NR601 BOOK QS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED LATEST UPDATE

NR601 BOOK QS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED LATEST UPDATE Terms in this set (75) An 81-year-old transgender female with history of depression and hyperlipidemia presents to your clinic for routine care. She endorses a history of smoking, currently smoking 1 pack per day, and occasionally drinks a glass of wine, although she denies illicit drug use. She reports she takes atorvastatin 20 mg and subcutaneous estrogen therapy. Which of the following is the most important next step in this patient's primary care? c. Counseling on smoking cessation . An 84-year-old male with history of stroke without residual deficit, systolic heart failure, and type 2 diabetes presents to clinic for follow-up. He is independently living in a retirement community and still works part time on a golf course. He currently takes aspirin 81 mg, metoprolol tartrate 25 mg BID (twice a day), furosemide 20 mg BID, and lisinopril 10 mg daily. He reports his last colonoscopy was 8 years ago, with no abnormality. He reports he is sexually active with men and women, engaging in receptive oral, receptive anal, and penetrative sex. He states he has had over three sexual partners in the last year with intermittent condom use. What sexually transmitted infection testing should be offered? d. Urine testing, blood testing, anal swab, and oropharyngeal swab Which of the following is true about tolterodine? d. It has greater risk of adverse effects with its twice-daily formulation. An 82-year-old man, Mr. A, complains of worsening nocturia, occurring four times per night. His other lower urinary tract symptoms are slow stream, occasional urgency, and urgency-related leakage once weekly. Medical problems include poorly controlled hypertension, diastolic heart failure, hyperlipidemia, osteoarthritis, and prediabetes. His medications include lisinopril 20 mg daily, metoprolol succinate 75 mg daily, atorvastatin 10 mg daily, metformin 500 mg twice daily, hydrocodone-acetaminophen as needed, and aspirin 81 mg daily. Amlodipine 5 mg daily was recently added by his cardiologist. On review of systems, Mr. A complains that nocturia is causing daytime fatigue, and he is more constipated. Physical examination is notable for blood pressure 162/83 mmHg, heart rate 60 beats per minute, clear lungs, soft abdomen, enlarged prostate, and 21 pretibial edemas. Your next step in management should be: b. Stop amlodipine and increase lisinopril. The daughter of a 79-year-old woman notes that her mother, who has dementia and lives with her, is wetting herself when she attends her new day program. Program staff have requested that "something be done" as she is requiring clothes change nearly every time she is there. She cannot describe the circumstances of leakage, saying "it just comes." Leakage is uncommon at home. Her medications include donepezil and acetaminophen. Physical examination is normal. Initial treatment approach will require intervention by which of the following? c. Day program staff Ms. J, who is 82 years old, complains of urine leakage while playing golf. This has gotten worse over the past year, and she rarely makes it through nine holes without feeling like she needs to "run into the bushes and go." Leakage is usually small volume, but causes her extreme embarrassment because she is afraid, she will smell of urine. She has tried limiting caffeine in the morning before she golfs and avoiding drinking water while playing to no effect. She also tried "those Kegler" exercises in the past without success. Which of the following is the most appropriate recommendation for Ms. J? a. Bladder training What is the most common cause of erectile dysfunction in older men? c. Atherosclerosis Which is the most reasonable first step in the treatment of older men with erectile dysfunction? d. Sildenafil A 72-year-old woman reports vaginal dryness that interferes with coitus. Her medical history includes type 2 diabetes, hypertension, and osteoarthritis. Medications are glyburide, chlorthalidone, and acetaminophen. What would be your first step in therapy? b. Stop chlorthalidone A 70-year-old woman reports sexual pain with deep penetration only. What is the most likely cause of her problem? c. High-tone pelvic floor dysfunction An 86-year-old man with no ADL deficits who has stopped driving because of macular degeneration is evaluated for a urinary tract infection associated with urinary retention. The consulting urologist places a Foley catheter and sends a prostate-specific antigen (PSA) level that comes back 12 ng/mL. Three months later after the Foley has been removed and he has had a good response to tamsulosin, his PSA is still 10 ng/mL. What is the appropriate next step in managing this man's prostate problem? d. Repeat PSA in 6 months