Nokea
A 34-year-old woman has presented to the clinic for the first time, and the nurse learns that she has been taking Depo Provera for the past 13 years. This aspect of the woman's medical history should prompt what assessment?
- A. Cardiac stress testing
- B. Renal ultrasound
- C. Bone density testing
- D. Evaluation of triglyceride levels
Correct Answer: C
Rationale: The correct answer is bone density testing (Choice C). Long-term use of Depo Provera, a hormonal contraceptive, is associated with decreased bone mineral density. Assessing bone density is crucial to monitor for potential osteoporosis. Cardiac stress testing (Choice A) is not indicated based on the medication history provided. Renal ultrasound (Choice B) and evaluation of triglyceride levels (Choice D) are not directly related to the use of Depo Provera.
You may also like to solve these questions
A patient has developed a decubitus ulcer on the coccyx. What defense mechanism is most affected by this homeostatic change?
- A. The mucous membrane is affected.
- B. The respiratory tract is affected.
- C. The skin is affected.
- D. The gastrointestinal tract is affected.
Correct Answer: C
Rationale: In this scenario, a decubitus ulcer on the coccyx indicates a breakdown of the skin's integrity due to prolonged pressure. The skin is the primary defense mechanism of the body against external pathogens. When the skin is compromised, it can lead to infections and other complications. The mucous membrane (Choice A) plays a role in protecting internal surfaces, not the skin. The respiratory tract (Choice B) is involved in breathing and not directly related to the skin's defense. The gastrointestinal tract (Choice D) is responsible for digestion and absorption of nutrients, not the primary defense mechanism against external threats like the skin.
When preparing to administer parenteral acyclovir (Zovirax) to an 80-year-old patient with chronic renal failure and herpes simplex, what would the nurse expect in regard to the dose?
- A. The dose is smaller due to the herpes simplex infection.
- B. The dose is smaller based on the patient's kidney function.
- C. The dose is higher in treating genital herpes.
- D. The dose is higher if the creatinine clearance is above 4.0 mg/dL.
Correct Answer: B
Rationale: In patients with chronic renal failure, especially in older adults, dosages of medications excreted renally need to be adjusted based on kidney function. Acyclovir is primarily eliminated by the kidneys, so in a patient with chronic renal failure, the dose would need to be smaller to prevent drug accumulation and toxicity. Choice A is incorrect because the dose adjustment is more related to the patient's kidney function than the presence of herpes simplex. Choice C is incorrect because the type of herpes infection does not determine the dose adjustment for acyclovir. Choice D is incorrect as the creatinine clearance is a more accurate measure of kidney function compared to creatinine levels.
What is the action of amphotericin B?
- A. It binds to ergosterol and forms holes in the membrane.
- B. It binds to an enzyme required for the synthesis of ergosterol.
- C. It disrupts the fungal cell walls rather than the cell membrane.
- D. It inhibits glucan synthetase required for glucan synthesis.
Correct Answer: A
Rationale: Amphotericin B is an antifungal medication that acts by binding to ergosterol, a component of fungal cell membranes, forming pores that disrupt the integrity of the membrane. This action leads to leakage of cellular contents and ultimately cell death. Choice B is incorrect as amphotericin B does not bind to an enzyme required for the synthesis of ergosterol. Choice C is incorrect as the drug primarily affects the cell membrane rather than the cell wall. Choice D is also incorrect as amphotericin B does not inhibit glucan synthetase.
What specific instructions should the nurse provide for proper administration of alendronate (Fosamax) in a patient with osteoporosis?
- A. Take the medication with milk to enhance calcium absorption.
- B. Take the medication with a full glass of water and remain upright for at least 30 minutes.
- C. Take the medication at bedtime to ensure absorption during sleep.
- D. Take the medication with food to prevent gastrointestinal upset.
Correct Answer: B
Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper drug absorption. Choice A is incorrect as alendronate should not be taken with milk due to potential interactions. Choice C is incorrect as there is no need to take the medication at bedtime specifically. Choice D is incorrect as taking alendronate with food can decrease its absorption.
A patient with breast cancer is prescribed tamoxifen (Nolvadex). What should the nurse emphasize during patient education?
- A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be aware of the signs and symptoms of blood clots.
- B. Tamoxifen may cause weight gain, so patients should monitor their diet.
- C. Tamoxifen may cause hot flashes and other menopausal symptoms.
- D. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.
Correct Answer: A
Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, a serious side effect. Therefore, patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, and redness in the legs, and advised to seek immediate medical attention if they occur. Choice B is incorrect because weight gain is not a significant side effect of tamoxifen. Choice C is incorrect because hot flashes and menopausal symptoms are common side effects of tamoxifen but are not as critical to address as venous thromboembolism. Choice D is incorrect because tamoxifen does not decrease the risk of osteoporosis; in fact, it may increase the risk of bone loss in premenopausal women.