Quiz 67 Flashcards
depression
During the treatment process, you help the patient realize that some of his perceptions and interpretations of reality may be false and lead to negative thoughts. Next, you help him discover alternative thoughts that reflect reality more closely, and to learn to discard his previous distorted thinking. By learning to substitute healthy thoughts for negative thoughts, he finds his mood, behavior, and physical reaction to different situations are improved.
Cognitive therapy
process of free association where repressed memories are recovered.
Psychoanalysis
instrumentation that gives feedback about a patient’s physiologic response to various situations in order to bring the autonomic nervous system under voluntary control.
Biofeedback
A 24-year-old male sustains a boxer’s fracture of the fifth metacarpal. A radiograph shows no rotational deformity and 25° of volar angulation. After an attempt at closed reduction the angulation remains unchanged.
Which one of the following would be most appropriate at this time?
An ulnar gutter splint
Up to 40° of volar angulation is acceptable for fifth metacarpal fractures. For second and third metacarpal fractures, less angulation is acceptable. Appropriate treatment is a gutter splint.
What is the recommended compression-to-breath ratio for basic life support with a single rescuer for a 2-year-old child?
30:2
For a single rescuer performing CPR on a 2-year-old, the ratio is 30 compressions to 2 ventilations. The
compression rate should be approximately 100 beats/min, and the chest should be compressed one-third
to one-half its depth with each compression. Compressions can be accomplished with one hand, the heel
of one or both hands, or the heel of one hand with the second hand on top.
Risk factors for delirium in hospitalized patients
include
interventions for reducing the risk of delirium
in hospitalized patients
vision impairment, hearing impairment, dehydration, immobility, cognitive impairment, and sleep
deprivation.
Repeated reorientation of patients with cognitive impairment, early mobilization, and
minimizing unnecessary noise or stimulation
A 70-year-old female becomes psychotic and risperidone (Risperdal) is prescribed. Which one of the following should be used to monitor the patient for adverse cardiac effects of this drug?
Both typical and atypical antipsychotics can cause prolongation of the QTc interval, resulting in torsades
de pointes, ventricular tachycardia, and sudden death. The best way of monitoring the QTc interval is
electrocardiography.
Presbycusis,
hearing loss associated with aging, is gradual in onset, bilateral, symmetric, and sensorineural.
Which one of the following sonographic measurements is most accurate for estimating gestational age?
Crown-rump length at 10 weeks of pregnancy
Crown-rump length is typically used to estimate gestational age before 13 weeks gestation. After 11 weeks gestation, combinations of biparietal diameter, femur length, head circumference, and abdominal circumference are used to estimate the gestational age.
Which one of the following treatment regimens is most appropriate for an HIV-positive 42-year old who has latent tuberculosis infection?
Isoniazid daily for 9 months
Latent tuberculosis infection carries a risk of progression to active disease, especially among patients who are immunosuppressed. Isoniazid monotherapy is the treatment of choice for most patients with latent tuberculosis infection. Rifampin is not recommended as monotherapy in patients with HIV infection because of increased rates of resistance and drug interactions with many antiretrovirals. Rifampin plus pyrazinamide is no longer recommended for treatment of latent tuberculosis infection because cases of significant hepatotoxicity have occurred with preventive therapy. Combination drug therapy is reserved for treatment of active tuberculosis in order to prevent drug resistance.
A 75-year-old female presents with a 2-month history of bilateral headache, diffuse myalgias, and diplopia. On examination she has substantially diminished vision in her left eye, but no other neurologic findings. A moderately tender, cordlike structure is palpable just anterior to her ear and extending up to her lateral scalp. Blood tests show a markedly elevated erythrocyte sedimentation rate.
Which one of the following would be most appropriate at this point?
The clinical findings in this patient are consistent with temporal arteritis: age over 50, new-onset headache, abnormalities of the temporal artery, and an elevated erythrocyte sedimentation rate. A temporal artery biopsy is needed to confirm the diagnosis, but when the findings are this compelling, corticosteroids should be started even before a biopsy, to prevent further vision loss.
A 25-year-old female presents with a maculopapular rash that has progressed to multiple areas and exhibits target lesions. A cold sore appeared on her upper lip 2 days before the rash appeared. She is not systemically ill and is on no medications.
Herpes simplex virus is the most common etiologic agent of erythema multiforme. Other infections, particularly Mycoplasma pneumoniae infections and fungal infections, may also be associated with this hypersensitivity reaction. Other causes include medications and vaccines. Skin biopsy findings are not specific for erythema multiforme. As opposed to the lesions of urticaria, the lesions of erythema multiforme usually are present and fixed for at least 1 week and may evolve into target lesions. The palms of the hands and soles of the feet may be involved. The lesions of erythema multiforme usually resolve spontaneously over 3–5 weeks without sequelae
