NR508 Pharm Midterm UPDATED VERSION.A primary care NP prescribes levothyroxine for a patient to treat thyroid deficiency. When teaching this patient about the medication, the NP should: -ANSWERS tell the patient that changing brands of the medication should be avoided.
Patients should be told no...
a 12 year old patient who is obese develops type 2 diabetes mellitus the primary care np should order metformin glucophage metformin is the only drug listed
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NR508 Pharm Midterm UPDATED
VERSION.
A primary care NP prescribes levothyroxine for a patient to treat thyroid deficiency.
When teaching this patient about the medication, the NP should: -ANSWERS tell the
patient that changing brands of the medication should be avoided.
Patients should be told not to change brands of the medication; there is potential
variability in the bioequivalence between manufacturers. The medication should be
taken at approximately the same time each day before breakfast or on an empty
stomach. Patients should be instructed to contact the provider if signs of thyrotoxicosis
are present. Thyroid replacement medications are usually given for life.
An African-American patient is taking captopril (Capoten) 25 mg twice daily. When
performing a physical examination, the primary care nurse practitioner (NP) learns that
the patient continues to have blood pressure readings of 135/90 mm Hg. The NP
should: -ANSWERS add a thiazide diuretic to this patient's regimen
Some African-American patients do not appear to respond as well as whites in terms of
blood pressure reduction. The addition of a low-dose thiazide diuretic often allows for
efficacy in blood pressure lowering that is comparable with that seen in white patients.
Increasing the captopril dose is not indicated. Losartan is an angiotensin receptor
blocker (ARB) and is not indicated in this case.
A primary care NP sees a patient who is about to take a cruise and reports having had
motion sickness with nausea on a previous cruise. The NP prescribes the scopolamine
transdermal patch and should instruct the patient to apply the patch: -ANSWERS every
3 days.
The transdermal system allows steady-state plasma levels of scopolamine to be
reached rapidly and maintained for 3 days. The onset of action is approximately 4
hours. The patch should be changed every 3 days and left on at all times, not as
needed
A 12-year-old patient who is obese develops type 2 diabetes mellitus. The primary care
NP should order -ANSWERS metformin (Glucophage).
Metformin is the only drug listed that is recommended for children
, A patient who has had four to five liquid stools per day for 4 days is seen by the primary
care NP. The patient asks about medications to stop the diarrhea. The NP tells the
patient that antidiarrheal medications are: -ANSWERS not curative and may prolong the
illness
Treatment of patients with acute diarrhea with antidiarrheals can prolong infection and
should be avoided if possible. Antidiarrheals are best used in patients with mild to
moderate diarrhea and are used for comfort and not cure. They should not be used for
patients with bloody diarrhea or high fever because they can worsen the disease.
Prolonged diarrhea can indicate a more serious cause, and antidiarrheals should not be
used in those cases.
In every state, prescriptive authority for NPs includes the ability to write prescriptions -
ANSWERS for specified classifications of medications.
All states now have some degree of prescriptive authority granted to NPs, but not all
states allow authority to prescribe controlled substances. Many states still require some
degree of physician involvement with certain types of drugs.
A 55-year-old woman has a history of myocardial infarction (MI). A lipid profile reveals
LDL of 130 mg/dL, HDL of 35 mg/dL, and triglycerides 150 mg/dL. The woman is
sedentary with a body mass index of 26. The woman asks the primary care NP about
using a statin medication. The NP should: -ANSWERS begin therapy with atorvastatin
10 mg per day
This woman would be using a statin medication for secondary prevention because she
already has a history of MI, so a statin should be prescribed. Dietary and lifestyle
changes should be a part of therapy, but not the only therapy. She is relatively young,
and quality-of-life issues are not a concern. There is no clinical evidence to support use
of statins as primary prevention in women.
A patient develops hypertension. The primary care nurse practitioner (NP) plans to
begin diuretic therapy for this patient. The NP notes clear breath sounds, no
organomegaly, and no peripheral edema. The patient's serum electrolytes are normal.
The NP should prescribe: -ANSWERS hydrochlorothiazide (HydroDIURIL)
Thiazide diuretics are first-line drugs for treating hypertension. The other three drugs
are not thiazide diuretics
The primary care nurse practitioner (NP) is using critical thinking skills when -
ANSWERS analyzing current research and synthesizing new approaches to patient
care.
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