Nokea
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.
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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.
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 school nurse is presenting information on human development and sexuality. When describing the role of hormones in sexual development, which hormone does the nurse teach the class is the most important one for developing and maintaining the female reproductive organs?
- A. Estrogen
- B. Progesterone
- C. Androgens
- D. Follicle-stimulating hormone
Correct Answer: A
Rationale: Estrogens are responsible for developing and maintaining the female reproductive organs. Progesterone is the most important hormone for conditioning the endometrium in preparation for implantation of the fertilized ovum. Androgens, secreted by the ovaries in small amounts, are involved in the early development of the follicle and affect the female libido. Follicle-stimulating hormone is responsible for stimulating the ovaries to secrete estrogen.
The nurse is working with a couple who have been unable to conceive despite more than 2 years of trying to get pregnant. The couple has just learned that in vitro fertilization (IVF) was unsuccessful and they are both tearful. What nursing diagnosis is most likely to apply to this couple?
- A. Hopelessness related to failed IVF
- B. Acute confusion related to reasons for failed IVF
- C. Compromised family coping related to unsuccessful IVF
- D. Moral distress related to unsuccessful IVF
Correct Answer: A
Rationale: The couple's tearful response to a failed IVF suggests hopelessness, a likely emotional reaction to the loss of a promising intervention. Acute confusion implies cognitive impairment, compromised coping is less specific, and moral distress is unrelated to the scenario.
A patient who is in the first trimester of pregnancy has experienced an incomplete abortion. The obstetric nurse should prepare the patient for what possible intervention?
- A. Dilation and evacuation
- B. Several days of bed rest
- C. Administration of hydromorphone
- D. IV administration of clomiphene
Correct Answer: A
Rationale: If only some of the tissue is passed, the abortion is referred to as incomplete. An emptying or evacuation procedure (D&C, or dilation and evacuation [D&E]) or administration of oral misoprostol (Cytotec) is usually required to remove the remaining tissue. Bed rest will not necessarily result in the passing of all the tissue. Clomiphene is used for ovulation induction, not abortion management, and hydromorphone is for pain relief, not a primary intervention.