Nokea
A 48-year-old woman presenting for care is seeking information about hormone therapy (HT) for the treatment of her perimenopausal symptoms. The patients need for relief from hot flashes and other symptoms will be weighed carefully against the increased risks of what complications of HT? Select all that apply.
- A. Anaphylaxis
- B. Osteoporosis
- C. Breast cancer
- D. Cardiovascular disease
- E. Venous thromboembolism
Correct Answer: C,D,E
Rationale: HT increases the risk of breast cancer, cardiovascular disease (e.g., heart attack, stroke), and venous thromboembolism, which must be considered against benefits like hot flash relief. HT reduces osteoporosis risk, and anaphylaxis is not a significant concern.
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The nurse is taking the sexual history of an adolescent who has come into the free clinic. What question best assesses the patients need for further information?
- A. Are you involved in an intimate relationship at this time?
- B. How many patients are you asking this of?
- C. What questions or concerns do you have about your sexual health?
- D. Have you ever been diagnosed with a sexually transmitted infection?
Correct Answer: C
Rationale: An open-ended question related to the patient's need for further information should be included while obtaining a sexual history. This approach encourages the patient to express specific concerns or areas of uncertainty, facilitating targeted education. The other listed questions are not open-ended and do not directly assess the need for further information.
A nurse presenting an educational event for a local community group is addressing premenstrual syndrome (PMS). What treatment guideline should the nurse teach this group?
- A. Avoid excessive fluid intake.
- B. Increase the frequency and intensity of exercise.
- C. Limit psychosocial stressors in order to reduce symptoms.
- D. Take opioid analgesics as ordered.
Correct Answer: B
Rationale: In general, the patient is encouraged to increase or initiate an exercise program to help relieve symptoms of PMS. Increased fluid intake is recommended, not avoidance. Opioids are not used to treat PMS, and while stress reduction has general benefits, it is not specifically noted to alleviate PMS symptoms.
An adolescent is brought to the clinic by her mother because of abnormal uterine bleeding. The nurse should understand that the most likely cause of this dysfunctional bleeding pattern is what?
- A. Lack of ovulation
- B. Chronic vaginitis
- C. A sexually transmitted infection
- D. Ectopic pregnancy
Correct Answer: A
Rationale: Dysfunctional uterine bleeding is most common in adolescents due to anovulation (lack of ovulation), which disrupts normal hormonal cycles. Vaginitis, STIs, and ectopic pregnancy are less likely causes of abnormal bleeding in this age group.
A clinic nurse is meeting with a 38-year-old patient who states that she would like to resume using oral contraceptives, which she used for several years during her twenties. What assessment question is most likely to reveal a potential contraindication to oral contraceptive use?
- A. Have you ever had surgery?
- B. Have you ever had a sexually transmitted infection?
- C. When did you last have your blood sugar levels checked?
- D. Do you smoke?
Correct Answer: D
Rationale: Women who smoke and who are 35 years of age or older should not take oral contraceptives because of an increased risk for cardiac problems. Previous surgeries or STIs do not necessarily contraindicate use, and while blood sugar monitoring is relevant for diabetes management, smoking is the most significant risk factor in this context.
A couple has come to the infertility clinic because they have been unable to get pregnant even though they have been trying for over a year. Diagnostic tests are planned for the woman to ascertain if ovulation is regular and whether her endometrium is adequately supported for implantation. What test would the nurse expect to have ordered for this woman?
- A. Serum progesterone
- B. Abdominal CT
- C. Oocyte viability test
- D. Urine testosterone
Correct Answer: A
Rationale: Serum progesterone levels are used to assess ovulation regularity and endometrial support for implantation, key factors in female infertility evaluation. Abdominal CT, oocyte viability tests, and urine testosterone are not standard for this purpose.