A patient who has diabetes is taking simvastatin (Zocor) 80 mg ...

[nautica902]

A patient who has diabetes is taking simvastatin (Zocor) 80 mg daily to treat LDL cholesterol level of 170 mg/dL. The patient has a body mass index of 29 . At a follow-up visit, the patient's LDL level is 120 mg/dL.
 
  The primary care NP should consider: a. increasing the simvastatin to 80 mg twice daily.
  b. adding nicotinic acid to the patient's drug regimen.
  c. changing the medication to ezetimibe/simvastatin (Vytorin).
  d. referring the patient to a dietitian for assistance with weight reduction.

Question 2

A patient tells a nurse practitioner (NP) that several coworkers have upper respiratory infections and asks about the best way to avoid getting sick. The NP should recommend which of the following?
 
  a. Echinacea
  b. Frequent hand washing
  c. Zinc gluconate supplements
  d. Normal saline nasal irrigation

[AngeliqueG]

Answer to Question 1

C
Patients with diabetes have a goal LDL of less than 100 mg/dL. If maximum-dose statin is unable to achieve the goal LDL, a combination product such as a statin plus ezetimibe is recommended. The maximum recommended dose is 80 mg daily, so increasing the dose to 80 mg twice daily is incorrect.

Answer to Question 2

B
Hand washing is the most effective way to prevent the spread of viral upper respiratory illness (VURI). Echinacea has not been shown to be effective in preventing VURI. Zinc gluconate may decrease the duration of a VURI if taken within 24 hours of onset, but it does not prevent infection. Normal saline irrigation is helpful for symptomatic relief after a VURI has begun.

[nautica902]

TYSM

[debra928]

Excellent