NR 291 FINAL EXAM 2

NR 291 FINAL EXAM 2 1.The primary care NP sees an adolescent who reports moderate to severe dysmenorrhea. The NP recommends an NSAID and counsels the patient about its use. Which statement by the patient indicates a need for further teaching? “I should not take this if I think I might be pregnant.” “I should take this medication on a schedule for 2 to 3 days.” “I will begin taking this 1 to 3 days before my period begins.” “I will take this medicine every 4 to 6 hours as needed for pain.” Explanation: When treating primary dysmenorrhea, NSAIDs should be started 24 to 72 hours before the patient starts menstrual bleeding. The medication should be taken on a routine basis for 2 to 3 days. It should not be taken during pregnancy. 2. patient who experiences migraines characterized by unilateral motor and sensory symptoms tells the primary care NP that despite abortive therapy with a triptan, the frequency of episodes has increased to three or four times each month. The NP should: add a selective serotonin reuptake inhibitor (SSRI) antidepressant. change to dihydroergotamine hydrochloride. prescribe a –B blocker such as propranolol. prescribe an anticonvulsant such as topiramate. Explanation: Topiramate is useful for migraine prophylaxis. SSRI antidepressants are considered second-line treatment for prophylaxis and are less effective than tricyclic antidepressants. Ergotamines are not used as prophylaxis. B-Blockers are commonly used but may aggravate neurologic symptoms associated with hemiplegic or basilar migraine, which is what this patient has. 3. A patient who has osteoarthritis is scheduled to have knee surgery. The patient takes aspirin for MI prophylaxis and naproxen (Naprosyn) for pain and inflammation. Which statement by the patient to the primary care NP indicates a need for further teaching?