NR 508 Final Exam.
NR 508 Final Exam
Question 1
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).
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
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.
,NR 508 Final Exam.
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
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.
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
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.
,NR 508 Final Exam.
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.
Patients with congestive heart failure may have tachycardia from fever
that aggravates their symptoms, so fever should be treated. High
doses should be given with caution in elderly patients because of
possible decreased hepatic function. Antibiotics should not be given
without evidence of bacterial infection.
Question 5
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.
Apomorphine injection is used for acute treatment of immobility
known as “freezing.”
Question 6
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.
, NR 508 Final Exam.
NR 508 Final Exam
Question 1
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).
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
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.
,NR 508 Final Exam.
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
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.
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
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.
,NR 508 Final Exam.
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.
Patients with congestive heart failure may have tachycardia from fever
that aggravates their symptoms, so fever should be treated. High
doses should be given with caution in elderly patients because of
possible decreased hepatic function. Antibiotics should not be given
without evidence of bacterial infection.
Question 5
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.
Apomorphine injection is used for acute treatment of immobility
known as “freezing.”
Question 6
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.
, NR 508 Final Exam.
