Nokea
A 45-year-old woman has been prescribed conjugated estrogens (Premarin) for the treatment of menopausal symptoms. What should the nurse include in the patient teaching?
- A. Increase fluid intake to prevent dehydration.
- B. Avoid smoking while taking this medication.
- C. Increase the intake of high-calcium foods.
- D. Take the medication at bedtime to prevent insomnia.
Correct Answer: B
Rationale: The correct answer is to 'Avoid smoking while taking this medication' because patients taking conjugated estrogens should avoid smoking due to the increased risk of cardiovascular events. Increasing fluid intake to prevent dehydration is a good practice but not specifically related to conjugated estrogens. Increasing the intake of high-calcium foods may be beneficial for bone health but is not directly related to the medication. Taking the medication at bedtime to prevent insomnia is not a specific teaching point for conjugated estrogens.
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When a patient asks the nurse what hypersensitivity is, how should the nurse respond? Hypersensitivity is best defined as:
- A. A reduced immune response found in most pathologic states
- B. A normal immune response to an infectious agent
- C. An excessive or inappropriate response of the immune system to a sensitizing antigen
- D. Antigenic desensitization
Correct Answer: C
Rationale: Hypersensitivity is correctly defined as an excessive or inappropriate response of the immune system to a sensitizing antigen. This response leads to tissue damage or other clinical manifestations. Choice A is incorrect as hypersensitivity involves an exaggerated, not a reduced, immune response. Choice B is incorrect because hypersensitivity is not a normal immune response to an infectious agent but rather an exaggerated one. Choice D is incorrect as it refers to desensitization, which is the opposite of hypersensitivity.
A client with a history of smoking presents with a chronic cough and shortness of breath. The nurse should suspect which condition?
- A. Pulmonary fibrosis
- B. Chronic obstructive pulmonary disease (COPD)
- C. Lung cancer
- D. Pulmonary edema
Correct Answer: B
Rationale: The correct answer is B: Chronic obstructive pulmonary disease (COPD). COPD is often associated with a chronic cough and shortness of breath, especially in individuals with a history of smoking. Pulmonary fibrosis (choice A) typically presents with progressive dyspnea and dry cough. Lung cancer (choice C) may present with a chronic cough, shortness of breath, and other symptoms like weight loss and hemoptysis. Pulmonary edema (choice D) presents with symptoms such as acute shortness of breath, orthopnea, and pink, frothy sputum.
A male patient is receiving testosterone therapy for hypogonadism. What serious adverse effect should the nurse monitor for during this therapy?
- A. Increased risk of liver dysfunction
- B. Increased risk of prostate cancer
- C. Increased risk of bone fractures
- D. Increased risk of breast cancer
Correct Answer: A
Rationale: The correct answer is A: Increased risk of liver dysfunction. Testosterone therapy can lead to liver dysfunction, including cholestatic jaundice and hepatitis. This adverse effect necessitates monitoring of liver function tests during testosterone therapy. Choice B, increased risk of prostate cancer, is incorrect because testosterone therapy does not cause prostate cancer but is contraindicated in patients with known or suspected prostate cancer. Choice C, increased risk of bone fractures, is incorrect as testosterone therapy is actually associated with an increase in bone mineral density, reducing the risk of fractures. Choice D, increased risk of breast cancer, is incorrect because testosterone therapy in males does not increase the risk of breast cancer.
The patient should be taught that an improvement in symptoms will likely be noticed within
- A. 48 hours.
- B. a week to 10 days.
- C. 2 to 3 weeks.
- D. 4 to 6 weeks.
Correct Answer: C
Rationale: When taking isoniazid and rifampin for active tuberculosis, patients should be taught that an improvement in symptoms will likely be noticed within 2 to 3 weeks. Choice A (48 hours) is too soon to expect significant improvement in symptoms. Choice B (a week to 10 days) is also too early for noticeable improvement with this medication regimen. Choice D (4 to 6 weeks) is too far out to expect a noticeable improvement in symptoms.
When educating a client about to undergo a pacemaker insertion, the nurse explains the normal phases of cardiac muscle tissue. During the repolarization phase, the nurse will stress that membranes must be repolarized before they can be re-excited. Within the cell, the nurse understands that:
- A. Potassium channels open while sodium channels close, causing repolarization to the resting state.
- B. The influx of calcium is the primary stimulus for the repolarization of cardiac tissue.
- C. Only the electrical activity within the heart will determine when repolarization occurs.
- D. The cell membranes need to stay calm, resulting in muscle tissue becoming refractory.
Correct Answer: A
Rationale: During the repolarization phase of cardiac muscle tissue, potassium channels open while sodium channels close. This process is crucial for the cardiac muscle to return to its resting state after depolarization. Potassium moving out of the cell and sodium staying out helps reset the membrane potential and prepare the cell for the next depolarization phase. The influx of calcium is not the primary stimulus for repolarization in cardiac tissue; it is mainly involved in the depolarization phase. While electrical activity within the heart influences repolarization, the specific ion movements described in choice A are what physiologically drive repolarization. Cell membranes need to be in an active state during repolarization, not calm, to facilitate the necessary ion movements for muscle tissue to properly function.