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:
oxybutynin chloride (Ditropan XL).
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
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.
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 high-dose acetaminophen.
tell the patient that antibiotics are needed with a fever that high.
A patient who takes levodopa and carbidopa for Parkinson’s disease reports experiencing
freezing episodes between doses. The primary care NP should consider using:
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.
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
perform a dipstick urinalysis.
prescribe desmopressin (DDAVP).
prescribe oxybutynin chloride (Ditropan XL).
teach exercises to strengthen the pelvic muscles.
A 7-year-old patient who has severe asthma takes oral prednisone daily. At a well-child
examination, the primary care NP notes a decrease in the child’s linear growth rate. The NP
should consult the child’s asthma specialist about:
gradually tapering the child off the prednisone.
a referral for possible growth hormone therapy.
giving a double dose of prednisone every other day.
dividing the prednisone dose into twice-daily dosing.
A patient who is taking isoniazid and rifampin for latent TB is seen by the primary care NP for a
routine follow-up visit. The patient reports having nausea, vomiting, and a decreased appetite.
The NP should:
ask about alcohol intake.
suggest taking the medications with food.
reassure the patient that these side effects are common.
order liver and renal function tests and serum glucose.
A primary care NP sees a child with asthma to evaluate the child’s response to the prescribed
therapy. The child uses an ICS twice daily and an albuterol metered-dose inhaler as needed. The
child’s symptoms are well controlled. The NP notes slowing of the child’s linear growth on a
standardized growth chart. The NP should change this child’s medication regimen to a:
combination ICS/LABA inhaler twice daily.
short-acting β2-agonist (SABA) with oral corticosteroids when symptomatic.
combination ipratropium/albuterol inhaler twice daily.
SABA as needed plus a leukotriene modifier once daily.
A patient is newly diagnosed with Alzheimer’s disease stage 6 on the Global Deterioration Scale.
The primary care NP should prescribe: