1
, dosing is based on the trimethoprim component of the drug.
TMP/SMX should not be prescribed for children younger than 2 years.
folic acid supplements must be given to children who take this medication.
the medication should be given three or four times per day because of rapid
metabolism.
Question 6.6. 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: (Points : 2)
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.
Question 7.7. The primary care NP is preparing to prescribe sildenafil for a man who has
erectile dysfunction. The NP should remember to tell this patient: (Points : 2)
to avoid oral nitrates while taking this medication.
that the drug may cause penile aching.
to use a condom if his sexual partner is pregnant.
dyspepsia may occur and may warrant discontinuation of the drug.
Question 8.8. A woman has a Chlamydia infection. Before initiating treatment with a
tetracycline antibiotic, the primary care nurse practitioner (NP) should: (Points : 2)
perform a pregnancy test.
obtain baseline liver function and renal function tests.
check her bilirubin and serum amylase levels.
tell her she must stop using oral contraceptive pills.
Question 9.9. A patient is taking levofloxacin to treat sinusitis. The patient calls the primary
care NP to report pain just above the heel of the right foot. The NP should: (Points : 2)
change to ofloxacin.
change to ciprofloxacin.
discontinue the levofloxacin.
reassure the patient that this is a common side effect.
, Question 10.10. A patient comes to the clinic with a history of fever of 102° F for several
days, poor appetite, and cough. A sputum culture is pending, but Gram stain indicates a
bacterial infection. The primary care nurse practitioner (NP) should: (Points : 2)
begin empirical antibiotic therapy.
use a broad-spectrum antibiotic for initial treatment.
prescribe an antibiotic when culture and sensitivity results are known.
offer symptomatic treatment only unless the patient’s condition worsens.
Question 11.11. A primary care nurse practitioner (NP) is prescribing once-daily
azithromycin to a 25-year-old woman. When teaching her about the drug, the NP should tell
her to: (Points : 2)
take the medication on an empty stomach.
use a backup contraception method other than oral contraceptive pills.
expect severe gastrointestinal side effects while taking this drug.
cut the pill in half and take twice daily if side effects are severe.
Patients who use oral contraceptive pills for birth control should be advised that macrolidescan
reduce their efficacy and that they should consider using a backup method ofcontraception.
Azithromycin can be taken without regard to food. Severe gastrointestinal sideeffects are
uncommon. The tablets should not be chewed, crushed, or cut.
Question 12.12. A patient comes to the clinic before a trip to an area where malaria is
endemic. The primary care NP will prescribe: (Points : 2)
tinidazole (Tindamax).
metronidazole (Flagyl).
chloroquine (Plaquenil).
amantadine (Symmetrel).
Chloroquine is used as malaria prophylaxis.
Question 13.13. A patient who has genital herpes has frequent outbreaks. The patient asks
the primary care NP why it is necessary to take oral acyclovir all the time and not just for
acute outbreaks. The NP should explain that oral acyclovir may: (Points : 2)
prevent the virus from developing resistance.
cause episodes to be shorter and less frequent.
actually eradicate the virus and cure the disease.
reduce the chance of transmitting the virus to others.
Oral acyclovir has prevented or reduced the frequency of severity of recurrences in more
than95% of patients and so should be given to patients with recurrent episodes. It does not
affectresistance. The antiviral medication does not eradicate the virus; it prevents replication.
Thedisease is transmitted even without symptoms.
, dosing is based on the trimethoprim component of the drug.
TMP/SMX should not be prescribed for children younger than 2 years.
folic acid supplements must be given to children who take this medication.
the medication should be given three or four times per day because of rapid
metabolism.
Question 6.6. 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: (Points : 2)
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.
Question 7.7. The primary care NP is preparing to prescribe sildenafil for a man who has
erectile dysfunction. The NP should remember to tell this patient: (Points : 2)
to avoid oral nitrates while taking this medication.
that the drug may cause penile aching.
to use a condom if his sexual partner is pregnant.
dyspepsia may occur and may warrant discontinuation of the drug.
Question 8.8. A woman has a Chlamydia infection. Before initiating treatment with a
tetracycline antibiotic, the primary care nurse practitioner (NP) should: (Points : 2)
perform a pregnancy test.
obtain baseline liver function and renal function tests.
check her bilirubin and serum amylase levels.
tell her she must stop using oral contraceptive pills.
Question 9.9. A patient is taking levofloxacin to treat sinusitis. The patient calls the primary
care NP to report pain just above the heel of the right foot. The NP should: (Points : 2)
change to ofloxacin.
change to ciprofloxacin.
discontinue the levofloxacin.
reassure the patient that this is a common side effect.
, Question 10.10. A patient comes to the clinic with a history of fever of 102° F for several
days, poor appetite, and cough. A sputum culture is pending, but Gram stain indicates a
bacterial infection. The primary care nurse practitioner (NP) should: (Points : 2)
begin empirical antibiotic therapy.
use a broad-spectrum antibiotic for initial treatment.
prescribe an antibiotic when culture and sensitivity results are known.
offer symptomatic treatment only unless the patient’s condition worsens.
Question 11.11. A primary care nurse practitioner (NP) is prescribing once-daily
azithromycin to a 25-year-old woman. When teaching her about the drug, the NP should tell
her to: (Points : 2)
take the medication on an empty stomach.
use a backup contraception method other than oral contraceptive pills.
expect severe gastrointestinal side effects while taking this drug.
cut the pill in half and take twice daily if side effects are severe.
Patients who use oral contraceptive pills for birth control should be advised that macrolidescan
reduce their efficacy and that they should consider using a backup method ofcontraception.
Azithromycin can be taken without regard to food. Severe gastrointestinal sideeffects are
uncommon. The tablets should not be chewed, crushed, or cut.
Question 12.12. A patient comes to the clinic before a trip to an area where malaria is
endemic. The primary care NP will prescribe: (Points : 2)
tinidazole (Tindamax).
metronidazole (Flagyl).
chloroquine (Plaquenil).
amantadine (Symmetrel).
Chloroquine is used as malaria prophylaxis.
Question 13.13. A patient who has genital herpes has frequent outbreaks. The patient asks
the primary care NP why it is necessary to take oral acyclovir all the time and not just for
acute outbreaks. The NP should explain that oral acyclovir may: (Points : 2)
prevent the virus from developing resistance.
cause episodes to be shorter and less frequent.
actually eradicate the virus and cure the disease.
reduce the chance of transmitting the virus to others.
Oral acyclovir has prevented or reduced the frequency of severity of recurrences in more
than95% of patients and so should be given to patients with recurrent episodes. It does not
affectresistance. The antiviral medication does not eradicate the virus; it prevents replication.
Thedisease is transmitted even without symptoms.
