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NR 508 Week 4 Midterm Exam
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NR 508 Week 4 Midterm Exam NR508 Week 4 Midterm Exam
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NR 508 Week 4 Mid-TermQuestion 12 pts
Osteopenia is diagnosed in a 55-year-old woman who has not had a period in 15
months. She has a positive family history of breast cancer. The primary care NP
should recommend:
testosterone therapy.
estrogen-only therapy.
nonhormonal drugs for osteoporosis.
estrogen-progesterone therapy for 1 to 2
years.
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Question 22 pts
A woman is in her first trimester of pregnancy. She tells the primary care nurse
practitioner (NP) that she continues to have severe morning sickness on a daily
basis. The NP notes a weight loss of 1 pound from her previous visit 2 weeks
prior. The NP should consult an obstetrician and prescribe:
aprepitant (Emend).
ondansetron (Zofran).
scopolamine transdermal.
prochlorperazine
(Compazine).
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Question 32 pts
A 75-year-old patient who has cardiovascular disease reports insomnia and
vomiting for several weeks. The primary care NP orders thyroid function tests.
The tests show TSH is decreased and T4 is increased. The NP should consult
with an endocrinologist and order:
thyrotropin.
methimazole.
levothyroxine.
propylthiouracil.
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Question 42 pts
,A 55-year-old patient with no prior history of hypertension has a blood pressure
greater than 140/90 on three separate occasions. The patient does not smoke,
has a body mass index of 24, and exercises regularly. The patient has no known
risk factors for cardiovascular disease. The primary care NP should:
prescribe a thiazide diuretic and an angiotensin-converting enzyme inhibitor.
perform a careful cardiovascular physical assessment.
counsel the patient about dietary and lifestyle changes.
order a urinalysis and creatinine clearance and begin therapy with a β-blocker.
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Question 52 pts
A patient reports fatigue, weight loss, and dry skin. The primary care nurse
practitioner (NP) orders thyroid function tests. The patient’s thyroid stimulating
hormone (TSH) is 40 microunits/mL, and T4 is 0.1 ng/mL. The NP should refer
the patient to an endocrinologist and prescribe:
methimazole.
liothyronine.
levothyroxine.
propylthiouracil.
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Question 62 pts
When prescribing a medication for a chronic condition, the primary care NP
should tell the patient:
to contact the pharmacy whenever refills are needed.
that it is necessary to return to the clinic for each monthly refill of the medication.
about the frequency of clinic visits necessary for the number of refills authorized.
to ask the pharmacist to supply several months’ worth of the medication at a time.
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Question 72 pts
A child who has congenital hypothyroidism takes levothyroxine 75 mcg/day. The
child weighs 15 kg. The primary care NP sees the child for a 3-year-old check-
up. The NP should consult with a pediatric endocrinologist to discuss:
increasing the dose to 90 mcg/day.
decreasing the dose to 30 mcg/day.
stopping the medication and checking TSH and T4 in 4 weeks.
discussing the need for lifetime replacement therapy with the child’s parents.
, Flag this Question
Question 82 pts
A patient who has IBS experiences diarrhea, bloating, and pain but does not
want to take medication. The primary care NP should recommend:
25 g of fiber each day.
avoiding gluten and lactose in the diet.
increasing water intake to eight to ten glasses per day.
beginning aerobic exercise, such as running, every day.
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Question 92 pts
A woman who uses a transdermal contraceptive calls the primary care NP to
report that while dressing that morning she discovered that the patch had come
off and she was unable to find the patch. The NP should tell her to apply a new
patch and:
take one cycle of COCPs.
take a home pregnancy
test.
use condoms for the next 7 days.
contact the clinic if she misses a period.
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Question 102 pts
A patient has been diagnosed with IBS and tells the primary care NP that
symptoms of diarrhea and cramping are worsening. The patient asks about
possible drug therapy to treat the symptoms. The NP should prescribe:
mesalamine (Asacol).
dicyclomine (Bentyl).
simethicone (Phazyme).
metoclopramide (Reglan).
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Question 112 pts
A patient wants to know why a cheaper version of a drug cannot be used when
the primary care NP writes a prescription for a specific brand name of the drug
and writes, “Dispense as Written.” The NP should explain that a different brand of
this drug:
may cause different adverse effects.
does not necessarily have the same therapeutic effect.
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