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An 83-Year-Old Woman with Mild Cognitive Impairment Comes to the Office

question 467

Multiple Choice

An 83-year-old woman with mild cognitive impairment comes to the office due to a feeling of "not being myself." The patient has lived in an assisted living facility since her husband died 2 years ago. She is accompanied by a caregiver, who notes that the patient has developed progressive changes in behavior and personality over the last several months. The patient has often refused meals and snacks and has had decreased participation in group activities that she previously enjoyed. She also gets agitated very easily and often "wants to be left alone." Medical history is notable for hypertension, heart failure with preserved ejection fraction, and osteoporosis. The patient was also diagnosed with atrial fibrillation 6 months ago, and apixaban and escalating doses of metoprolol succinate were prescribed. She has never used tobacco, alcohol, or illicit drugs. Temperature is 37.4 C (99.3 F) , blood pressure is 150/60 mm Hg, pulse is 92/min, and respirations are 22/min. Oxygen saturation is 97% on room air. Weight is 68.7 kg (151.5 lb) ; a month ago, it was 72.3 kg (159.4 lb) . Ocular examination is normal. There is no nuchal rigidity or thyroid enlargement. The heart has an irregularly irregular rhythm, and the chest is clear to auscultation. No focal neurologic deficits are present and the patient's gait appears stable. Laboratory tests show normal complete blood count, serum chemistry panel, and urinalysis. ECG shows atrial fibrillation with nonspecific T-wave abnormalities. Which of the following is the most appropriate next step in management of this patient?

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Cash Dividends

The allocation of a part of a corporation's profits, determined by its board of directors, to a group of its stockholders as cash.

Comprehensive Income

Comprehensive income includes all changes in equity during a period except those resulting from investments by owners and distributions to owners. It encompasses net income and other comprehensive income items.

Interest Revenue

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