Author Question: A patient is taking a cytokine immunomodulator to treat RA. The primary care NP caring for this ... (Read 13 times)

SAVANNAHHOOPER23 · **on:** Jul 24, 2018

A patient is taking a cytokine immunomodulator to treat RA. The primary care NP caring for this patient should:

a. obtain periodic complete blood counts (CBCs) and liver function tests (LFTs).
b. perform annual tuberculosis (TB) skin testing.
c. advise the patient of an increased risk of bone cancer.
d. administer the intranasal live attenuated influenza vaccine (LAIV) each year.

Question 2

A patient reports having episodes of dizziness, nausea, and lightheadedness and describes a sensation of the room spinning when these occur.

The primary care NP will refer the patient to a specialist who, after diagnostic testing, is likely to prescribe: a. meclizine.
b. ondansetron.
c. scopolamine.
d. dimenhydrinate.

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

Answer to Question 1

A
Routine monitoring for patients taking cytokine immunomodulators should include periodic CBCs and LFTs. TB skin testing should be performed before initiating therapy but is not indicated annually. Patients taking immunomodulators do not have an increased risk of bone cancer. Providers should administer the trivalent influenza vaccine intramuscularly and not the LAIV given intranasally because the LAIV is a live virus, which is contraindicated in patients who are immunosuppressed.

Answer to Question 2

A
Patients with vertigo may experience whirling or a feeling of the room spinning around. In true vertigo, the patient can identify the direction in which the room is spinning. Anticholinergics are the most effective agents in cases of motion sickness or vertigo. Meclizine has a specific indication to treat vertigo.