1. Question : Osteopenia is diagnosed in a 55-year-old woman who
has not had a period in 15 months. She has a positive
family history of breast cancer. The primary care NP
should recommend:
testosterone therapy.
estrogen-only therapy.
nonhormonal drugs for osteoporosis.
estrogen-progesterone therapy for 1 to 2 years.
Although estrogen slows the progression of osteoporosis, it also
increases the risk of breast cancer when initiated early in
menopause. This woman should receive a nonhormonal treatment
for osteoporosis and may receive HT in 5 years if menopausal
symptoms persist. Testosterone therapy, estrogen-only therapy,
and estrogen-progesterone therapy are not indicated.
Question 2 Question : A patient takes a cardiac medication that has a very
. narrow therapeutic range. The primary care NP learns
that the particular brand the patient is taking is no longer
covered by the patient’s medical plan. The NP knows
that the bioavailability of the drug varies from brand to
brand. The NP should:
contact the insurance provider to explain why this
particular formulation is necessary.
change the patient’s medication to a different drug
class that doesn’t have these bioavailability variations.
accept the situation and monitor the patient closely
for drug effects with each prescription refill.
, ask the pharmaceutical company that makes the
drug for samples so that the patient does not incur out-
of-pocket expense.
In this case, the NP should advocate for the desired drug
because changing the drug can have life-threatening
consequences. If this fails, other options may have to be
explored.
Question 3 Question : A patient brings written information about a medication
. to a primary care NP about a new drug called Prism and
wants to know if the NP will prescribe it. The NP notes
that the information is from an internet site called
“Prism.com.” The NP should tell this patient that:
this information is probably from a drug
advertisement website.
this is factual, evidence-based material with
accurate information.
the information is from a nonprofit group that will
not profit from drug sales.
internet information is unreliable because anyone
can post information there.
Commercial internet sites are identifiable by “com” at the end
of their web address. Many provide reliable information, but
others may be more interested in selling something. Nonprofit
groups use “org” at the end of their web addresses. Internet
information is reliable as long as the internet user is aware of
how things are posted and by whom.
Question 4 Question : A primary care NP is reviewing written information
. about a newly prescribed medication with a patient. To
evaluate this patient’s understanding of the information,
the NP should ask the patient to:
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