A primary care NP is developing a clinical practice guideline for ...

[tichca]

A primary care NP is developing a clinical practice guideline for management of a patient population in a midsized suburban hospital. The NP should:
 
  a. use an existing guideline from a leading research hospital.
  b. follow the guideline provided by a third-party payer to help ensure reimbursement.
  c. review expert opinion and experimental, anecdotal, correlational study data.
  d. write the guideline to adhere to long-standing practice protocols already in use.

Question 2

A primary care NP provides teaching for a patient who will begin taking propranolol (Inderal). Which statement by the patient indicates understanding of the teaching?
 
  a. I should take this medication on an empty stomach.
  b. I should use caution while driving while taking this medication.
  c. I should not take the medication if my pulse is less than 60 beats per minute.
  d. If I have shortness of breath, I should discontinue the medication immediately.

[aham8f]

Answer to Question 1

C
Clinical guidelines should be written using all available evidence as well as expert opinion. Existing guidelines from a different type of hospital may not be based on data generalizable to this population. Third-party payer guidelines are usually weighted toward decreased costs. Long-standing protocols often do not take into account current knowledge and research.

Answer to Question 2

B
Because the medication can cause fatigue and drowsiness, patients should be advised to use caution when driving. The medication should be taken with food. Patients should not take a dose if the heart rate is less than 50 beats per minute. Patients should be advised to report shortness of breath but should not abruptly stop taking the medication.

[tichca]

TYSM

[emsimon14]

Excellent