NR 508 Week 1 Quiz and Answers
1. Question :
NR 508 WK 1 QUIZ
Osteopenia is diagnosed in a 55-year-old woman who has not had a period in
15 months.
... [Show More] She has a positive family history of breast cancer. The primary
care NP should recommend:
Student
Answer:
testosterone therapy.
estrogen-only therapy.
nonhormonal drugs for osteoporosis.
estrogen-progesterone therapy for 1 to 2 years.
Instructor
Explanation:
Although estrogen slows the progression of osteoporosis, it also increases the risk of breast
cancer when initiated early in menopause. This woman should receive a nonhormonal
treatment for osteoporosis and may receive HT in 5 years if menopausal symptoms
persist. Testosterone therapy, estrogen-only therapy, and estrogen-progesterone therapy
are not indicated.
Question 2
.
Question :
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:
Student Answer: 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
Instructor
Explanation:
samples so that the patient does not incur out-of-pocket expense.
In this case, the NP should advocate for the desired drug because changing the
drug can have life-threatening consequences. If this fails, other options may have to
be explored.
Question 3
.
Question :
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:
Student Answer: 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
Instructor
Explanation:
information there.
Commercial internet sites are identifiable by “com” at the end of their web address. Many
provide reliable information, but others may be more interested in selling something.
Nonprofit groups use “org” at the end of their web addresses. Internet information is
reliable as long as the internet user is aware of how things are posted and by whom.
Question 4
.
Question :
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:
Student
Answer:
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.
Instructor
Explanation:
To evaluate a patient’s understanding, the NP should ask the patient to describe in his or her
own words what is taught. Asking a patient to read aloud is sometimes used to assess
literacy. Patients who are not literate may not be able to write down questions and, because
of shame, may not tell the NP that the written information is unclear.
Question 5
.
Question :
A patient is diagnosed with lupus and reports occasional use of herbal
supplements. The primary care NP should caution this patient to avoid:
Student Answer: ginseng.
echinacea.
ginkgo biloba.
St. John’s wort.
Instructor
Explanation:
Patients with lupus who take echinacea may experience an increase in symptoms, even if
the patient is taking immunosuppressants.
Question 6
.
Question :
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:
Student Answer: fill the prescription and document the patient’s explanation of
the reason.
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 drugseeking
behaviors.
confront the patient about misuse of narcotics and refuse to fill
Instructor
Explanation:
the prescription.
When patients fill prescriptions early for drugs that have abuse potential, providers
should be alert to possible abuse. The first step would be to see if this is a one-time
occurrence or a pattern. Providers should do this before refilling the prescription. If this
is a pattern, the pharmacist should be notified. Patients should be confronted if a problem
is apparent, and practitioners should not refill the prescriptions. [Show Less]