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A 51-year-old woman is experiencing perimenopausal symptoms and expresses confusion around the possible use of hormone therapy (HT). She explains that her mother and aunts used HT and she is unsure why few of her peers have been prescribed this treatment. What should the nurse explain to the patient?
- A. Large, long-term health studies have revealed that HT is minimally effective.
- B. HT has been largely replaced by other nonpharmacologic interventions.
- C. Research has shown that significant health risks are associated with HT.
- D. HT has been shown to exacerbate symptoms of menopause in a minority of women.
Correct Answer: C
Rationale: Research, such as the Women's Health Initiative, has shown significant health risks (e.g., breast cancer, cardiovascular events) associated with HT, leading to reduced use. HT remains effective for symptom relief, has not been replaced by nonpharmacologic options, and does not exacerbate symptoms.
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A patient in her late fifties has expressed to the nurse her desire to explore hormone replacement therapy (HRT). Based on what aspect of the patients health history is HRT contraindicated?
- A. History of vaginal dryness
- B. History of hot flashes and night sweats
- C. History of vascular thrombosis
- D. Family history of osteoporosis
Correct Answer: C
Rationale: The use of HRT is contraindicated in women with a history of vascular thrombosis, active liver disease, some cases of uterine cancer, and undiagnosed vaginal bleeding. HRT is beneficial in women with a risk for osteoporosis and can relieve symptoms like vaginal dryness, hot flashes, and night sweats. A history of vascular thrombosis is a clear contraindication.
The school nurse is presenting a class on female reproductive health. The nurse should describe what aspect of Pap smears?
- A. The test may be performed at any time during the patients menstrual cycle.
- B. The smear should be done every 2 years.
- C. The test can detect early evidence of cervical cancer.
- D. Falsepositive Pap smear results occur mostly from not douching before the examination.
Correct Answer: C
Rationale: The Pap smear is used to detect early evidence of cervical cancer, which is a key point to emphasize. It should not be performed during menstruation, and douching can cause false-negative results by washing away cells. Annual Pap smears are recommended for most women, not every 2 years.
The nurse is caring for a couple trying to get pregnant and have not been able to for over a year. The couple asks what kind of problems a man can have that can cause infertility. What should be the nurses response?
- A. Men can have increased prolactin levels that decrease sperm viability.
- B. Men can have problems that increase the temperature around their testicles and decrease the quality of their semen.
- C. Men may inherit the gene that causes low sperm production.
- D. Men may produce sperm that are incompatible with the shape of the egg.
Correct Answer: B
Rationale: Varicoceles, which increase testicular temperature, can decrease semen quality and contribute to male infertility. Increased prolactin is less common, genetic factors are not specifically noted, and sperm-egg shape incompatibility is not a recognized cause.
A 36-year-old woman comes to the clinic complaining of premenstrual syndrome (PMS) that is disrupting her quality of life. What signs and symptoms are associated with this health problem? Select all that apply.
- A. Loss of appetite
- B. Breast tenderness
- C. Depression
- D. Fluid retention
- E. Headache
Correct Answer: B,C,D,E
Rationale: Physiologic symptoms of PMS include headache, breast tenderness, and fluid retention, along with affective symptoms like depression. Loss of appetite is not a common symptom of PMS.
A nurse practitioner is preparing to perform a patients scheduled Pap smear and the patient asks the nurse to ensure that the speculum is well-lubricated. How should the nurse proceed with assessment?
- A. Reassure the patient that ample petroleum jelly will be used.
- B. Reassure that patient that a water-based lubricant will be used.
- C. Explain to the patient that water is the only lubricant that can be used.
- D. Explain to the patient why the speculum must be introduced dry.
Correct Answer: C
Rationale: Because lubricants may obscure cells on a Pap smear, warm water is the only lubricant that can be used to facilitate speculum insertion without compromising test results. Petroleum jelly and water-based lubricants can interfere with cell collection, and a dry speculum may cause discomfort and is not preferred.