A 71-year-old man on the geriatric behavioral inpatient unit displays ataxia, vestibular dysfunction, and a variety of ocular motility abnormalities such as horizontal nystagmus and a sluggish reaction to light. He has a 40-year history of alcohol abuse. What is his most likely diagnosis?
Creutzfeldt-Jacob disease
Lewy body dementia
Wernicke's encephalopathy
Delirium
The Correct Answer is C
Choice A reason: Creutzfeldt-Jacob disease is a rare neurodegenerative disorder caused by prion proteins. It presents with rapidly progressive dementia, myoclonus, and motor dysfunction, but does not typically include the classic triad of Wernicke’s encephalopathy.
Choice B reason: Lewy body dementia is characterized by fluctuating cognition, visual hallucinations, and parkinsonian features. While it may include motor and cognitive symptoms, it does not typically present with the acute ocular and vestibular signs seen in Wernicke’s encephalopathy.
Choice C reason: Wernicke’s encephalopathy is a neurologic emergency caused by thiamine deficiency, often due to chronic alcohol abuse. The classic triad includes ophthalmoplegia (e.g., nystagmus), ataxia, and confusion. The patient’s history and symptoms strongly support this diagnosis.
Choice D reason: Delirium is an acute disturbance in attention and cognition, often reversible and multifactorial. While it may coexist with Wernicke’s encephalopathy, it does not explain the specific ocular and vestibular findings.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: While law enforcement may eventually be involved, the immediate priority is child safety and mandated reporting. Arresting the older child without a full assessment may not be developmentally appropriate or trauma-informed.
Choice B reason: Calling 911 may be necessary in cases of acute danger, but in this scenario, the PMHNP should first ensure safety and follow mandated reporting protocols. Emergency services are not the first-line response unless there is imminent risk.
Choice C reason: Involuntary psychiatric hospitalization requires specific criteria, including danger to self or others and inability to care for oneself. While the older child may need evaluation, this step is premature without a full assessment and proper reporting.
Choice D reason: This is the correct and legally mandated response. The PMHNP must ensure the younger child is protected and report the incident to child protective services. This initiates a formal investigation and ensures both children receive appropriate care and intervention.
Correct Answer is B
Explanation
Choice A reason: Telmisartan is an angiotensin II receptor blocker (ARB), which prevents angiotensin II from binding to its receptors. It does not inhibit the conversion of angiotensin I to II and is less likely to cause a dry cough.
Choice B reason: Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor. It blocks the conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion. A common side effect is a persistent dry cough due to increased bradykinin levels.
Choice C reason: Amlodipine is a calcium channel blocker that reduces blood pressure by relaxing vascular smooth muscle. It does not affect the renin-angiotensin system and does not cause dry cough.
Choice D reason: Furosemide is a loop diuretic that acts on the ascending loop of Henle to promote sodium and water excretion. It is used in heart failure and edema but does not influence angiotensin conversion or cause dry cough.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.