Question 1
pts
The primary care NP sees a patient who has a 1-week history of nasal congestion; red, watery
eyes; cough; and a temperature ranging from 99.1° F to 100.5° F. The NP notes thin, white nasal
discharge and an erythematous oropharynx without swelling or exudates. The NP should:
Correct!
reassure the patient that this is likely a viral infection.
obtain a nasal culture and consider antibiotic therapy.
prescribe antiviral medications and decongestants.
begin empiric antibiotic therapy to treat sinusitis.
The patient does not have severe symptoms indicating a bacterial infection. Unless symptoms
worsen, reassurance is indicated. Empiric antibiotic therapy is contraindicated for viral
infections. Antiviral medications are not routinely used. A nasal culture is not indicated.
Question 2
pts
When prescribing TMP/SMX to children, the primary care NP should recall that:
folic acid supplements must be given to children who take this medication.
You Answered
the medication should be given three or four times per day because of rapid metabolism.
TMP/SMX should not be prescribed for children younger than 2 years.
Correct Answer
, dosing is based on the trimethoprim component of the drug.
When determining the dose of TMP/SMX, the dose is based on the trimethoprim component of
the drug. Children older than 2 months of age may take this medication. Folic acid supplements
are not indicated. The medication is given twice daily in all age groups.
Question 3
pts
A patient is taking levofloxacin to treat sinusitis. The patient calls the primary care NP to report
pain just above the heel of the right foot. The NP should:
reassure the patient that this is a common side effect.
change to ciprofloxacin.
Correct!
discontinue the levofloxacin.
change to ofloxacin.
Warnings have been issued for the fluoroquinolone antibiotics for the increased risk of tendon
ruptures. Ruptures have occurred unilaterally and bilaterally, and have involved the Achilles
tendon; however, ruptures in the shoulder joint, hand, biceps, thumb, and other tendon sites have
been reported. The risk of tendon rupture is further increased in those over age 60, those
receiving concomitant steroid therapy, and in kidney, heart, and lung transplant recipients.
Reasons for tendon ruptures also include physical activity or exercise, kidney failure, and tendon
problems in the past. These ruptures may occur during therapy or up to several months after
discontinuation of drugs.
Question 4
pts
A child with a febrile illness is taking a cephalosporin. While in the clinic for a follow-up visit,
the child has a tonic-clonic seizure. The primary care NP should:
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