhas declining cognitive function
A 68 year old smoker with a history of well controlled hypertension, describes a syncopal episode which occurred yesterday while mowing his lawn. Today he has no complaints. Initially the NP should: - answerperform a complete neurological and cardiac exam with auscultation of carotid arteries.
a referral to speciality care is indicated after workup by nP.
Syncope is a significant finding especially in a smoker with HTN
Which cranial nerve is assessed by administering the Snellen Test? - answercranial nerve 2
Cranial nerves 3,4,6 do - answerextraocular movement
A person with 20/60 vision:
has better vision than someone with 20/80 - answerfirst number represents distance (usually 20 feet)
The second number represents distance the average eye can see the letters on a specific line of the chart.
In other words the examinee can see at 20 feet what the average eye (20/20) can see at 80 feet. 20/80 is a measure of distance vision, not near vision.
The big E represents 20/200 vision. 20/200 is considered legally blind by most standards.
A 72 year old patient with relatively benign medical history complains of a new onset headache associated with abrupt onset of visual disturbances. There sedimentation rate is elevated. Her neuro exam is otherwise normal. What is the most likely reason for her symptoms? - answerTemporal Arteritis
Temoral Arteritis - answerdiagnosed by temporal artery biopsy.
Temporal arteritis is a chronic vasculitis of the medium and large vessels. A biopsy can be performed on the same day it is suspected. Generally patients have complaints of new onset headaches, abrupt onset visual disturbances jaw claudication, unexplained fever or anemia and an elevated sedimentation rate. The average age of diagnosis is 72 years. She should be referred to neurology for evaluation today.
Which finding below is typical in a patient with Bells Palsy?
Unilateral Numbness of the cheek - answerBells Palsy is weakness or temporary paralysis of CN 7. It is usually idiopathic and unilateral. It is unusual to have pain. [Show Less]