1. The primary care NP sees a patient covered by Medicaid, writes a prescription for a
medication, and is informed by the pharmacist that the medication is “off-formulary.” The NP
should: (Points : 2)
inform the patient that an out-of-pocket expense will be necessary.
write the prescription for a generic drug if it meets the patient’s needs.
call the patient’s insurance provider to advocate for this particular drug.
contact the pharmaceutical company to see if medication samples are available.
Question 2.2. A patient asks a primary care nurse practitioner (NP) about using over-the-
counter medications to treat an upper respiratory infection with symptoms of cough, fever,
and nasal congestion. The NP should: (Points : 2)
recommend a cough preparation that also contains acetaminophen.
suggest using single-ingredient products to treat each symptom separately.
recommend a product containing antitussive, antipyretic, and decongestant
ingredients.
tell the patient that over-the-counter medications are usually not effective in
manufacturer-recommended doses.
Question 3.3. A patient has recurrent symptoms and tells the primary care NP that she can’t
remember to take her medication all the time. The NP should: (Points : 2)
give her shortened regimens of the drug to facilitate compliance.
provide written information about her condition and the medication.
administer the medication in the clinic to ensure that she takes the drug.
ask her about her lifestyle, her schedule, and her understanding of her condition.
Question 4.4. A woman who began taking a COCP 2 months ago calls the primary care NP to
report having nausea every day. She takes a pill at the same time each morning. The NP
should tell her to: (Points : 2)
try taking the pill in the evening each day.
come to the clinic for a urine pregnancy test.
take the pill on an empty stomach with water.
stop taking the pill for 7 days and then restart.
Question 5.5. A primary care NP will begin practicing in a state in which the governor has
opted out of the federal facility reimbursement requirement. The NP should be aware that this
defines how NPs may write prescriptions: (Points : 2)
without physician supervision in private practice.
as CRNAs without physician supervision in a hospital setting.
in any situation but will not be reimbursed for this by government insurers.
, only with physician supervision in both private practice and a hospital setting.
Question 6.6. A parent calls a clinic for advice about giving an over-the-counter cough
medicine to a 6-year-old child. The parent tells the NP that the medication label does not give
instructions about how much to give a child. The NP should: (Points : 2)
order a prescription antitussive medication for the child.
ask the parent to identify all of the ingredients listed on the medication label.
calculate the dose for the active ingredient in the over-the-counter preparation.
tell the parent to approximate the dose at about one third to one half the adult dose.
Question 7.7. A primary care NP sees a 5-year-old child who is morbidly obese. The child has
an elevated hemoglobin A1c and increased lipid levels. Both of the child’s parents are
overweight but not obese, and they tell the NP that they see nothing wrong with their child.
They both state that it is difficult to refuse their child’s requests for soda or ice cream. The NP
should: (Points : 2)
suggest that they give the child diet soda and low-fat frozen yogurt.
understand and respect the parents’ beliefs about their child’s self-image.
initiate a dialogue with the parents about the implications of the child’s laboratory
values.
suggest family counseling to explore ways to improve parenting skills and limits.
Question 8.8. A patient has been using an herbal supplement for 2 years that the primary
care NP knows may have toxic side effects. The NP should: (Points : 2)
tell the patient to stop taking the supplement immediately.
inform the patient of the risks of toxic side effects with this supplement.
refer the patient to a CAM provider who can manage this patient’s therapy.
prescribe another herbal drug that has fewer adverse effects than the one the
patient is taking.
Question 9.9. A primary care NP has prescribed phentermine for a patient who is obese. The
patient loses 10 lb in the first month but reports that the drug does not seem to be
suppressing appetite as much as before. The NP should: (Points : 2)
discontinue the phentermine.
increase the dose of phentermine.
continue the phentermine at the same dose.
change to a combination of phentermine and topiramate.
Question 10.10. A patient asks a primary care NP whether over-the-counter drugs are safer
than prescription drugs. The NP should explain that over-the-counter drugs are: (Points : 2)
medication, and is informed by the pharmacist that the medication is “off-formulary.” The NP
should: (Points : 2)
inform the patient that an out-of-pocket expense will be necessary.
write the prescription for a generic drug if it meets the patient’s needs.
call the patient’s insurance provider to advocate for this particular drug.
contact the pharmaceutical company to see if medication samples are available.
Question 2.2. A patient asks a primary care nurse practitioner (NP) about using over-the-
counter medications to treat an upper respiratory infection with symptoms of cough, fever,
and nasal congestion. The NP should: (Points : 2)
recommend a cough preparation that also contains acetaminophen.
suggest using single-ingredient products to treat each symptom separately.
recommend a product containing antitussive, antipyretic, and decongestant
ingredients.
tell the patient that over-the-counter medications are usually not effective in
manufacturer-recommended doses.
Question 3.3. A patient has recurrent symptoms and tells the primary care NP that she can’t
remember to take her medication all the time. The NP should: (Points : 2)
give her shortened regimens of the drug to facilitate compliance.
provide written information about her condition and the medication.
administer the medication in the clinic to ensure that she takes the drug.
ask her about her lifestyle, her schedule, and her understanding of her condition.
Question 4.4. A woman who began taking a COCP 2 months ago calls the primary care NP to
report having nausea every day. She takes a pill at the same time each morning. The NP
should tell her to: (Points : 2)
try taking the pill in the evening each day.
come to the clinic for a urine pregnancy test.
take the pill on an empty stomach with water.
stop taking the pill for 7 days and then restart.
Question 5.5. A primary care NP will begin practicing in a state in which the governor has
opted out of the federal facility reimbursement requirement. The NP should be aware that this
defines how NPs may write prescriptions: (Points : 2)
without physician supervision in private practice.
as CRNAs without physician supervision in a hospital setting.
in any situation but will not be reimbursed for this by government insurers.
, only with physician supervision in both private practice and a hospital setting.
Question 6.6. A parent calls a clinic for advice about giving an over-the-counter cough
medicine to a 6-year-old child. The parent tells the NP that the medication label does not give
instructions about how much to give a child. The NP should: (Points : 2)
order a prescription antitussive medication for the child.
ask the parent to identify all of the ingredients listed on the medication label.
calculate the dose for the active ingredient in the over-the-counter preparation.
tell the parent to approximate the dose at about one third to one half the adult dose.
Question 7.7. A primary care NP sees a 5-year-old child who is morbidly obese. The child has
an elevated hemoglobin A1c and increased lipid levels. Both of the child’s parents are
overweight but not obese, and they tell the NP that they see nothing wrong with their child.
They both state that it is difficult to refuse their child’s requests for soda or ice cream. The NP
should: (Points : 2)
suggest that they give the child diet soda and low-fat frozen yogurt.
understand and respect the parents’ beliefs about their child’s self-image.
initiate a dialogue with the parents about the implications of the child’s laboratory
values.
suggest family counseling to explore ways to improve parenting skills and limits.
Question 8.8. A patient has been using an herbal supplement for 2 years that the primary
care NP knows may have toxic side effects. The NP should: (Points : 2)
tell the patient to stop taking the supplement immediately.
inform the patient of the risks of toxic side effects with this supplement.
refer the patient to a CAM provider who can manage this patient’s therapy.
prescribe another herbal drug that has fewer adverse effects than the one the
patient is taking.
Question 9.9. A primary care NP has prescribed phentermine for a patient who is obese. The
patient loses 10 lb in the first month but reports that the drug does not seem to be
suppressing appetite as much as before. The NP should: (Points : 2)
discontinue the phentermine.
increase the dose of phentermine.
continue the phentermine at the same dose.
change to a combination of phentermine and topiramate.
Question 10.10. A patient asks a primary care NP whether over-the-counter drugs are safer
than prescription drugs. The NP should explain that over-the-counter drugs are: (Points : 2)
