A patient who has had a new onset of AF the day prior will ...

[ts19998]

A patient who has had a new onset of AF the day prior will undergo cardioversion that day. The primary care NP will expect the cardiologist to:
 
  a. give clopidogrel after administering cardioversion.
  b. administer cardioversion without using anticoagulants.
  c. give warfarin and aspirin before attempting cardioversion.
  d. give low-dose aspirin before administering cardioversion.

Question 2

A patient who has BPH is taking tamsulosin and dutasteride and asks the primary care NP why he needs to take both medications. The NP should tell him:
 
  a. the combination helps reduce the risk of prostate carcinoma.
  b. two-drug therapy is required before corrective prostatectomy surgery.
  c. both drugs are given so that smaller doses of each drug may be administered.
  d. one gives faster symptom relief, whereas the other shrinks the size of the prostate.

[Mholman93]

Answer to Question 1

B
If the onset of AF has occurred within 48 hours, cardioversion can be done without anticoagulation. Clopidogrel is used in other cases for patients who cannot take aspirin. For patients with rheumatic mitral valve disease and AF or a history of systemic embolism, cardioversion plus aspirin is used. Warfarin is used in patients with one or more risk factors for stroke.

Answer to Question 2

D
A 5B-reductase inhibitor is given to shrink the size of the prostate, but maximum benefit is not achieved until 6 months of therapy. The B-blocker is given to provide more rapid relief. The combination does not decrease the risk of carcinoma. The drug therapy is not a prerequisite to surgery, although it may be used before surgical intervention. The combination therapy does not affect the dose of either drug.

[ts19998]

Excellent

[kjohnson]

TYSM