A child who has congenital hypothyroidism takes levothyroxine 75 mcg/day.

Discussion: Congenital Hypothyroidism

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Question 72 pts A child who has congenital hypothyroidism takes levothyroxine 75 mcg/day. The child weighs 15 kg. The primary care NP sees the child for a 3-year-old check-up. The NP should consult with a pediatric endocrinologist to discuss: increasing the dose to 90 mcg/day. decreasing the dose to 30 mcg/day. stopping the medication and checking TSH and T4 in 4 weeks. discussing the need for lifetime replacement therapy with the child’s parents. Question 82 pts A patient who has IBS experiences diarrhea, bloating, and pain but does not want to take medication. The primary care NP should recommend: 25 g of fiber each day. avoiding gluten and lactose in the diet. increasing water intake to eight to ten glasses per day. beginning aerobic exercise, such as running, every day. Question 92 pts A woman who uses a transdermal contraceptive calls the primary care NP to report that while dressing that morning she discovered that the patch had come off and she was unable to find the patch. The NP should tell her to apply a new patch and: take one cycle of COCPs. take a home pregnancy test. use condoms for the next 7 days. contact the clinic if she misses a period. Question 102 pts A patient has been diagnosed with IBS and tells the primary care NP that symptoms of diarrhea and cramping are worsening. The patient asks about possible drug therapy to treat the symptoms. The NP should prescribe: mesalamine (Asacol). dicyclomine (Bentyl). simethicone (Phazyme). metoclopramide (Reglan). Question 112 pts A patient wants to know why a cheaper version of a drug cannot be used when the primary care NP writes a prescription for a specific brand name of the drug and writes, “Dispense as Written.” The NP should explain that a different brand of this drug: may cause different adverse effects. does not necessarily have the same therapeutic effect. is likely to be less safe than the brand specified in the prescription. may vary in the amount of drug that reaches the site of action in the body.