A woman comes to the clinic to talk about weight reduction. The ...

[piesebel]

A woman comes to the clinic to talk about weight reduction. The primary care nurse practitioner (NP) calculates a body mass index (BMI) of 28 . The woman's waist measures 34 inches.
 
  The woman tells the NP that she would like to lose 20 lb for her daughter's wedding in 6 months. The NP should: a. suggest she try over-the-counter (OTC) orlistat.
  b. consider prescribing phentermine short-term.
  c. discuss her short-term and long-term weight loss goals.
  d. give her information about physical activity and diet modification.

Question 2

The parent of a 2-month-old infant who will soon begin daycare refuses the rotavirus vaccine (RV) because of fears of intussusception.
 
  The parent tells the primary care NP that the daycare is strict about preventing infants who have fever or gastrointestinal symptoms from attending. The NP should tell the parent that: a. herd immunity will protect the infant from infection.
  b. asymptomatic children can spread rotavirus infection.
  c. the risk of intussusception is nonexistent with the newer vaccine.
  d. the infant can be treated with antibiotics if rotavirus infection occurs.

[xoxo123]

Answer to Question 1

C
This woman's BMI is in the moderate range for overweight, and her waist circumference is 34, which is not diagnostic for metabolic syndrome. Because her apparent motivation for losing weight is based on an upcoming event, the NP first should determine what her short-term and long-term weight loss goals are before initiating therapy. Orlistat is used long-term and would not be appropriate in this case. Phentermine should be used short-term and, because of serious risks, should be used only as adjunct therapy to lifestyle modifications. The initial intervention for weight loss is physical activity and diet modification.

Answer to Question 2

B
Asymptomatic infection with spread to nonimmune children can occur. The risk of intussusception is less with the newer rotavirus vaccine but is still present. Rotavirus cannot be treated with antibiotics.

[piesebel]

TYSM

[T4T]

Excellent