An NP student asks the primary care NP about guidelines for using ...

[Melani1276]

An NP student asks the primary care NP about guidelines for using topical steroids. The NP should tell the student that:
 
  a. evidence-based guidelines are available for each product.
  b. standardized guidelines have been developed for use in children.
  c. standardized guidelines may be found for disease-specific conditions.
  d. evidence-based studies support limited corticosteroid use in pregnancy.

Question 2

A patient with a previous history of myocardial infarction (MI) who takes nitroglycerin for angina develops hypertension. The primary care NP is considering ordering an ACE inhibitor. Preliminary laboratory tests reveal decreased renal function.
 
  The NP should: a. begin therapy with a low-dose ACE inhibitor.
  b. choose an ARB instead.
  c. add a low-dose thiazide diuretic to the drug regimen.
  d. order a renal perfusion study before starting treatment.

[nicoleclaire22]

Answer to Question 1

C
Standardized guidelines are available for disease-specific conditions; there are no evidence-based studies or standardized guidelines for using topical steroids.

Answer to Question 2

D
ACE inhibitors are contraindicated in patients with bilateral renal stenosis. Because this patient has decreased renal function, perfusion studies are indicated. If the patient does not have bilateral renal stenosis, a low-dose ACE inhibitor may be used. An ARB is indicated if perfusion studies show bilateral renal stenosis. A thiazide diuretic is not indicated.