A 79-year-old woman was admitted to the hospital a month ago with an acute ischemic stroke. Which would be the next best step in management?

Correct Answer: C

Rationale: The correct answer is C: Start a high-calorie supplement twice a day. After an acute ischemic stroke, nutritional support is crucial for recovery and prevention of complications. Malnutrition is common post-stroke due to swallowing difficulties and decreased appetite. High-calorie supplements can help meet the patient's nutritional needs. Choice A (escitalopram) is a selective serotonin reuptake inhibitor used for depression and anxiety, which may not be the immediate priority in this case. Choice B (eszopiclone) is a nonbenzodiazepine hypnotic used for insomnia, which is not directly related to managing the patient's stroke. Choice D (changing the time of physical therapy) may be beneficial, but ensuring adequate nutrition is more critical in the acute phase of stroke recovery.

Correct Answer: D

Rationale: The correct answer is D because each of the choices addresses a different aspect of how racial disparities in healthcare can impact the expectations of older Black Americans. A is correct because unethical studies in the past can lead to reluctance to participate in medical research. B is correct because the underrepresentation of Black physicians may affect the quality of care older Black Americans receive. C is correct because differences in access to healthcare providers can result in cumulative negative effects on health outcomes for older Black Americans. Therefore, the combination of these factors can significantly impact the expectations and experiences of older Black Americans in healthcare.

Correct Answer: B

Rationale: The correct answer is B: Appreciation. In this scenario, Mr. Jones may understand the information presented about the colonoscopy, but he may not fully appreciate the implications and consequences of undergoing the procedure. Appreciation involves the ability to understand the personal relevance of the information provided. This is crucial in ensuring that the individual can make a truly informed decision. A: Understanding is not impaired as Mr. Jones may comprehend the information presented. C: Ability to express a choice is not necessarily impaired in this case, as Mr. Jones may still be able to verbalize his decision. D: None of the above is incorrect because Appreciation is indeed impaired in this situation.

Correct Answer: B

Rationale: The correct answer is B because knowing how the patient defines quality of life is crucial for making healthcare decisions aligned with the patient's values and preferences. This ensures the healthcare agent can advocate for the patient's wishes effectively. Geographic proximity (A) is not necessary as communication can be maintained remotely. Being a family member (C) may create biases, and medical training (D) is not essential for understanding the patient's values.

Correct Answer: B

Rationale: The correct answer is B because durable medical equipment under Medicare typically requires the patient to pay 20% of the Medicare-approved amount. A is incorrect because Medicare funding also comes from payroll taxes and individual premiums. C is incorrect as Part B covers outpatient services and physician fees only in outpatient settings. D is incorrect as patients are generally responsible for 20% of Part B bills, not no out-of-pocket cost for durable medical equipment.