A patient with lower back pain and right-sided sciatica has taken ...

[EAugust]

A patient with lower back pain and right-sided sciatica has taken an NSAID and a TCA for 1 week. The patient reports some decrease in pain but is experiencing increased tingling and numbness of the right leg. The primary care NP should:
 
  a. order a magnetic resonance imaging (MRI) study.
  b. order physical therapy.
  c. refer the patient to a neurologist.
  d. continue the TCA for 1 more week.

Question 2

A sexually active patient tells the primary care NP that she has been unable to get her new COCP pill pack until today and has missed 3 days of pills. The NP should tell her to:
 
  a. use backup contraception and take 2 pills each day for the next 2 days.
  b. begin a new pack of pills today and use backup contraception for 7 days.
  c. begin a new pack of pills today, take a Plan B pill, and use backup contraception for 7 days.
  d. Take a pregnancy test, begin a new pack of pills today, and use backup contraception for 7 days.

[carolinefletcherr]

Answer to Question 1

A
Acute episodes of low back pain should be treated with an analgesic for 1 to 2 weeks. A muscle relaxant is used to treat spasms. Patients with sciatica should be treated for 6 weeks. If a neurologic deficit progresses, MRI should be ordered. Physical therapy is not indicated until serious injury is ruled out. A neurology consultation is necessary in urgent conditions and conditions with bilateral neurologic findings. The TCA may be continued, but the progression of symptoms necessitates radiologic evaluation.

Answer to Question 2

C
Patients who miss 2 or more pills at the beginning or end of a pack should use emergency contraceptive pills, such as the Plan B pill, restart a new pill pack, and use backup contraception for 7 days.

[EAugust]

Gracias!

[softEldritch]

TYSM