Author Question: The primary care NP sees a patient who has a 1-week history of nasal congestion; red, watery eyes; ... (Read 47 times)

JGIBBSON · **on:** Jul 24, 2018

The primary care NP sees a patient who has a 1-week history of nasal congestion; red, watery eyes; cough; and a temperature ranging from 99.1 F to 100.5 F.

The NP notes thin, white nasal discharge and an erythematous oropharynx without swelling or exudates. The NP should: a. begin empiric antibiotic therapy to treat sinusitis.
b. reassure the patient that this is likely a viral infection.
c. prescribe antiviral medications and decongestants.
d. obtain a nasal culture and consider antibiotic therapy.

Question 2

A patient who has Alzheimer's disease is taking 10 mg of donepezil daily and reports difficulty sleeping. The primary care NP should recommend:

a. decreasing the dose to 5 mg.
b. increasing the dose to 15 mg.
c. taking the drug in the morning.
d. taking the drug in the evening.

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

Answer to Question 1

B
The patient does not have severe symptoms indicating a bacterial infection. Unless symptoms worsen, reassurance is indicated. Empiric antibiotic therapy is contraindicated for viral infections. Antiviral medications are not routinely used. A nasal culture is not indicated.

Answer to Question 2

C
Donepezil is typically taken in the evening just before going to bed; however, in patients experiencing sleep disturbance, daytime administration is preferred. The dose should not be increased or decreased.