NR-508 MIDTERM 2024 110 COMPLETE QUESTIONS AND ANSWERS ALREADY PASSED

Osteopenia is diagnosed in a 55-year-old woman who has not had a period in 15 months. She has a positive family history of breast cancer. The primary care NP should recommend testosterone therapy. estrogen-only therapy. nonhormonal drugs for osteoporosis. estrogen-progesterone therapy for 1 to 2 years. - CORRECT ANSWER nonhormonal drugs for osteoporosis A woman is in her first trimester of pregnancy. She tells the primary care nurse practitioner (NP) that she continues to have severe morning sickness on a daily basis. The NP notes a weight loss of 1 pound from her previous visit 2 weeks prior. The NP should consult an obstetrician and prescribe: aprepitant (Emend). ondansetron (Zofran). scopolamine transdermal. prochlorperazine (Compazine). - CORRECT ANSWER Ondansetron (Zofran) A 75-year-old patient who has cardiovascular disease reports insomnia and vomiting for several weeks. The primary care NP orders thyroid function tests. The tests show TSH is decreased and T4 is increased. The NP should consult with an endocrinologist and order: thyrotropin. methimazole. levothyroxine. propylthiouracil. - CORRECT ANSWER Methimazole A 55-year-old patient with no prior history of hypertension has a blood pressure greater than 140/90 on three separate occasions. The patient does not smoke, has a body mass index of 24, and exercises regularly. The patient has no known risk factors for cardiovascular disease. The primary care NP should: prescribe a thiazide diuretic and an angiotensin-converting enzyme inhibitor. perform a careful cardiovascular physical assessment. counsel the patient about dietary and lifestyle changes. order a urinalysis and creatinine clearance and begin therapy with a β-blocker. - CORRECT ANSWER perform a careful cardiovascular physical assessment. A patient reports fatigue, weight loss, and dry skin. The primary care nurse practitioner (NP) orders thyroid function tests. The patient's thyroid stimulating hormone (TSH) is 40 microunits/mL, and T4 is 0.1 ng/mL. The NP should refer the patient to an endocrinologist and prescribe: methimazole. liothyronine. levothyroxine. propylthiouracil. - CORRECT ANSWER levothyroxine When prescribing a medication for a chronic condition, the primary care NP should tell the patient: to contact the pharmacy whenever refills are needed. that it is necessary to return to the clinic for each monthly refill of the medication. about the frequency of clinic visits necessary for the number of refills authorized. to ask the pharmacist to supply several months' worth of the medication at a time. - CORRECT ANSWER about the frequency of clinic visits necessary for the number of refills authorized. A child who has congenital hypothyroidism takes levothyroxine 75 mcg/day. The child weighs 15 kg. The primary care NP sees the child for a 3-year-old check-up. The NP should consult with a pediatric endocrinologist to discuss: increasing the dose to 90 mcg/day. decreasing the dose to 30 mcg/day. stopping the medication and checking TSH and T4 in 4 weeks. discussing the need for lifetime replacement therapy with the child's parents. - CORRECT ANSWER stopping the medication and checking TSH and T4 in 4 weeks. A patient who has IBS experiences diarrhea, bloating, and pain but does not want to take medication. The primary care NP should recommend: 25 g of fiber each day. avoiding gluten and lactose in the diet. increasing water intake to eight to ten glasses per day. beginning aerobic exercise, such as running, every day. - CORRECT ANSWER 25 g of fiber each day A woman who uses a transdermal contraceptive calls the primary care NP to report that while dressing that morning she discovered that the patch had come off and she was unable to find the patch. The NP should tell her to apply a new patch and: take one cycle of COCPs. take a home pregnancy test. use condoms for the next 7 days. contact the clinic if she misses a period. - CORRECT ANSWER use condoms for the next 7 days. A patient has been diagnosed with IBS and tells the primary care NP that symptoms of diarrhea and cramping are worsening. The patient asks about possible drug therapy to treat the symptoms. The NP should prescribe: mesalamine (Asacol). dicyclomine (Bentyl). simethicone (Phazyme). metoclopramide (Reglan). - CORRECT ANSWER Dicyclomine (Bentyl) A patient wants to know why a cheaper version of a drug cannot be used when the primary care NP writes a prescription for a specific brand name of the drug and writes, "Dispense as Written." The NP should explain that a different brand of this drug: may cause different adverse effects. does not necessarily have the same therapeutic effect. is likely to be less safe than the brand specified in the prescription. may vary in the amount of drug that reaches the site of action in the body. - CORRECT ANSWER may vary in the amount of drug that reaches the site of action in the body. A patient comes to the clinic with a history of syncope and weakness for 2 to 3 days. The primary care NP notes thready, rapid pulses and 3-second capillary refill. An ECG reveals a heart rate of 198 beats per minute with a regular rhythm. The NP should: (PSVT) administer intravenous fluids and obtain serum electrolytes. administer amiodarone in the clinic and observe closely for response. order digoxin and verapamil and ask the patient to return for a follow-up examination in 1 week. send the patient to an emergency department for evaluation and treatment. - CORRECT ANSWER send the patient to an emergency department for evaluation and treatment. An adolescent girl has chosen Depo-Provera as a contraceptive method and tells the primary care NP that she likes the fact that she won't have to deal with pills or periods. The primary care NP should tell her that she: