NR 508 NURSING PRIMARY CARE
2026 UPDATED QUESTIONS WITH
ANSWERS VERIFIED BY EXPERTS
Question 11
pts
A patient is newly diagnosed with Alzheimer’s disease stage 6 on the Global
Deterioration Scale. The primary care NP should prescribe:
donepezil (Aricept).
rivastigmine (Exelon).
memantine (Namenda).
galantamine (Razadyne).
1
,Patients with moderate to severe dementia (stages 5 to 7) may be started on memantine.
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.
2
,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.
3
, 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.
4
2026 UPDATED QUESTIONS WITH
ANSWERS VERIFIED BY EXPERTS
Question 11
pts
A patient is newly diagnosed with Alzheimer’s disease stage 6 on the Global
Deterioration Scale. The primary care NP should prescribe:
donepezil (Aricept).
rivastigmine (Exelon).
memantine (Namenda).
galantamine (Razadyne).
1
,Patients with moderate to severe dementia (stages 5 to 7) may be started on memantine.
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.
2
,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.
3
, 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.
4
