Author Question: The primary care nurse practitioner (NP) sees a 50-year-old woman who reports frequent leakage of ... (Read 81 times)

lunatika · **on:** Jul 24, 2018

The primary care nurse practitioner (NP) sees a 50-year-old woman who reports frequent leakage of urine. The NP learns that this occurs when she laughs or sneezes. She also reports having an increased urge to void even when her bladder is not full.

She is not taking any medications. The NP should: a. perform a dipstick urinalysis.
b. prescribe desmopressin (DDAVP).
c. prescribe oxybutynin chloride (Ditropan XL).
d. teach exercises to strengthen the pelvic muscles.

Question 2

The primary care nurse practitioner (NP) is performing a physical examination on a patient who has been taking mesoridazine (Serentil) for several weeks to treat schizophrenia. The patient is exhibiting rhythmic movements of the face and jaw.

The NP should be concerned that the patient may: a. need a higher dose of mesoridazine.
b. need to change to thioridazine (Mellaril).
c. have developed neuroleptic malignant syndrome.
d. be exhibiting signs of an irreversible adverse effect.

Sweetkitty24130 · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

A
A focused history with a careful physical examination is essential for determining the cause of incontinence. Urinalysis can rule out urinary tract infection (UTI), which can cause incontinence. Medications are prescribed after determining the cause, if any, and treating underlying conditions. Exercises to strengthen the pelvic muscles are part of treatment.

Answer to Question 2

D
Tardive dyskinesia, or abnormal involuntary movements characterized by rhythmic involuntary movements of the tongue, face, mouth, or jaw, may be progressive and irreversible. This condition can occur with all antipsychotics, especially the first-generation antipsychotics. Increasing the dose may increase the symptoms. Thioridazine is another first-generation antipsychotic with a similar adverse-effect profile. Neuroleptic malignant syndrome occurs weeks after initiation and is characterized by fever, catatonia, muscle rigidity, and autonomic instability.