A patient is in the clinic complaining of nausea and vomiting ...

[ETearle]

A patient is in the clinic complaining of nausea and vomiting that has lasted 2 to 3 days. The patient has dry oral mucous membranes, a blood pressure of 90/56 mm Hg, a pulse of 96 beats per minute, and a temperature of 38.8 C.
 
  The primary care NP notes a capillary refill of greater than 3 seconds. The NP should: a. obtain a complete blood count and serum electrolytes.
  b. prescribe a rectal antiemetic medication.
  c. admit to the hospital for intravenous (IV) rehydration.
  d. encourage the patient to take small, frequent sips of Gatorade.

Question 2

A patient is newly diagnosed with type 2 diabetes mellitus. The primary care NP reviews this patient's laboratory tests and notes normal renal function, increased triglycerides, and deceased HDL levels. The NP should prescribe:
 
  a. nateglinide (Starlix).
  b. glyburide (Micronase).
  c. colesevelam (Welchol).
  d. metformin (Glucophage).

[SeanoH09]

Answer to Question 1

C
If vomiting is not controlled, dehydration may occur. Patients who are dehydrated, as this patient is, must be treated with IV fluids in a hospital or emergency department setting.

Answer to Question 2

D
Metformin is recommended as initial pharmacologic treatment for type 2 diabetes. It has been shown to decrease triglycerides and LDLs.

[ETearle]

Excellent

[vickyvicksss]

TYSM