A 50-year-old woman who is postmenopausal is taking an aromatase ...

[haleyc112]

A 50-year-old woman who is postmenopausal is taking an aromatase inhibitor as part of a breast cancer treatment regimen. She calls her primary care NP to report that she has had hot flashes and increased vaginal discharge but no bleeding.
 
  The NP should: a. schedule her for a gynecologic examination.
  b. recommend that she use a barrier method of contraception.
  c. tell her to stop taking the medication and call her oncologist.
  d. reassure her that these are normal side effects of the medication.

Question 2

A patient who has Alzheimer's disease begins taking donepezil (Aricept). After 3 months of treatment, the patient does not show improvement of symptoms. The primary care NP should:
 
  a. switch to rivastigmine (Exelon).
  b. switch to galantamine (Razadyne).
  c. switch to memantine (Namenda).
  d. continue donepezil and reevaluate in 3 months.

[vickybb89]

Answer to Question 1

A
Any abnormal vaginal discharge should be reported immediately and should be evaluated with a gynecologic examination to rule out carcinoma. She is not showing signs of ovulation, so contraception is not necessary. She should not stop taking the medication unless the gynecologic examination is positive. These are common side effects but are not always normal.

Answer to Question 2

D
Patients should be switched to other medications if initial therapy fails, but switching to another medication should be considered only after a minimum of 6 months of treatment.

[haleyc112]

Excellent

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