NR 508 Week 6 Quiz / NR508 Week 6 Quiz : Chamberlain College of Nursing (2020/21, All Correct)

NR508 Week 6 Quiz (Latest): Chamberlain College of Nursing NR 508 Week 6 Quiz (Latest): Chamberlain College of Nursing Question 1.1. A patient is diagnosed with a condition that causes chronic pain. The primary care NP prescribes an opioid analgesic and should instruct the patient to: (Points : 2) wait until the pain is at a moderate level before taking the medication. take the medication at regular intervals and not just when pain is present. start the medication at higher doses initially and taper down gradually. take the minimum amount needed even when pain is severe to avoid dependency. Question 2.2. A patient who is taking methotrexate for RA sees the primary care NP for an annual physical examination. The patient’s alanine aminotransferase (ALT) and AGT are elevated. The NP should: (Points : 2) decrease the dose of methotrexate. recheck ALT and AGT levels in 2 weeks. contact the patient’s rheumatologist to discuss discontinuing the drug. counsel the patient not to take acetaminophen while taking methotrexate. Question 3.3. A patient who has migraine headaches tells the primary care NP that drinking coffee and taking nonsteroidalantiinflammatory drugs (NSAIDs) seems to help with discomfort. The NP should tell the patient that: (Points : 2) this combination can lead to longer lasting headache pain. these substances are not indicated for migraine headaches. doing this can increase the risk of more chronic migraines. an opioid analgesic would be a better choice for migraine pain. Question 4.4. The primary care NP sees an adolescent who reports moderate to severe dysmenorrhea. The NP recommends an NSAID and counsels the patient about its use. Which statement by the patient indicates a need for further teaching? (Points : 2) “I should not take this if I think I might be pregnant.” “I should take this medication on a schedule for 2 to 3 days.” “I will begin taking this 1 to 3 days before my period begins.” “I will take this medicine every 4 to 6 hours as needed for pain.” Question 5.5. A 60-year-old woman has a central dual-energy x-ray absorptiometry with a T-score of 1.9. A health history reveals no risk factors for osteoporosis. The primary care NP should: (Points : 2) prescribe alendronate sodium (Fosamax). counsel her to increase her physical activity. prescribe calcitonin (Miacalcin nasal spray). prescribe supplemental calcium and vitamin D. Question 6.6. A 50-year-old white woman who is experiencing menopause asks the primary care NP what she can do to prevent osteoporosis. She has a negative family history and no risk factors. The NP should counsel her to: (Points : 2) consider bisphosphonate therapy in 5 years. undergo bone density testing every 2 years. avoid high-impact sports that can lead to fractures. take supplemental calcium and vitamin D every day. Question 7.7. A patient has been taking an opioid analgesic for 2 weeks after a minor outpatient procedure. At a follow-up clinic visit, the patient tells the primary care NP that he took extra doses for the past 2 days because of increased pain and wants an early refill of the medication. The NP should suspect: (Points : 2) dependence. drug addiction. possible misuse. increasing pain. Question 8.8. A patient reports having an acute onset of low back pain associated with lifting a heavy object the day before. Besides advising the patient to rest and apply ice, the primary care NP should prescribe: (Points : 2) an opioid analgesic. metaxalone (Skelaxin) cyclobenzaprine (Flexeril). anonsteroidalantiinflammatory drug (NSAID). Question 9.9. A patient who is taking an antibiotic to treat bronchitis reports moderate rib pain associated with frequent coughing. The primary care NP should consider prescribing: (Points : 2) morphine. hydrocodone. hydromorphone. oxycodone CR. Question 10.10. A patient who has migraine headaches without an aura reports difficulty treating the migraines in time because they come on so suddenly. The patient has been using over-the-counter NSAIDs. The primary care NP should prescribe: (Points : 2) frovatriptan (Frova). sumatriptan (Imitrex). cyproheptadine (Periactin). dihydroergotamine (D.H.E. 45). Question 11.11. A patient comes to the clinic and reports recurrent headaches. The patient has a headache diary, which reveals irritability and food cravings followed the next day by visual disturbances and unilateral right-sided headache, nausea, and photophobia lasting 2 to 3 days. The NP should recognize these symptoms as _____ migraine. (Points : 2) classic hemiplegic basilar-type ophthalmoplegic Question 12.12. The primary care NP is performing a medication reconciliation on a patient who takes digoxin for congestive heart failure and learns that the patient uses ibuprofen as needed for joint pain. The NP should counsel this patient to: (Points : 2) use naproxen (Naprosyn) instead of ibuprofen. increase the dose of digoxin while taking the ibuprofen. use an increased dose of ibuprofen while taking the digoxin. take potassium supplements to minimize the effects of the ibuprofen. Question 13.13. A 70-year-old patient who has a high fracture risk has been taking alendronate (Fosamax) and calcium for 6 months. The primary care NP orders a urineNTx level, which is 42. The NP should discontinue the alendronate and prescribe: (Points : 2) raloxifene (Evista). teriparatide (Forteo). calcitonin (Miacalcin nasal spray). ibandronate sodium (Boniva). Question 14.14. A patient who has a history of stomach ulcers is taking a nonselective NSAID along with a DMARD for RA. The primary care NP should: (Points : 2) order a glucocorticoid. change to acetaminophen. order a proton pump inhibitor (PPI). change to a selective COX-2 inhibitor. Question 15.15. A patient who has mild to moderate migraine headaches has severe nausea and vomiting with each episode. For the best treatment of this patient, the primary care NP should prescribe: (Points : 2) triptan nasal spray. metoclopramide and aspirin. an NSAID and prochlorperazine. sumatriptan and metoclopramide. Question 16.16. A patient is taking 81 mg of aspirin daily to decrease MI risk and uses acetaminophen for mild osteoarthritis symptoms. For flare-ups of osteoarthritis pain, the primary care NP should prescribe: (Points : 2) ibuprofen (Motrin). celecoxib (Celebrex). naproxen (Naprosyn). increasing the dose of aspirin. Question 17.17. A 60-year-old female patient has begun taking a daily bisphosphonate to prevent osteoporosis and complains of gastrointestinal (GI) upset and dyspepsia. The primary care NP’s initial response should be to: (Points : 2) prescribe a proton pump inhibitor (PPI). order intravenous (IV) bisphosphonates. suggest that she take the drug with food. review the instructions for taking the drug with the patient. Question 18.18. A patient has been taking a COX-2 selective NSAID to treat pain associated with a recent onset of RA. The patient tells the primary care NP that the pain and joint swelling are becoming worse. The patient does not have synovitis or extraarticular manifestations of the disease. The NP will refer the patient to a rheumatologist and should expect the specialist to prescribe: (Points : 2) methotrexate. corticosteroids. opioid analgesics. hydroxychloroquine. Question 19.19. A patient reports having persistent mild to moderate pain in both knees usually associated with standing. The patient reports knee stiffness for 15 to 20 minutes each morning. The primary care nurse practitioner (NP) learns that the patient has used heating pads and acetaminophen, which no longer relieve the pain. The NP orders an erythrocyte sedimentation rate, which is normal. The NP should consider prescribing: (Points : 2) aspirin. a cyclooxygenase-2 (COX-2) inhibitor. glucosamine and chondroitin. a topical nonsteroidalantiinflammatory drug (NSAID). Question 20.20. A patient is taking a cytokine immunomodulator to treat RA. The primary care NP caring for this patient should: (Points : 2) obtain periodic complete blood counts (CBCs) and liver function tests (LFTs). perform annual tuberculosis (TB) skin testing. advise the patient of an increased risk of bone cancer. administer the intranasal live attenuated influenza vaccine (LAIV) each year. Question 21.21. A patient who is obese and has hypertension is taking a thiazide diuretic and develops gouty arthritis, which is treated with probenecid. At a follow-up visit, the patient’s serum uric acid level is 7 mg/dL, and the patient denies any current symptoms. The primary care NP should discontinue the probenecid and: (Points : 2) prescribe colchicine. prescribefebuxostat. tell the patient to use an NSAID if symptoms recur. counsel the patient to report recurrence of symptoms. Question 22.22. A patient who has a previous history of renal stones will begin taking probenecid for gout. The primary care NP should: (Points : 2) add colchicine to the patient’s drug regimen. counsel the patient to use high-dose aspirin for pain. teach the patient to drink plenty of acidic fluids such as juice. tell the patient to stop taking the medication when symptoms subside. Question 23.23. A patient with lower back pain and right-sided sciatica has taken an NSAID and a TCA for 1 week. The patient reports some decrease in pain but is experiencing increased tingling and numbness of the right leg. The primary care NP should: (Points : 2) order a magnetic resonance imaging (MRI) study. order physical therapy. refer the patient to a neurologist. continue the TCA for 1 more week. Question 24.24. A patient has recent weight loss, fatigue, and recurrent low-grade fever along with pain and stiffness of knees and hands. The primary care nurse practitioner (NP) notes symmetric joint swelling and warmth of these joints. The NP should: (Points : 2) refer the patient to a specialist. order erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), and antinuclear antibody (ANA) tests. begin therapy with methotrexate. order x-rays of the affected joints. Question 25.25. A 50-year-old woman with osteopenia will begin taking raloxifene (Evista). When counseling this patient about this drug regimen, the primary care NP should tell her to: (Points : 2) go for walks daily. take the medication 1 hour before meals. sit upright for 30 minutes after taking the drug. avoid using diuretics while taking this medication.