Author Question: A patient comes to the clinic and reports having insomnia that began within the last year. The ... (Read 21 times)

brutforce · **on:** Jul 24, 2018

A patient comes to the clinic and reports having insomnia that began within the last year. The primary care nurse practitioner (NP) learns that the patient often lies awake worrying about problems at work.

The patient feels fatigued during the day and experiences frequent stomach discomfort. The NP should prescribe: a. buspirone.
b. melatonin.
c. alprazolam.
d. diphenhydramine.

Question 2

A primary care NP sees a patient who was recently hospitalized for infection and treated with gentamicin for 10 days. The patient tells the NP that the drug was discontinued early because my blood level was too high. The NP should order:

a. a serial audiometric test.
b. a serum blood urea nitrogen (BUN) and creatinine.
c. a urinalysis and complete blood count.
d. serum calcium, magnesium, and sodium.

Chocorrol77 · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

A
This patient is having insomnia because of anxiety. Alprazolam has a high abuse potential, so starting therapy with an antianxiety medication is a good choice. Melatonin and diphenhydramine are given for insomnia.

Answer to Question 2

A
Aminoglycosides are associated with ototoxicity and nephrotoxicity. Recovery of renal function occurs if the drug is stopped at the first sign of renal impairment. The NP should evaluate the possibility of ototoxicity with a serial audiometric test.