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A 58-Year-Old Woman Comes to the Office for an Annual

question 106

Multiple Choice

A 58-year-old woman comes to the office for an annual health examination. She has a history of hypothyroidism, hypercholesterolemia, and depression. Medications include levothyroxine, simvastatin, and escitalopram. The patient reports feeling "tired and worn out" due to difficulty falling asleep and also awakening several times a night over the past several months. She reports no change in appetite, bowel habits, interest in activities, or concentration. The patient limits her caffeine intake to mornings and does not drink alcohol. She quit her job last year in order to care full-time for her mother, who has Alzheimer disease and lives with her. The patient says, "It's been difficult to see my mother decline, and I worry because she is increasingly confused and wanders at night. I feel badly, because I get irritable when I am tired and lose patience with her. I would like to keep Mom at home as long as possible, but it is difficult."
Vital signs and physical examination are unremarkable. TSH is within normal limits.
Which of the following is the most appropriate intervention for this patient?

Definitions:

Required Reserve Ratio

The fraction of deposits that banks are mandated by regulation to hold in reserve and not lend out.

Excess Reserves

The banks' reserves over and above the required minimum that they choose to hold rather than loan out.

Depositors

People or organizations that deposit their funds into a bank to secure them and gain interest as time passes.

Borrowers

Individuals or entities that take funds from a lender under the agreement to pay back the principal amount along with interest.