Patient Management Flashcards

A 14-year-old patient discloses substance use during a confidential visit. Under HIPAA and most state laws, the FNP should FIRST:

Answer: Provide counseling, assess for dependence, and determine if the minor is in immediate danger before breaching confidentiality

Minors have confidentiality rights for substance use treatment in most states; the FNP should assess safety and engage the patient in treatment before any breach.

The FNP is counseling a 25-year-old female on combined oral contraceptive pills (COCs). Which absolute contraindication (WHOMEC Category 4) should be screened for?

Answer: History of DVT or pulmonary embolism

Personal history of DVT or PE is a WHO Medical Eligibility Criteria Category 4 (absolute) contraindication to estrogen-containing contraceptives due to thrombosis risk.

A patient with CKD stage 3 (eGFR 35 mL/min) and diabetes has a blood pressure of 142/88 mmHg. The PREFERRED antihypertensive agent is:

Answer: ACE inhibitor or ARB for renoprotection

ACE inhibitors and ARBs reduce intraglomerular pressure and proteinuria, providing renoprotection in diabetic CKD and are the preferred antihypertensive agents.

A patient with alcohol use disorder requires treatment for acute alcohol withdrawal. Which medication class is FIRST-LINE?

Answer: Benzodiazepines (e.g., lorazepam)

Benzodiazepines are first-line for alcohol withdrawal as they treat GABA deficiency, preventing seizures and progression to delirium tremens.

The FNP is conducting a sports physical for a 16-year-old. Which finding warrants DISQUALIFICATION from contact sports?

Answer: Single functional kidney

A single functional kidney is a relative-to-absolute contraindication for contact sports because trauma could result in loss of the only functioning kidney.

A patient in the third trimester of pregnancy presents with severe headache, visual changes, and BP of 162/110. The FNP's IMMEDIATE action is:

Answer: Emergency transfer to the hospital for evaluation of severe preeclampsia/eclampsia

Severe-range BPs (≥160/110) with CNS symptoms in the third trimester meet criteria for severe preeclampsia, requiring emergency hospitalization and IV antihypertensives.