Author Question: A patient who is diagnosed with Alzheimer's disease experiences visual hallucinations. The primary ... (Read 24 times)

amal · **on:** Jul 24, 2018

A patient who is diagnosed with Alzheimer's disease experiences visual hallucinations. The primary care NP should initially prescribe:

a. donepezil (Aricept).
b. rivastigmine (Exelon).
c. memantine (Namenda).
d. galantamine (Razadyne).

Question 2

A patient who has had two recent urinary tract infections is in the clinic with dysuria and fever. The primary care NP reviews the patient's chart and notes that in both previous cases the causative organism and sensitivity were the same.

The NP should: a. treat the patient empirically without a culture.
b. order a microscopic evaluation of the urine and an antibiotic.
c. order a urine culture and treat empirically pending culture results.
d. order a urine culture and sensitivity and wait for results before treating.

essyface1 · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

B
Patients with dementia with Lewy bodies may show benefit with rivastigmine. Visual hallucinations are a hallmark feature of Lewy body dementia.

Answer to Question 2

C
Because this patient has had similar infections in the past, treating empirically is acceptable. The NP must still obtain a culture and sensitivity so that appropriate antibiotic therapy can be provided, even though it is likely that this is a recurrence of the same organism. A culture should always be obtained when possible. A microscopic evaluation is used to determine whether or not a culture should be performed and is not diagnostic.