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 0 / 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 0 / 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 0 / 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

All you have to do is read this post and respond to it in 1-2 paragraphs and use at least 2 sources. 3 is preferred but if you can only find 2 that is no problem.  The goal of the reply is to “provide further suggestions on how their database search might be improved.”

POST:

I work on an acute inpatient psychiatric unit where all of the patients have been detained on involuntary holds. A high number of these patients are readmitted over and over again. There are several agencies in my county that serve the same population, the patients hop from one facility to the next depending on who has an open bed. Having witnessed this firsthand, I can appreciate the need for strong outpatient support services and timely follow up appointments. My clinical area of interest deals with how prompt follow up care is associated with a reduction in rapid (within 30 days of discharge) readmission rates.

My PICOT question is:

In psychiatric patients, how does having outpatient supports and follow up appointments in the first 30 days of discharge compared with having delayed follow up care or no follow-up care affect readmission rates to an inpatient psychiatric facility within 30 days of discharge?

For the search, I used CINAHL Plus with full text, MEDLINE with full text, PubMed, PsychInfo, and Academic Search Complete all accessed through the Walden library (Walden University, 2019). The terms used during this search included “psychiatric readmission”, “psychiatric readmission rates”, “behavioral health,” or “mental health” in the first search box. Additionally, the terms “psychiatric units,” “adults,” “inpatient psychiatry,” “rehospitalization,” “prevention,” “psych hospitals,” and “readmission rates” were used. Using Boolean operators “AND” and “OR” I was able to focus my search further to better answer the PICOT question (Walden University Library). In general, I prefer to narrow my searches by choosing full text, peer-reviewed journals and limiting the date range within the last five years.

In the CINAHL database, I used the search terms “psychiatric readmission rates” AND “factors or causes or influences,” this search yielded 52 articles, they were trimmed down by checking the full-text box (33 articles) and limiting the date range to 2015-present. The use of these additional modifiers reduced the results to 17 articles. There are one or two that may be useful to my PICOT question, but there not enough quality results. I then searched “readmission” AND “psychiatric units” AND “adults,” which resulted in 147 articles. These were further focused by selecting ‘full text”, peer-reviewed”, and “academic journals” with a date range between 2015-present. This resulted in 25 articles, many of which look to be useful for this project.

The formation of a PICOT question is the first step of evidence-based practice (Melnyk & Fineout-Overholt, 2019). According to Melnyk and Fineout-Overholt (2019), it is essential to formulate a focused, well-designed PICOT question in order to generate relevant information. The PICOT question should include the patient population, intervention or issue of interest, comparison intervention, outcome, and a time frame in order to be specific enough to result in relevant results in a timely fashion (Melnyk & Fineout-Overholt, 2019). Before formulating a PICOT question, one must decide on a clinical area that interests them and generate a background question, one that is broad in nature (Stillwell, Fineout-Overholt, Melnyk & Williamson, 2010). Once the broad question has been formed, the next step is to narrow the area of interest into a foreground question which is more specific and relevant to the topic (Stillwell, Fineout-Overholt, Melnyk & Williamson, 2010). Utilizing the terms that comprise the PICOT, one can search databases to find pertinent research for their inquiry (Melnyk & Fineout-Overholt, 2019). More results can be obtained by using synonyms in the search and by separating terms with “OR” within the search boxes themselves (Walden University, 2019).

 

References

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare a guide to best practice (4th ed.). Philadelphia: Wolters Kluwer.

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M. & Williamson, K. M. (2010). Evidence-Based Practice, Step by Step: Searching for the Evidence. AJN, American Journal of Nursing, 110(5), 41-47. DOI: 10.1097/01.NAJ.0000372071.24134.7e.

Walden University Library. (n.d.). Evidence-Based Practice Research: CINAHL Search Help. Retrieved December 17, 2019, from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp.

Walden University. (2019). Databases A-Z. Retrieved December 17, 2019, from https://academicguides.waldenu.edu/az.php?s=19981.

Attend a committee meeting in your health care organization. If you are not currently employed in a health care setting, you may elect to attend a committee meeting at another company, a community center, a local school, local chamber of commerce or other professional organization.

Observe the interactions between committee members and the process used by the committee to arrive at decisions.

In 500-750 words, describe the function of the committee and the roles of those in attendance. Describe your observations of the interactions between members of the committee and determine whether the process used to arrive at decisions is a form of shared governance.

A minimum of two academic references from credible sources are required for this assignment.

Submit the completed “Collaborative Committee Meeting Verification Form” with the assignment.

Prepare this assignment according to the APA guidelines found in the APA Style Guide,     AttachmentsAMP450.R.CollaborativeMeetingVerificationForm_11-18-13.doc

You have been invited to assemble a task force to design a medication assistance program. You need to submit a proposal, regarding who you would invite, to the CEO. Consider the perspectives of prescribers, discharge planners, financial navigators, patients, suppliers, book keepers and subsidizers. If you were to seek the input of 5-7 stakeholders, who would you invite to the planning table, and why? Consider the need for a group facilitator. Who would that person be, and why?

Submit a 2-3 page APA style response to this query. Open with a paragraph of purpose, dedicate a paragraph to each stakeholder that you would invite, and close with a summary of what you hope to accomplish with the group, within a designated time frame.