What aspects of sleep hygiene may make your facility more conducive for nighttime sleep?

Explain the procedure for measuring vibratory sense using a tuning fork. What anatomical location is commonly used for this assessment?

An 82-year-old man, Mr. A, complains of worsening nocturia, occurring four times per night. His other lower urinary tract symptoms are slow stream, occasional urgency, and urgency-related leakage once weekly. Medical problems include poorly controlled hypertension, diastolic heart failure, hyperlipidemia, osteoarthritis, and prediabetes. His medications include lisinopril 20 mg daily, metoprolol succinate 75 mg daily, atorvastatin 10 mg daily, metformin 500 mg twice daily, hydrocodone-acetaminophen as needed, and aspirin 81 mg daily. Amlodipine 5 mg daily was recently added by his cardiologist. On review of systems, Mr. A complains that nocturia is causing daytime fatigue, and he is more constipated. Physical examination is notable for blood pressure 162/83 mmHg, heart rate 60 beats per minute, clear lungs, soft abdomen, enlarged prostate, and 21 pre-tibial edema.

During a routine skin examination, a patient presents with a new lesion that has irregular borders and varied pigmentation. What should be your next step based on your observations?

When performing a visual acuity test, the nurse practitioner notes 20/30 in the left eye and 20/40 in the right eye using the Snellen eye chart. This means: