A patient reports difficulty returning to sleep after getting up ...

[rosent76]

A patient reports difficulty returning to sleep after getting up to go to the bathroom every night. A physical examination and a sleep hygiene history are noncontributory. The primary care NP should prescribe:
 
  a. zaleplon.
  b. ZolpiMist.
  c. ramelteon.
  d. chloral hydrate.

Question 2

A primary care NP prescribes TMP/SMX for a patient who is experiencing an exacerbation of COPD. The patient calls the NP 2 days later to report increased fever, cough, and shortness of breath. The NP should tell the patient:
 
  a. to stop taking the medication.
  b. that symptoms such as sore throat and arthralgia are more worrisome.
  c. to continue the medication because these are signs of the disease process.
  d. that sulfisoxazole (Gantrisin) will be prescribed instead to minimize side effects.

[shaikhs]

Answer to Question 1

B
ZolpiMist oral spray is useful for patients who have trouble returning to sleep in the middle of the night. Zaleplon and ramelteon are used for insomnia caused by difficulty with sleep onset. Chloral hydrate is not typically used as outpatient therapy.

Answer to Question 2

A
Fever, cough, and shortness of breath are included on a list of symptoms that may be early signs of serious reactions. Patients experiencing these symptoms should stop taking the medication immediately. Sore throat and arthralgia should also be reported but are not more worrisome than the symptoms this patient is experiencing. The patient should not continue the medication. Changing to another sulfonamide is incorrect because similar symptoms would occur.

[rosent76]

Excellent

[LVPMS]

Thanks for the timely response, appreciate it