Gastrointestinal Reflux Disease Assignment

Gastrointestinal Reflux Disease Assignment

Gastrointestinal Reflux Disease Assignment

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Question 152 pts A patient who is taking trimethoprim-sulfamethoxazole for prophylaxis of urinary tract infections tells the primary care NP that a sibling recently died from a sudden cardiac arrest, determined to be from long QT syndrome. The NP should: schedule a treadmill stress test. order genetic testing for this patient. discontinue the trimethoprim-sulfamethoxazole. refer the patient to a cardiologist for further evaluation. Flag this Question Question 162 pts A patient has three consecutive blood pressure readings of 140/95 mm Hg. The patient’s body mass index is 24. A fasting plasma glucose is 100 mg/dL. Creatinine clearance and cholesterol tests are normal. The primary care NP should order: a ?-blocker. an angiotensin-converting enzyme inhibitor. a thiazide diuretic. dietary and lifestyle changes. Flag this Question Question 172 pts A male patient tells the primary care NP he is experiencing decreased libido, lack of energy, and poor concentration. The NP performs an examination and notes increased body fat and gynecomastia. A serum testosterone level is 225 ng/dL. The NP’s next action should be to: order LH and FSH levels. order a serum prolactin level. prescribe testosterone replacement. obtain a morning serum testosterone level. Flag this Question Question 182 pts A woman has severe IBS and takes hyoscyamine sulfate (Levsin), simethicone (Phazyme), and a TCA. She reports having continued severe diarrhea. The primary care NP should: order diphenoxylate (Lomotil). prescribe alosetron after ruling out pregnancy. refer her to a gastroenterologist for endoscopy. increase the fiber in her diet to 30 g per day. Flag this Question Question 192 pts A patient is given a diagnosis of peptic ulcer disease. A laboratory test confirms the presence of Helicobacter pylori. The primary care NP orders a proton pump inhibitor (PPI) before meals twice daily, clarithromycin, and amoxicillin. After 14 days of treatment, H. pyloriis still present. The NP should order: continuation of the PPI for 4 to 8 weeks. a PPI, amoxicillin, and metronidazole for 14 days. a PPI, clarithromycin, and amoxicillin for 14 more days. a PPI, bismuth subsalicylate, tetracycline, and metronidazole. Flag this Question Question 202 pts A patient is taking drug A and drug B. The primary care NP notes increased effects of drug B. The NP should suspect that in this case drug A is a cytochrome P450 (CYP450) enzyme: inhibitor. substrate. inducer. metabolizer. Flag this Question Question 212 pts The primary care NP sees a new patient who has diabetes and hypertension and has been taking a thiazide diuretic for 6 months. The patient’s blood pressure at the beginning of treatment was 150/95 mm Hg. The blood pressure today is 138/85 mm Hg. The NP should: order a ?-blocker. add an angiotensin-converting enzyme inhibitor. continue the current drug regimen. change to an aldosterone antagonist medication. Flag this Question Question 222 pts A patient has been taking antibiotics to treat recurrent pneumonia. The patient is in the clinic after having diarrhea for 5 days with six to seven liquid stools each day. The primary care NP should: obtain a stool specimen and order vancomycin. order testing for Clostridium difficile and consider metronidazole therapy. prescribe diphenoxylate (Lomotil) to provide symptomatic relief. reassure the patient that diarrhea is a common side effect of antibiotic therapy. Flag this Question Question 232 pts 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: compromise with the parents and order a nasogastric tube for feedings. initiate a discussion with the parents about the potential outcomes of each possible action. refer the family to a case manager who can help guide the parents to the best decision. understand that the child’s parents have a right to make choices that override those of the medical team.

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