NR 508 Midterm Exam – Question and Answers
A primary care NP prescribes levothyroxine for a patient to treat thyroid deficiency. When teaching this
patient about the medication, the NP should:
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:
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:
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
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:
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
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:
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:
hydrochlorothiazide (HydroDIURIL)
Thiazide diuretics are first-line drugs for treating hypertension. The other three drugs are not thiazide
diuretics
A primary care NP prescribes levothyroxine for a patient to treat thyroid deficiency. When teaching this
patient about the medication, the NP should:
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:
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:
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
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:
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
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:
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:
hydrochlorothiazide (HydroDIURIL)
Thiazide diuretics are first-line drugs for treating hypertension. The other three drugs are not thiazide
diuretics
