A 26-year-old female patient with no significant PMH is brought to the Emergency Department after experiencing a witnessed generalized tonic-clonic seizure in the supermarket. The seizure ended after 2 minutes, but the patient remained confused. Vital signs: BP 118/72, HR 90/min, RR 16/min, T 98.6F On exam, she is currently alert and fully oriented. She does not remember the events during the seizure and states she has not experienced this before. There is no nuchal rigidity and motor and sensory exam is unremarkable. Fingerstick blood glucose is 100 mg/dL. Serum electrolytes, CBC, and urine toxicology results are all within normal limits. EKG is without abnormality noted. What is the most appropriate next step in the management of this patient?

Evaluation of a patient who presents with a new onset peripheral neuropathy should include which of the following laboratory tests?

Hyperglycemia before reperfusion in patients with acute ischemic stroke has been associated with diminished neurologic improvement, greater infarct size, and worse clinical outcome at three months after treatment with intravenous tPA.

A 24-year-old woman, who has been consuming a strict total vegan diet (without dairy products or eggs) for the past 6 years, presents with a 2-week history of persistent fatigue and decreased functional capacity. She also gives history of numbness and pins and needle sensation in her feet for the past 3 weeks. The patient is having other problems, such as increased irritability and forgetfulness. Physical exam reveals pallor, peripheral neuropathy of her lower extremity, and memory deficits. CBC shows a macrocytic, normochromic anemia. There is also an elevation in the levels of methylmalonic acid and homocysteine. Which of the following therapies is indicated for this patient?

A 46-year-old male presents to the Emergency Department with a severe headache. He has had several of these headaches over the last few days and has tried over-the-counter pain relievers with no relief. His current headache started 15 minutes ago. The pain is located next to and behind his left eye and is “stabbing/excruciating.” His left eye tears up profusely with these headaches. He reports he has been healthy otherwise, with no other significant medical history and no drug allergies. On physical exam, the patient appears slightly agitated and uncomfortable. Left eye conjunctiva is mildly injected, and lacrimation is noted. Right eye is normal. Cranial nerves II-VII are intact, but the patient expresses discomfort when the light is shown in his left eye. Speech, gait, coordination, and reflexes are all normal. The remainder of his exam is normal. Brain MRI is performed and reported as normal. Which of the following medications is the most appropriate prevention for this patient’s type of headache?

A 20-year-old female presents to the Emergency Department after falling during cheerleading practice. The patient hit her head on the ground. Initially, she felt confused and vomited x 2. She currently states that she feels fine and at her baseline. Vital signs: BP 122/62, HR 88/min, RR 15/min, T 99.5F, O2sat (room air) 98%. On exam, a small scalp abrasion is noted with no laceration. Neurologic exam, including strength, sensation, and cranial nerves, is within normal limits. Which of the following interventions in the most appropriate next step in management of this patient?

Which of the following statements about primary brain tumors is true?

A 42-year-old man starts to notice that he has become clumsy and is frequently dropping things. Over a period of time he starts to develop strange behavior and becomes quite withdrawn. He also has a decrease in his mental capacity. He has developed an accompanying movement disorder consisting of involuntary irregular movements. His limbs are primarily involved with the abnormal movements, which generally subside during sleep. His wife is quite concerned because her father-in- law had the same condition. He is referred to a neurologist by his primary care doctor. Which of the following clinical findings would you expect in this patient?

A nurse is caring for a client who is 12 hr postpartum following a vaginal delivery. Which of the following findings should the nurse expect?

Simplify the expression. Write your answer with only positive exponents. Assume that all variables represent nonzero real numbers.