Author Question: A 5-year-old child has atopic dermatitis that is refractory to treatment with hydrocortisone acetone ... (Read 48 times)

lb_gilbert · **on:** Jul 24, 2018

A 5-year-old child has atopic dermatitis that is refractory to treatment with hydrocortisone acetone 2.5 cream. The primary care NP should prescribe:

a. desonide cream 0.01.
b. triamcinolone acetonide.
c. fluocinolone cream 0.2.
d. betamethasone dipropionate ointment 0.05.

Question 2

A patient who has type 2 diabetes is seen by a primary care NP for a physical examination. The NP notes a blood pressure of 140/95 mm Hg on three occasions. A urinalysis reveals macroalbuminuria. The patient's serum creatinine is 1.9 mg/dL.

Adhering to evidence-based practice, the NP should prescribe: a. losartan (Cozaar).
b. captopril (Capoten).
c. enalapril maleate (Vasotec).
d. fosinopril sodium (Monopril).

Chocorrol77 · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

B
An over-the-counter steroid has failed to treat this child's dermatitis, so the NP should prescribe something in a higher strength. Triamcinolone is a medium-strength steroid and should be used. The other three are in groups I and II, which are high-strength steroids and are not recommended in children.

Answer to Question 2

A
In patients with type 2 diabetes, hypertension, macroalbuminuria, and renal insufficiency (serum creatinine >1.5 mg/dL), ARBs have been shown to delay the progression of nephropathy. Losartan is an ARB. The other medications are ACE inhibitors.