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).
Correct!
oxybutynin chloride (Ditropan XL).
This patient is describing urge incontinence, or overactive bladder, which occurs
when the detrusor muscle is hyperactive, causing an intense urge to void before
the bladder is full. Urge incontinence is associated with many conditions,
including diabetes. Oxybutynin chloride, which is an anticholinergic, acts to
decrease detrusor overactivity and is indicated for treatment of urge
incontinence. Flavoxate is used to treat dysuria associated with UTI. Bethanechol
is indicated for urinary retention. Phenazopyridine is used to treat dysuria.
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.
Correct!
ZolpiMist.
ramelteon.
chloral hydrate.
ZolpiMist oral spray is useful for patients who have trouble returning to sleep in
the middle of the night. Zaleplon and ramelteon are used for insomnia caused by
difficulty with sleep onset. Chloral hydrate is not typically used as outpatient
therapy.
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.
Correct!
initiate antibiotic therapy if the child’s condition worsens.
Signs and symptoms of otitis media that indicate a need for antibiotic treatment
include otalgia, fever, otorrhea, or a bulging yellow or red tympanic membrane.
This child has a low-grade fever, no history of otitis media, a nonbulging tympanic
membrane, and no otorrhea, so watchful waiting is appropriate. When an
antibiotic is started, amoxicillin is the drug of choice.
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:
Correct!
recommend acetaminophen
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