A patient who has GERD has been taking a PPI for 2 months and ...

[Deast7027]

A patient who has GERD has been taking a PPI for 2 months and reports a slight decrease in symptoms. The next response of the primary care NP is to:
 
  a. add a histamine-2-receptor agonist.
  b. increase the dose of the PPI.
  c. change to long-term, low-dose PPI therapy.
  d. refer the patient to an endocrinologist for endoscopy and further management.

Question 2

A patient reports having urinary frequency and discomfort associated with urination. After a careful physical examination and history to determine the cause, the NP should prescribe a medication from which drug class?
 
  a. Cholinergics
  b. Antispasmodics
  c. Anticholinergics
  d. Urinary tract analgesics

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Answer to Question 1

A
If treatment with a PPI is inadequate by 2 months, histamine-2-receptor agonist therapy is indicated. Increasing the dose is not indicated. Long-term, lower dose therapy is used for recurrences of symptoms on a limited basis. When symptoms fail to resolve with pharmacologic treatments, patients should be referred to an endocrinologist.

Answer to Question 2

B
Antispasmodics are smooth muscle relaxants. Use of these drugs can produce increased bladder capacity and exhibit local anesthetic and analgesic actions. Cholinergic agents increase detrusor muscle tone to improve initiation of voiding and bladder emptying. Anticholinergics decrease detrusor tone to treat urge incontinence. Urinary tract analgesics are used to treat pain via a local analgesic effect on urinary tract mucosa and are used in conjunction with antibiotics to treat UTI.

[Deast7027]

TYSM

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