The primary care NP sees a new African-American patient who has ...

[tingc95]

The primary care NP sees a new African-American patient who has blood pressure readings of 140/90 mm Hg, 130/85 mm Hg, and 142/80 mm Hg on three separate occasions. The NP learns that the patient has a family history of hypertension. The NP should:
 
  a. initiate monotherapy with a thiazide diuretic.
  b. prescribe a thiazide diuretic and an angiotensin-converting enzyme inhibitor.
  c. discuss dietary and lifestyle modifications with the patient.
  d. begin combination therapy with an ARB and a calcium-channel blocker.

Question 2

A patient is diagnosed with lupus and reports occasional use of herbal supplements. The primary care NP should caution this patient to avoid:
 
  a. ginseng.
  b. echinacea.
  c. ginkgo biloba.
  d. St. John's wort.

[Smiles0805]

Answer to Question 1

A
African Americans tend to respond better than whites to diuretic monotherapy, so this is an appropriate starting therapy. Calcium-channel blockers and ARBs are preferred as adjunct medications in African Americans.

Answer to Question 2

B
Patients with lupus who take echinacea may experience an increase in symptoms, even if the patient is taking immunosuppressants.

[tingc95]

Excellent

[aruss1303]

TYSM