A patient asks a primary care nurse practitioner (NP) about using ...

[Shelles]

A patient asks a primary care nurse practitioner (NP) about using over-the-counter medications to treat an upper respiratory infection with symptoms of cough, fever, and nasal congestion. The NP should:
 
  a. recommend a cough preparation that also contains acetaminophen.
  b. suggest using single-ingredient products to treat each symptom separately.
  c. recommend a product containing antitussive, antipyretic, and decongestant ingredients.
  d. tell the patient that over-the-counter medications are usually not effective in manufacturer-recommended doses.

Question 2

A primary care NP is evaluating a patient who has COPD. The patient uses a LABA twice daily. The patient reports having increased exertional dyspnea, a frequent cough, and poor sleep.
 
  The patient also uses a short-acting -adrenergic agonist (SABA) five or six times each day. Pulse oximetry reveals an oxygen saturation of 92. The patient's FEV1/forced vital capacity is 65, and FEV1 is 55 of predicted. The NP should prescribe a(n): a. oral corticosteroid.
  b. long-acting anticholinergic.
  c. long-acting oral theophylline.
  d. combination ICS/LABA inhaler.

[Shshxj]

Answer to Question 1

B
A basic principle guiding over-the-counter use is to look at specific symptoms and treat each separately because some products contain therapeutic doses of one ingredient and subtherapeutic doses of others. Cough preparations containing acetaminophen often do not contain therapeutic doses, and patients often overdose when they supplement with acetaminophen. Over-the-counter medications are effective at recommended doses. Patients should follow dosing recommendations on the package.

Answer to Question 2

D
Providers should administer combination inhaled therapies for symptomatic patients with stable COPD and FEV1 less than 60. Oral corticosteroids have not been shown to be effective, even in severe cases of COPD. Long-acting anticholinergic medications may be used as monotherapy in early stages of COPD. Long-acting theophylline is poorly tolerated because of side effects.

[Shelles]

TYSM

[recede]

Gracias!