Author Question: A patient is in the clinic with acute symptoms of anxiety. The patient is restless and has not slept ... (Read 23 times)

Pineappleeh · **on:** Jul 24, 2018

A patient is in the clinic with acute symptoms of anxiety. The patient is restless and has not slept in 3 days. The primary care NP observes that the patient is irritable and has moderate muscle tension.

The patient's spouse reports that similar symptoms have occurred before in varying degrees for several years. The NP should refer the patient to a psychologist and should prescribe which drug for short-term use? a. Alprazolam
b. Buspirone
c. Melatonin
d. Zolpidem

Question 2

An 80-year-old patient who has COPD takes TMP/SMX for acute exacerbations, which occur three or four times each year. To monitor this patient for adverse drug reactions, the primary care NP should order:

a. liver function tests.
b. blood urea nitrogen and creatinine.
c. serum bilirubin levels.
d. a complete blood count (CBC) with differential.

ju · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

A
For acute anxiety, a benzodiazepine should be prescribed. SSRIs or buspirone should be used for long-term treatment. Melatonin and zolpidem are anti-insomnia agents.

Answer to Question 2

D
The most frequently reported severe adverse reactions in elderly patients include bone marrow depression and decreased platelets. A CBC with differential is indicated to monitor for this. Evaluation of liver and renal function should be performed before beginning treatment because adverse effects are more common in patients with decreased renal and liver function.