Question NR 508 Final Exam Question 1

16 Jun Question NR 508 Final Exam Question 1

Question
NR 508 Final Exam

Question 1

2 / 2 pts

A patient who has diabetes reports intense discomfort when needing to void. A urinalysis is normal. To treat this, the primary care NP should consider prescribing:

flavoxate (Urispas).

bethanechol (Urecholine).

phenazopyridine (Pyridium).

oxybutynin chloride (Ditropan XL).

Question 2

2 / 2 pts

A patient reports difficulty returning to sleep after getting up to go to the bathroom every night. A physical examination and a sleep hygiene history are noncontributory. The primary care NP should prescribe:

zaleplon.

ZolpiMist.

ramelteon.

chloral hydrate.

Question 3

2 / 2 pts

A 5-year-old child who has no previous history of otitis media is seen in clinic with a temperature of 100° F. The primary care NP visualizes bilateral erythematous, nonbulging, intact tympanic membranes. The child is taking fluids well and is playing with toys in the examination room. The NP should:

prescribe azithromycin once daily for 5 days.

prescribe amoxicillin twice daily for 10 days.

prescribe amoxicillin-clavulanate twice daily for 10 days.

initiate antibiotic therapy if the child’s condition worsens.

Question 4

2 / 2 pts

An 80-year-old patient with congestive heart failure has a viral upper respiratory infection. The patient asks the primary care NP about treating the fever, which is 38.5° C. The NP should:

recommend acetaminophen.

recommend high-dose acetaminophen.

tell the patient that antibiotics are needed with a fever that high.

tell the patient a fever less than 40° C does not need to be treated.

Question 5

2 / 2 pts

A patient who takes levodopa and carbidopa for Parkinson’s disease reports experiencing freezing episodes between doses. The primary care NP should consider using:

selegiline.

amantadine.

apomorphine.

modified-release levodopa.

Question 6

2 / 2 pts

A patient is being tapered from long-term therapy with prednisolone and reports weight loss and fatigue. The primary care NP should counsel this patient to:

consume foods high in vitamin D and calcium.

begin taking dexamethasone because it has longer effects.

expect these side effects to occur as the medication is tapered.

increase the dose of prednisolone to the most recent amount taken.

Question 7

2 / 2 pts

The primary care nurse practitioner (NP) sees a 50-year-old woman who reports frequent leakage of urine. The NP learns that this occurs when she laughs or sneezes. She also reports having an increased urge to void even when her bladder is not full. She is not taking any medications. The NP should:

perform a dipstick urinalysis.

prescribe desmopressin (DDAVP).

prescribe oxybutynin chloride (Ditropan XL).

teach exercises to strengthen the pelvic muscles.

Question 8

2 / 2 pts

A 7-year-old patient who has severe asthma takes oral prednisone daily. At a well-child examination, the primary care NP notes a decrease in the child’s linear growth rate. The NP should consult the child’s asthma specialist about:

gradually tapering the child off the prednisone.

a referral for possible growth hormone therapy.

giving a double dose of prednisone every other day.

dividing the prednisone dose into twice-daily dosing.

Question 9

2 / 2 pts

A patient who is taking isoniazid and rifampin for latent TB is seen by the primary care NP for a routine follow-up visit. The patient reports having nausea, vomiting, and a decreased appetite. The NP should:

ask about alcohol intake.

suggest taking the medications with food.

reassure the patient that these side effects are common.

order liver and renal function tests and serum glucose.

Question 10

2 / 2 pts

A primary care NP sees a child with asthma to evaluate the child’s response to the prescribed therapy. The child uses an ICS twice daily and an albuterol metered-dose inhaler as needed. The child’s symptoms are well controlled. The NP notes slowing of the child’s linear growth on a standardized growth chart. The NP should change this child’s medication regimen to a:

combination ICS/LABA inhaler twice daily.

short-acting ?2-agonist (SABA) with oral corticosteroids when symptomatic.

combination ipratropium/albuterol inhaler twice daily.

SABA as needed plus a leukotriene modifier once daily.

Question 11

2 / 2 pts

A patient is newly diagnosed with Alzheimer’s disease stage 6 on the Global Deterioration Scale. The primary care NP should prescribe:

donepezil (Aricept).

rivastigmine (Exelon).

memantine (Namenda).

galantamine (Razadyne).

Question 12

2 / 2 pts

The primary care NP sees a 12-month-old infant who needs the MMR, Varivax, influenza, and hepatitis A vaccines. The child’s mother tells the NP that she is pregnant. The NP should:

administer all of these vaccines today.

give the hepatitis A and influenza vaccines.

give the Varivax, hepatitis A, and influenza vaccines.

withhold all of these vaccines until after the baby is born.

Question 13

2 / 2 pts

A parent brings a 5-year-old child to a clinic for a hospital follow-up appointment. The child is taking a medication at a dose equal to an adult dose. The parent reports that the medication is not producing the desired effects. The NP should:

order renal function tests.

prescribe another medication to treat this child’s symptoms.

discontinue the drug and observe the child for toxic side effects.

obtain a serum drug level and consider increasing the drug dose.

Question 14

2 / 2 pts

An NP orders an inhaled corticosteroid 2 puffs twice daily and an albuterol metered-dose inhaler 2 puffs every 4 hours as needed for cough or wheezing for a 65-year-old patient with recent onset of reactive airways disease who reports symptoms occurring every 1 or 2 weeks. At a follow-up appointment several months later, the patient reports no change in frequency of symptoms. The NP’s initial action should be to:

order spirometry to evaluate pulmonary function.

prescribe a systemic corticosteroid to help with symptoms.

ask the patient to describe how the medications are taken each day.

give the patient detailed information about the use of metered-dose inhalers.

Question 15

2 / 2 pts

A patient is diagnosed with a condition that causes chronic pain. The primary care NP prescribes an opioid analgesic and should instruct the patient to:

wait until the pain is at a moderate level before taking the medication.

take the medication at regular intervals and not just when pain is present.

start the medication at higher doses initially and taper down gradually.

take the minimum amount needed even when pain is severe to avoid dependency.

Question 16

2 / 2 pts

A patient tells the primary care NP that he has difficulty getting and maintaining an erection. The NP’s initial response should be to:

prescribe sildenafil (Viagra).

perform a medication history.

evaluate his cardiovascular status.

order a papaverine injection test to screen for erectile dysfunction.

Question 17

2 / 2 pts

A 55-year-old patient develops Parkinson’s disease characterized by unilateral tremors only. The primary care NP will refer the patient to a neurologist and should expect initial treatment to be:

levodopa.

carbidopa.

pramipexole.

carbidopa/levodopa.

Question 18

2 / 2 pts

A patient who has migraine headaches without an aura reports difficulty treating the migraines in time because they come on so suddenly. The patient has been using over-the-counter NSAIDs. The primary care NP should prescribe:

frovatriptan (Frova).

sumatriptan (Imitrex).

cyproheptadine (Periactin).

dihydroergotamine (D.H.E. 45).

Question 19

2 / 2 pts

A woman tells a primary care NP that she is considering getting pregnant. During a health history, the NP learns that the patient has seasonal allergies, asthma, and epilepsy, all of which are well controlled with a second-generation antihistamine daily, an inhaled steroid daily with albuterol as needed, and an antiepileptic medication daily. The NP should counsel this patient to:

take her asthma medications only when she is having an acute exacerbation.

avoid using antihistamine medications during her first trimester of pregnancy.

discontinue her seizure medications at least 6 months before becoming pregnant.

use only oral corticosteroids and not inhaled steroids while pregnant for improved asthma control.

Question 20

2 / 2 pts

A patient who has partial seizures has been taking phenytoin (Dilantin). The patient has recently developed thrombocytopenia. The primary care nurse practitioner (NP) should contact the patient’s neurologist to discuss changing the patient’s medication to:

topiramate (Topamax).

levetiracetam (Keppra).

zonisamide (Zonegran).

carbamazepine (Tegretol).

Question 21

2 / 2 pts

A patient is taking dicloxacillin (Dynapen) 500 mg every 6 hours to treat a severe penicillinase-resistant infection. At a 1-week follow-up appointment, the patient reports nausea, vomiting, and epigastric discomfort. The primary care NP should:

change the medication to a cephalosporin.

decrease the dose to 250 mg every 6 hours.

reassure the patient that these are normal adverse effects of this drug.

order blood cultures, a white blood cell (WBC) count with differential, and liver function tests (LFTs).

Question 22

2 / 2 pts

A 75-year-old patient who lives alone will begin taking a narcotic analgesic for pain. To help ensure patient safety, the NP prescribing this medication should:

assess this patient’s usual sleeping patterns.

ask the patient about problems with constipation.

obtain a baseline creatinine clearance test before the first dose.

perform a thorough evaluation of cognitive and motor abilities.

Question 23

2 / 2 pts

A patient has been taking intramuscular (IM) meperidine 75 mg every 6 hours for 3 days after surgery. When the patient is discharged from the hospital, the primary care NP should expect the patient to receive a prescription for _____ mg orally every _____ hours.

hydrocodone 30; 6

hydrocodone 75; 6

meperidine 300;12

meperidine 75; 6

Question 24

2 / 2 pts

A patient who is obese and has hypertension is taking a thiazide diuretic and develops gouty arthritis, which is treated with probenecid. At a follow-up visit, the patient’s serum uric acid level is 7 mg/dL, and the patient denies any current symptoms. The primary care NP should discontinue the probenecid and:

prescribe colchicine.

prescribe febuxostat.

tell the patient to use an NSAID if symptoms recur.

counsel the patient to report recurrence of symptoms.

Question 25

2 / 2 pts

A mother brings her a college-age son to the primary care NP and asks the NP to talk to him about alcohol use. He reports binge drinking on occasion and drinking only beer on weekends. The NP notes diaphoresis, tachycardia, and an easy startle reflex. The NP should:

admit him to the hospital for detoxification.

ask him how much he had to drink last night.

prescribe lorazepam (Ativan) to help with symptoms.

suggest that he talk to a counselor about alcohol abuse.

Question 26

2 / 2 pts