Author Question: A 45-year-old patient who has a positive family history but no personal history of coronary artery ... (Read 72 times)

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

A 45-year-old patient who has a positive family history but no personal history of coronary artery disease is seen by the primary care NP for a physical examination. The patient has a body mass index of 27 and a blood pressure of 130/78 mm Hg.

Laboratory tests reveal low-density lipoprotein, 110 mg/dL; high-density lipoprotein, 70 mg/dL; and triglycerides, 120 mg/dL. The patient does not smoke but has a sedentary lifestyle. The NP should recommend: a. 30 minutes of aerobic exercise daily.
b. taking 81 to 325 mg of aspirin daily.
c. beginning therapy with a statin medication.
d. starting a thiazide diuretic to treat hypertension.

Question 2

A parent brings a child who has moderate-persistent asthma to the clinic and tells the primary care NP that none of the child's medications are working. The parent says, Everybody tells me something different. I don't know what to do.

The NP suspects that the parent is not administering the medications appropriately. The NP should initially: a. perform a careful history of the child's symptoms and the medications that are given.
b. provide a written asthma action plan and encourage the parent to call when symptoms are worse.
c. review what other providers have prescribed in the past and explain these interventions to the parent.
d. explain the different purposes of maintenance and rescue medications and give the parent a schedule for medication administration.

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

Answer to Question 1

A
This patient is overweight but not obese, and blood lipids are within normal limits. Blood pressure is not elevated. Exercise is recommended as an initial risk reduction strategy because of its positive effects on blood pressure and blood lipids. Aspirin is generally given to patients older than 55 to 65 who are at risk. Statin medications and thiazide diuretics are not indicated.

Answer to Question 2

A
Clinical providers must refine listening and questioning skills and focus on the patient and the environment. It is important to begin with a thorough history and to elicit the patient's understanding of a disease or a medication to identify potential problems. Providing written action plans, reviewing past providers' prescriptions, and explaining medications are useful only after the NP determines what the problem is.