Author Question: During a gynecologic examination of a sexually active adolescent girl, the primary care NP notes ... (Read 85 times)

ghost! · **on:** Jul 24, 2018

During a gynecologic examination of a sexually active adolescent girl, the primary care NP notes mucopurulent cervicitis. A culture is positive for Neisseria gonorrhoeae. The NP should:

a. give a single dose of 2 g of oral azithromycin.
b. administer benzathine penicillin G 2.4 million units intramuscularly.
c. prescribe oral doxycycline 100 mg daily for 7 days.
d. give intramuscular ceftriaxone and a single dose of 1 g of azithromycin.

Question 2

A patient who has migraine headaches tells the primary care NP that drinking coffee and taking nonsteroidal antiinflammatory drugs (NSAIDs) seems to help with discomfort. The NP should tell the patient that:

a. this combination can lead to longer lasting headache pain.
b. these substances are not indicated for migraine headaches.
c. doing this can increase the risk of more chronic migraines.
d. an opioid analgesic would be a better choice for migraine pain.

welcom1000 · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

D
Many patients who present with one sexually transmitted disease (STD) have other concomitant STDs. When gonorrhea or urethritis/cervicitis is diagnosed, the NP should treat for both N. gonorrhoeae and Chlamydia. A single-dose treatment ensures compliance. A single, 2-g dose of azithromycin is indicated to treat chancroid. Benzathine penicillin G is indicated to treat syphilis. A 7-day regimen of doxycycline is used to treat Chlamydia, but not gonorrhea.

Answer to Question 2

A
Overuse of pain or migraine medications can cause a transformed migraine, which is a long-lasting headache. Following a migraine episode, the patient has rebound headache daily or nearly daily. NSAIDs, caffeine, opiates, and triptans can cause these rebound headaches. NSAIDs and caffeine are often used to treat migraines. Narcotics and barbiturates increase the risk for development of chronic migraine headaches and should not be first-line drugs.