A woman who has been taking a COCP for 2 months tells the primary ...

[pepyto]

A woman who has been taking a COCP for 2 months tells the primary care NP that she has had several headaches, breakthrough bleeding, and nausea. The NP should counsel the woman:
 
  a. to change to a progestin-only pill.
  b. to stop taking the COCP immediately.
  c. to use a backup form of contraception.
  d. that these effects will likely decrease in another month.

Question 2

The primary care nurse practitioner (NP) is seeing a patient who reports chronic lower back pain. The patient reports having difficulty sleeping despite taking ibuprofen at bedtime each night. The NP should prescribe:
 
  a. diazepam (Valium).
  b. metaxalone (Skelaxin).
  c. methocarbamol (Robaxin).
  d. cyclobenzaprine (Flexeril).

[dyrone]

Answer to Question 1

D
Breakthrough bleeding, nausea, and headaches are common during the first 3 months of therapy and should improve without intervention. Progestin-only pills are used for lactating women only. Prolonged bleeding and severe headache would warrant discontinuation of the COCP. Backup contraception is not indicated.

Answer to Question 2

D
Cyclobenzaprine (Flexeril) is indicated for chronic low back pain and provides an added benefit of aiding sleep, which is a common problem among patients with back pain. The other medications are used for acute lower back pain.

[pepyto]

Excellent

[debra928]

TYSM