Correct Answer: B

Rationale: The correct answer is B: Straight-leg raise. This test is used to assess for herniated disc by stretching the sciatic nerve. A positive test is indicated by reproduction of leg pain when the leg is raised between 30 to 70 degrees. This suggests nerve root irritation, common in herniated disc.

A: Leg-length test - This test is used to assess for leg length discrepancy, not herniated disc.
C: Tinel's test - This test is used to assess for nerve compression, typically in carpal tunnel syndrome, not specifically for herniated disc.
D: Phalen's test - This test is used to assess for carpal tunnel syndrome, not herniated disc.

Correct Answer: B

Rationale: The correct answer is B: Dopamine agonist. In early PD, dopamine agonists are preferred due to their lower risk of motor complications compared to levodopa. Dopamine agonists help improve motor symptoms by directly stimulating dopamine receptors. COMT inhibitors are usually used in combination with levodopa to prolong its effects. Levodopa is effective but can lead to motor complications with long-term use. Careful observation is not a treatment strategy and delays symptom management.
Therefore, starting with a dopamine agonist is the most suitable option for early PD to manage symptoms effectively with minimal risk of motor complications.

Correct Answer: A

Rationale: The correct answer is A because in an older adult with an indwelling urinary catheter, a fever >100°F can be a sign of urinary tract infection (UTI) or urosepsis. Given her acute decline in mental status and fever, empiric antibiotic therapy is warranted to treat a potential infection.
Choice B is incorrect because older adults with indwelling catheters are at increased risk for UTIs and bloodstream infections.
Choice C is incorrect as obtaining a urine culture is important to confirm the diagnosis and guide appropriate antibiotic therapy.
Choice D is incorrect as the duration of antibiotic treatment for a UTI is typically longer than 3 days.

Correct Answer: C

Rationale: The correct answer is C: Lower dose of antibiotics. The rationale is that the patient has early renal insufficiency, which means the kidney may have difficulty clearing medications from the body.
Therefore, a lower dose of antibiotics is needed to prevent potential drug toxicity. A shorter course of antibiotics (choice
A) may not be effective in treating pneumonia adequately. A longer course of antibiotics (choice
B) may increase the risk of drug accumulation in the body. A higher dose of antibiotics (choice
D) can lead to increased toxicity in a patient with renal insufficiency. Thus, the most appropriate option is to reduce the dose to ensure safe and effective treatment.

Correct Answer: C

Rationale: The correct answer is C: Advise them to file an advanced directive. An advanced directive is a legal document that allows individuals to specify their healthcare preferences in advance, including who they want to make medical decisions for them if they are unable to do so. In this scenario, since the patient and her partner are not married, it is important for her to have an advanced directive in place to ensure that her partner is legally recognized as the decision-maker. This documentation will help ensure her goals of care are followed in case she becomes incapacitated.


Choice A (Advise them to complete a POLST) is incorrect because a POLST (Physician Orders for Life-Sustaining Treatment) form is used to specify a patient's wishes for end-of-life care, not for designating a medical decision-maker.


Choice B (Advise them that they have adequate documentation to be recognized legally) is incorrect because without an advanced directive, there may be legal challenges to the partner's authority to make medical decisions