A patient reports going to bed at 10:00 pm every night but often ...

[xroflmao]

A patient reports going to bed at 10:00 pm every night but often lays awake until midnight. The primary care NP instructs the patient to practice good sleep hygiene and to avoid caffeine in the evening.
 
  After 1 week of this regimen, the patient reports still lying awake until 11:00 PM. The NP should: a. order a sleep study.
  b. consider short-term zolpidem.
  c. order ramelteon for several weeks.
  d. reassure the patient and re-evaluate in 1 week.

Question 2

The primary care NP teaches a patient about TMP/SMX before prescribing it to treat a urinary tract infection (UTI). Which statement by the patient indicates a need for further teaching?
 
  a. I will take this medication with food.
  b. I should drink a full glass of water with each dose.
  c. I should stay out of direct sunlight and use sunscreen.
  d. I should report any ringing in my ears or a sore throat.

[dawsa925]

Answer to Question 1

D
Treatment of patients with insomnia begins with sleep hygiene. It is important that the patient have reasonable expectations and understand that the time of onset of sleep can be moved up only by 15 minutes every 3 or 4 days. This patient is showing improvement, which means the measures are working. When these measures are ineffective, medications may be considered.

Answer to Question 2

A
TMP/SMX should be taken on an empty stomach, so this statement is incorrect and indicates the need for further teaching. The other statements all are correct.

[xroflmao]

Thanks

[dawsa925]

Welcome