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.
Question 22 pts
A woman is in her first trimester of pregnancy. She tells the primary care nurse practitioner (NP) that she continues to have severe morning
sickness on a daily basis. The NP notes a weight loss of 1 pound from her previous visit 2 weeks prior. The NP should consult an obstetrician
and prescribe:
aprepitant (Emend).
ondansetron (Zofran).
scopolamine transdermal.
prochlorperazine (Compazine).
Question 32 pts
A 75-year-old patient who has cardiovascular disease reports insomnia and vomiting for several weeks. The primary care NP orders thyroid
function tests. The tests show TSH is decreased and T4 is increased. The NP should consult with an endocrinologist and order:
thyrotropin.
methimazole.
levothyroxine.
propylthiouracil.
Question 42 pts
A 55-year-old patient with no prior history of hypertension has a blood pressure greater than 140/90 on three separate occasions. The patient
does not smoke, has a body mass index of 24, and exercises regularly. The patient has no known risk factors for cardiovascular disease. The
primary care NP should:
prescribe a thiazide diuretic and an angiotensin-converting enzyme inhibitor.
perform a careful cardiovascular physical assessment.
counsel the patient about dietary and lifestyle changes.
order a urinalysis and creatinine clearance and begin therapy with a ?-blocker.
Question 52 pts
A patient reports fatigue, weight loss, and dry skin. The primary care nurse practitioner (NP) orders thyroid function tests. The patient’s
thyroid stimulating hormone (TSH) is 40 microunits/mL, and T4 is 0.1 ng/mL. The NP should refer the patient to an endocrinologist and
prescribe:
methimazole.
liothyronine.
levothyroxine.
propylthiouracil.
Question 62 pts
When prescribing a medication for a chronic condition, the primary care NP should tell the patient:
to contact the pharmacy whenever refills are needed.
that it is necessary to return to the clinic for each monthly refill of the medication.
about the frequency of clinic visits necessary for the number of refills authorized.
to ask the pharmacist to supply several months’ worth of the medication at a time.
Question 72 pts
A child who has congenital hypothyroidism takes levothyroxine 75 mcg/day. The child weighs 15 kg. The primary care NP sees the child for a 3-
year-old check-up. The NP should consult with a pediatric endocrinologist to discuss:
increasing the dose to 90 mcg/day.
decreasing the dose to 30 mcg/day.
stopping the medication and checking TSH and T4 in 4 weeks.
discussing the need for lifetime replacement therapy with the child’s parents.
Question 82 pts
A patient who has IBS experiences diarrhea, bloating, and pain but does not want to take medication. The primary care NP should recommend:
25 g of fiber each day.
avoiding gluten and lactose in the diet.
increasing water intake to eight to ten glasses per day.
beginning aerobic exercise, such as running, every day.
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