A patient recovering from shingles presents with tenderness and sensitivity to the upper back. He states it is bothersome to put a shirt on most days. This patient has end stage renal disease (ESRD) and is scheduled to have hemodialysis tomorrow but states that he does not know how he can lie in a recliner for 3 hours feeling this uncomfortable. What will be the PMHNP’s priority?
a) order herpes simplex virus (HSV) antibody testing
b) Order a blood urea nitrogen (BUN) and creatinine STAT
c) Prescribe lidocaine 5%
d) Prescribe hydromorphone (dilaudid) 2mg
The PMHNP prescribed a patient lamotrigine (Lamictal), 25 mg by mouth daily, for nerve pain 6 months ago. The patient suddenly presents to the office with the complaint that the medication is no longer working and complains of increased pain. What action will the PMHNP most likely take?
a) Increase the dose of lamotrigine (Lamictal) to 25mg twice daily
b) Ask if the pt has been taking the medication as prescribed
c) Order gabapentin, 100mg TID because lamotrigine is no longer working for this patient
d) Order a CBC to assess for an infection
An elderly woman with a hx of alzheimer’s disease, coronary artery disease, and myocardial infarction had a fall at home 3 months ago that resulted in her receiving an open reduction internal fixation. While assessing this patient, the pmhnp is made aware that the patient continues to experience mild to moderate pain. What is the pmhnp most likely to do?
a) order an X-ray because it is possible that she dislocated her hip
b) order ibuprofen because she mayneed long term treatment and chronic pain is not uncommon
c) Order naproxen because she may havarthritis and chronic pain is not uncommon
d) Order morphine and physical therapy