Author Question: A patient develops hepatotoxicity from chronic acetaminophen use. The primary care NP may recommend: ... (Read 29 times)

abc · **on:** Jul 24, 2018

A patient develops hepatotoxicity from chronic acetaminophen use. The primary care NP may recommend:

a. milk thistle.
b. chondroitin.
c. coenzyme Q.
d. glucosamine.

Question 2

A patient who has a history of angina has sublingual nitroglycerin tablets to use as needed. The primary care nurse practitioner (NP) reviews this medication with the patient at the patient's annual physical examination.

Which statement by the patient indicates understanding of the medication? a. I should call 9-1-1 if chest pain persists 5 minutes after the first dose.
b. I should take 3 nitroglycerin tablets 5 minutes apart and then call 9-1-1.
c. I should take aspirin along with the nitroglycerin when I have chest pain.
d. I should take nitroglycerin and then rest for 15 minutes before taking the next dose.

voltaire123 · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

A
Milk thistle has been shown to protect the liver after exposure to hepatotoxins such as acetaminophen, ethanol, and halothane. The other supplements listed do not have this effect.

Answer to Question 2

A
Although the traditional recommendation is for patients to take up to 3 nitroglycerin doses over 15 minutes before accessing emergency medical services (EMS), more recent guidelines suggest an alternative strategy to reduce delays in emergency care. These include instructions to call 9-1-1 immediately if pain persists for 5 minutes after the first dose. Aspirin is recommended when the patient is being transported to emergency care and is not recommended as an adjunct to nitroglycerin with each episode of chest pain. The three doses of nitroglycerin are given 5 minutes apart over 15 minutes.