Discussion: Nonhormonal drugs for osteoporosis.

Discussion: Nonhormonal drugs for osteoporosis.

1. 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.

Question 2. A patient takes a cardiac medication that has a very narrow therapeutic range. The primary care NP learns that the particular brand the patient is taking is no longer covered by the patient’s medical plan. The NP knows that the bioavailability of the drug varies from brand to brand. The NP should:

contact the insurance provider to explain why this particular formulation is necessary.

change the patient’s medication to a different drug class that doesn’t have these bioavailability variations.

accept the situation and monitor the patient closely for drug effects with each prescription refill.

ask the pharmaceutical company that makes the drug for samples so that the patient does not incur out-of-pocket expense.

Question 3. A patient brings written information about a medication to a primary care NP about a new drug called Prism and wants to know if the NP will prescribe it. The NP notes that the information is from an internet site called “Prism.com.” The NP should tell this patient that:

this information is probably from a drug advertisement website.

this is factual, evidence-based material with accurate information.

the information is from a nonprofit group that will not profit from drug sales.

internet information is unreliable because anyone can post information there.

Question 4. A primary care NP is reviewing written information about a newly prescribed medication with a patient. To evaluate this patient’s understanding of the information, the NP should ask the patient to:

read the information aloud.

describe how the medication will be taken.

write down questions about the medication.

tell the NP if the information is unclear.

Question 5. A patient is diagnosed with lupus and reports occasional use of herbal supplements. The primary care NP should caution this patient to avoid:

ginseng.

echinacea.

ginkgo biloba.

St. John’s wort.

Question 6. A patient who has chronic pain and who takes oxycodone (Percodan) calls the clinic to ask for a refill of the medication. The primary care NP notes that the medication refill is not due for 2 weeks. The patient tells the NP that the refill is needed because he is going out of town. The NP should:

fill the prescription and document the patient’s explanation of the reason. Discussion: Nonhormonal drugs for osteoporosis.

review the patient’s chart to see if this is a one-time or repeat occurrence.

call the patient’s pharmacist and report suspicion of drug-seeking behaviors.

confront the patient about misuse of narcotics and refuse to fill the prescription.

Question 7. The primary care NP prescribes an extended-cycle monophasic pill regimen for a young woman who reports having multiple partners.Which statement by the patient indicates she understands the  regimen?

“I have to take a pill only every 3 months.”

“I should expect to have only four periods each year.”

“I will need to use condoms for only 7 more days.”

“This type of pill has fewer side effects than other types.”

Question 8. 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:

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 9. A 55-year-old woman has not had menstrual periods for 5 years and tells the primary care nurse practitioner (NP) that she is having increasingly frequent vasomotor symptoms. She has no family history or risk factors for coronary heart disease (CHD) or breast cancer but is concerned about these side effects of hormone therapy (HT). The NP should:

tell her that starting HT now may reduce her risk of breast cancer.

advise a short course of HT now that may decrease her risk for CHD.

tell her that HT will not help control her symptoms during postmenopause.

recommend herbal supplements for her symptoms to avoid HT side effects.

Question 10. A primary care NP recommends an over-the-counter medication for a patient who has acid reflux. When teaching the patient about this drug, the NP should tell the patient:

to take the dose recommended by the manufacturer.

not to worry about taking this drug with any other medications.

to avoid taking other drugs that cause sedation while taking this drug.

that over-the-counter acid reflux medications are generally safe to take with other medications.

Question 11. A patient will begin taking two drugs that are both protein-bound. The primary care NP should:

prescribe increased doses of both drugs.

monitor drug levels, actions, and side effects.

teach the patient to increase intake of protein.

stagger the doses of drugs to be given 1 hour apart.

Question 12. The primary care NP has referred a child who has significant gastrointestinal reflux disease to a specialist for consideration for a fundoplication and gastrostomy tube placement. The child’s weight is 80% of what is recommended for age, and a recent swallow study revealed significant risk for aspiration. The child’s parents do not want the procedure. The NP should:

Discussion: Nonhormonal drugs for osteoporosis.