A primary care NP is performing a previsit health history on a ...

[pragya sharda]

A primary care NP is performing a previsit health history on a new patient. The patient reports taking vitamins every day. The NP should:
 
  a. ask the patient to bring all vitamin bottles to the clinic appointment.
  b. recommend natural vitamin products over synthetic vitamin products.
  c. reassure the patient that vitamins that are high in folic acid are safe to take.
  d. tell the patient that some vitamins, such as vitamin C, are safe in large doses.

Question 2

A 75-year-old patient requires frequent use of corticosteroids to control COPD exacerbations. To monitor adverse drug effects in this patient, the primary care NP should:
 
  a. order a bone density study.
  b. monitor the patient's renal function at every visit.
  c. order an electrocardiogram to assess for arrhythmias.
  d. order routine chest radiographs to watch for pneumonia.

[canderson530]

Answer to Question 1

A
It is important to determine exactly what the patient is taking, so asking patients to bring vitamin bottles to the clinic is appropriate. There is no evidence that natural products are better than synthetic products. High doses of folic acid may mask signs of vitamin B12 deficiency. Vitamin C in high doses can cause dependency.

Answer to Question 2

A
High-dose ICSs and oral corticosteroids that are often used in COPD may cause or worsen osteoporosis in an older adult. The NP should order a bone density study.