Author Question: A primary care NP prescribes probenecid to treat a patient who has gout. The patient comes to the ... (Read 89 times)

humphriesbr@me.com · **on:** Jul 24, 2018

A primary care NP prescribes probenecid to treat a patient who has gout. The patient comes to the clinic 2 weeks later with severe flank pain. The NP should:

a. ask the patient about fluid intake.
b. order a urinalysis and urine culture.
c. change the medication to allopurinol.
d. recommend nonsteroidal antiinflammatory drugs (NSAIDs) to treat flank pain.

Question 2

A patient has been diagnosed with IBS and tells the primary care NP that symptoms of diarrhea and cramping are worsening. The patient asks about possible drug therapy to treat the symptoms. The NP should prescribe:

a. mesalamine (Asacol).
b. dicyclomine (Bentyl).
c. simethicone (Phazyme).
d. metoclopramide (Reglan).

jonathanballen97 · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

A
Uricosuric agents are tubular blocking agents and decrease serum uric acid levels by increasing urinary excretion of uric acid. During this process, high concentrations of uric acid develop in the proximal renal tubules and may predispose the patient to the development of urinary stones. Patients should be encouraged to drink plenty of fluids. The patient who presents with flank pain should be questioned about fluid intake. If fluid intake is sufficient and renal stones are ruled out, a urinary tract infection may be considered. Allopurinol is not indicated. NSAIDs are not indicated.

Answer to Question 2

B
Dicyclomine has indirect and direct effects on the smooth muscle of the gastrointestinal (GI) tract. Both actions help to relieve smooth muscle spasm. Mesalamine is used to treat ulcerative colitis. Simethicone acts locally to treat symptoms of trapped air and gas. Metoclopramide is used to increase motility.