Flashcards
NR 508 Final Exam
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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.
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.
An 80-year-old patient with congestive heart failure has a viral upper respiratory
infection. The pa...
recommend acetaminophen.
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.
expect these side effects to occur as the medication is tapered.
increase the dose of prednisolone to the most recent amount taken.
A patient is being tapered from long-term therapy with prednisolone and reports
weight loss and fati...
increase the dose of prednisolone to the most recent amount taken.
Sudden discontinuation or rapid tapering of glucocorticoids in patients who have
developed adrenal suppression can precipitate symptoms of adrenal
insufficiency, including nausea, weakness, depression, anorexia, myalgia,
hypotension, and hypoglycemia. When patients experience these symptoms
during a drug taper, the dose should be increased to the last dose. Vitamin D
deficiency is common while taking glucocorticoids, but these are not symptoms of
vitamin D deficiency. Changing to another glucocorticoid is not recommended.
Patients should be taught to report the side effects so that action can be taken
and should not be told that they are to be expected.
The primary care nurse practitioner (NP) sees a 50-year-old woman who reports
frequent leakage of urine. The NP learns that this occurs when she laughs or
sneezes. She also reports having an increased urge to void even when her
bladder is not full. She is not taking any medications. The NP should:
perform a dipstick urinalysis.
prescribe desmopressin (DDAVP).
prescribe oxybutynin chloride (Ditropan XL).
teach exercises to strengthen the pelvic muscles.
The primary care nurse practitioner (NP) sees a 50-year-old woman who reports
frequent leakage of ur...
perform a dipstick urinalysis.
A focused history with a careful physical examination is essential for determining
the cause of incontinence. Urinalysis can rule out urinary tract infection (UTI),
which can cause incontinence. Medications are prescribed after determining the
cause, if any, and treating underlying conditions. Exercises to strengthen the
pelvic muscles are part of treatment.
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