1
,nonsteroidalantiinflammatory
ophthalmic antibiotic
You Answered
sympathomimetic ophthalmic
The patient has symptoms of viral conjunctivitis; clear discharge is characteristic. Antibiotic
drops are often prescribed to prevent a bacterial infection. Ganciclovir drops are antiviral drops
but are reserved for patients with a clinical diagnosis of herpetic keratitis by an ophthalmologist.
Sympathomimetic drops are used to treat glaucoma. Nonsteroidal antiinflammatory drops are
sometimes used for allergic conjunctivitis.
Question 3
An NP sees a patient who reports persistent seasonal symptoms of rhinorrhea, sneezing, and
nasal itching every spring unrelieved with diphenhydramine (Benadryl). The NP should
prescribe:
Correct!
triamcinolone (Nasacort AQ).
phenylephrine (Neo-Synephrine).
cromolyn sodium (Nasalcrom).
azelastine (Astelin).
According to randomized controlled trials in patients with allergic rhinitis, oral antihistamines
are used first to help control itching, sneezing, rhinorrhea, and stuffiness in most patients.
Intranasal corticosteroids are indicated for patients who do not respond to antihistamines.
Azelastine is a topical antihistamine. Phenylephrine is a decongestant, and this patient does not
have congestion. Cromolyn sodium is less effective than intranasal corticosteroids.
, Question 4
A patient comes to the clinic with a 3-day history of fever and a severe cough that interferes with
sleep. The patient asks the NP about using a cough suppressant to help with sleep. The NP
should:
Correct!
obtain a thorough history of the patient’s symptoms.
order a narcotic antitussive to suppress cough.
prescribe an antibiotic to treat the underlying cause of the patient’s cough.
suggest that the patient try a guaifenesin-only over-the-counter product.
It is important to determine the underlying disorder that is causing the cough to rule out serious
causes of cough. The NP should obtain a thorough history before prescribing any treatment. A
narcotic antitussive may be used after serious causes are ruled out. Guaifenesin may be used to
make nonproductive coughs more productive. Antibiotics are indicated only for a proven
bacterial infection.
Question 5
A parent brings in a 2-month-old infant with a 5-day history of a white coating on the tongue and
decreased oral intake. The primary care NP should prescribe:
chlorhexidine, 15 mL oral rinse bid.
carbamide peroxide, 2 to 3 drops tid.
clotrimazole, one troche tid.
Correct!
,nonsteroidalantiinflammatory
ophthalmic antibiotic
You Answered
sympathomimetic ophthalmic
The patient has symptoms of viral conjunctivitis; clear discharge is characteristic. Antibiotic
drops are often prescribed to prevent a bacterial infection. Ganciclovir drops are antiviral drops
but are reserved for patients with a clinical diagnosis of herpetic keratitis by an ophthalmologist.
Sympathomimetic drops are used to treat glaucoma. Nonsteroidal antiinflammatory drops are
sometimes used for allergic conjunctivitis.
Question 3
An NP sees a patient who reports persistent seasonal symptoms of rhinorrhea, sneezing, and
nasal itching every spring unrelieved with diphenhydramine (Benadryl). The NP should
prescribe:
Correct!
triamcinolone (Nasacort AQ).
phenylephrine (Neo-Synephrine).
cromolyn sodium (Nasalcrom).
azelastine (Astelin).
According to randomized controlled trials in patients with allergic rhinitis, oral antihistamines
are used first to help control itching, sneezing, rhinorrhea, and stuffiness in most patients.
Intranasal corticosteroids are indicated for patients who do not respond to antihistamines.
Azelastine is a topical antihistamine. Phenylephrine is a decongestant, and this patient does not
have congestion. Cromolyn sodium is less effective than intranasal corticosteroids.
, Question 4
A patient comes to the clinic with a 3-day history of fever and a severe cough that interferes with
sleep. The patient asks the NP about using a cough suppressant to help with sleep. The NP
should:
Correct!
obtain a thorough history of the patient’s symptoms.
order a narcotic antitussive to suppress cough.
prescribe an antibiotic to treat the underlying cause of the patient’s cough.
suggest that the patient try a guaifenesin-only over-the-counter product.
It is important to determine the underlying disorder that is causing the cough to rule out serious
causes of cough. The NP should obtain a thorough history before prescribing any treatment. A
narcotic antitussive may be used after serious causes are ruled out. Guaifenesin may be used to
make nonproductive coughs more productive. Antibiotics are indicated only for a proven
bacterial infection.
Question 5
A parent brings in a 2-month-old infant with a 5-day history of a white coating on the tongue and
decreased oral intake. The primary care NP should prescribe:
chlorhexidine, 15 mL oral rinse bid.
carbamide peroxide, 2 to 3 drops tid.
clotrimazole, one troche tid.
Correct!
