A patient has recurrent symptoms and tells the primary care NP ...

[P68T]

A patient has recurrent symptoms and tells the primary care NP that she can't remember to take her medication all the time. The NP should:
 
  a. give her shortened regimens of the drug to facilitate compliance.
  b. provide written information about her condition and the medication.
  c. administer the medication in the clinic to ensure that she takes the drug.
  d. ask her about her lifestyle, her schedule, and her understanding of her condition.

Question 2

A patient who has angina uses 0.4 mg of sublingual nitroglycerin for angina episodes. The patient brings a log of angina episodes to an annual physical examination.
 
  The primary care NP notes that the patient has experienced an increase in frequency of episodes in the past month but no increase in duration or severity of pain. The NP should: a. increase the nitroglycerin dose to 0.6 mg per dose.
  b. change from a sublingual to a transdermal patch nitroglycerin.
  c. discontinue the nitroglycerin and order ranolazine (Ranexa ER).
  d. contact the patient's cardiologist to discuss admission to the hospital.

[rleezy04]

Answer to Question 1

D
If the attitude is that the patient has a problem for the health care provider to solve, then the provider owns the problem and often hastens to solve it. When patients own their problems, they are more likely to engage in their care and treatment. Giving shortened regimens, providing written information, and administrating medication in the clinic are examples of the provider solving the problem for the patient.

Answer to Question 2

D
Unstable angina is a change in pattern or pain, such as an increase in frequency, severity, or duration of pain and fewer precipitating factors. Patients with unstable angina should be admitted to a coronary care unit. The primary care NP should not change any medications without consultation with the patient's cardiologist.

[P68T]

TYSM

[shailee]

Excellent