1
,2
, 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.
7. 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:prescribe desmopressin (DDAVP).
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.
8. 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:giving a double dose of
prednisone every other day.
Administration of a double dose of a glucocorticoid every other morning has been found
to cause less suppression of the HPA axis and less growth suppression in children.
Because the child has severe asthma, an oral steroid is necessary. Growth hormone
therapy is not indicated. Twice-daily dosing would not change the HPA axis suppression.
3
,2
, 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.
7. 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:prescribe desmopressin (DDAVP).
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.
8. 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:giving a double dose of
prednisone every other day.
Administration of a double dose of a glucocorticoid every other morning has been found
to cause less suppression of the HPA axis and less growth suppression in children.
Because the child has severe asthma, an oral steroid is necessary. Growth hormone
therapy is not indicated. Twice-daily dosing would not change the HPA axis suppression.
3
