Assignment: Inhaled Corticosteroid
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Question 252 pts The primary care NP prescribes an inhaled corticosteroid for a patient who has asthma. The third-party payer for this patient denies coverage for the brand that comes in the specific strength the NP prescribes. The NP should: provide pharmaceutical company samples of the medication for the patient. inform the patient that the drug must be paid for out of pocket because it is not covered. order the closest formulary-approved approximation of the drug and monitor effectiveness. write a letter of medical necessity to the insurer to explain the need for this particular medication. Question 262 pts A patient with primary hypercholesterolemia is taking an HMG-CoA reductase inhibitor. All of the patient’s baseline LFTs were normal. At a 6-month follow-up visit, the patient reports occasional headache. A lipid profile reveals a decrease of 20% in the patient’s LDL cholesterol. The NP should: order LFTs. order CK-MM tests. consider decreasing the dose of the medication. reassure the patient that this side effect is common. Question 272 pts A patient who takes a thiazide diuretic will begin taking an ACE inhibitor. The primary care NP should counsel the patient to: report wheezing and shortness of breath, which may occur with these drugs. take care when getting out of bed or a chair after the first dose of the ACE inhibitor. discuss taking an increased dose of the thiazide diuretic with the cardiologist. minimize fluid intake for several days when beginning therapy with the ACE inhibitor. Question 282 pts A thin 52-year-old woman who has recently had a hysterectomy tells the primary care NP she is having frequent hot flashes and vaginal dryness. A recent bone density study shows early osteopenia. The woman’s mother had CHD. She has no family history of breast cancer. The NP should prescribe: estrogen-only HT now. estrogen-only HT in 5 years. estrogen-progesterone HT now. estrogen-progesterone HT in 5 years.
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