Author Question: A patient who has just been diagnosed with RA is experiencing minimal pain and mild symptoms. The ... (Read 102 times)

nramada · **on:** Jul 24, 2018

A patient who has just been diagnosed with RA is experiencing minimal pain and mild symptoms. The primary care NP should consult with a rheumatologist and should recommend:

a. ibuprofen.
b. methotrexate.
c. acetaminophen.
d. herbal remedies.

Question 2

A patient has been taking levothyroxine 100 mcg daily for several months. The patient comes to the clinic with complaints of insomnia and irritability. The primary care NP notes a heart rate of 92 beats per minute. The NP should:

a. change to liothyronine 75 mcg/day.
b. discontinue levothyroxine indefinitely.
c. order propylthiouracil to counter the increased thyroid levels.
d. order TSH and T4 levels and decrease the dose to 75 mcg/day.

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

Answer to Question 1

A
If the disease is mild, NSAIDs are recommended at full therapeutic doses for the first 2 to 3 months before starting DMARDs such as methotrexate. Acetaminophen and herbal remedies are not recommended as monotherapy.

Answer to Question 2

D
When signs of thyrotoxicosis occur, the drug should be decreased or temporarily discontinued for 5 to 7 days. Liothyronine is not indicated. Propylthiouracil is not indicated.