Nokea
A patient is starting on medroxyprogesterone acetate (Provera) for endometriosis. What should the nurse include in the patient teaching?
- A. Take the medication with food to prevent nausea.
- B. Take the medication at the same time each day to maintain consistent hormone levels.
- C. Avoid prolonged sun exposure while taking this medication.
- D. Discontinue the medication if side effects occur.
Correct Answer: B
Rationale: The correct answer is B. Patients starting on medroxyprogesterone acetate (Provera) for endometriosis should be instructed to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. Choice A is incorrect because medroxyprogesterone acetate can be taken with or without food. Choice C is unrelated to the medication and not a specific concern with its use. Choice D is incorrect as patients should not discontinue the medication without consulting their healthcare provider, even if side effects occur.
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A patient who is undergoing treatment for cytomegalovirus received his first dose of IV ganciclovir 3 days ago. When reviewing this patient's most recent blood work, what abnormality should the nurse most likely attribute to the use of this drug?
- A. Hemoglobin 17 g/dL (high normal)
- B. INR 3.8 (high)
- C. Platelet count 118,000/mm3 (low)
- D. Leukocytes 11,900/mm3 (high)
Correct Answer: C
Rationale: The correct answer is C: Platelet count 118,000/mm3 (low). Ganciclovir, used to treat cytomegalovirus, is known to cause bone marrow suppression, leading to decreased platelet count (thrombocytopenia). This condition can increase the risk of bleeding. Choices A, B, and D are not typically associated with ganciclovir therapy. High hemoglobin levels (choice A) are not commonly seen with ganciclovir treatment. INR elevation (choice B) is associated with coagulation abnormalities, which are not a typical side effect of ganciclovir. Elevated leukocyte count (choice D) is not a common consequence of ganciclovir use.
A male patient is receiving testosterone therapy for hypogonadism. What adverse effect should the nurse be most concerned about?
- A. Increased risk of breast cancer
- B. Increased risk of liver dysfunction
- C. Increased risk of cardiovascular events
- D. Increased risk of prostate cancer
Correct Answer: C
Rationale: The correct answer is C: Increased risk of cardiovascular events. Cardiovascular events such as stroke and myocardial infarction are the most concerning adverse effects of testosterone therapy, especially in older patients. Choice A, increased risk of breast cancer, is not a common adverse effect of testosterone therapy in males. Choice B, increased risk of liver dysfunction, is a potential adverse effect but is not the most concerning. Choice D, increased risk of prostate cancer, is a consideration in patients with a history of prostate cancer or those with prostate carcinoma, not typically in patients receiving testosterone therapy for hypogonadism.
A patient with breast cancer is prescribed tamoxifen (Nolvadex). What critical information should the nurse provide during patient education?
- A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
- B. Tamoxifen may decrease the risk of osteoporosis, so adequate calcium intake is important.
- C. Tamoxifen may cause weight gain, so patients should monitor their diet.
- D. Tamoxifen may increase the risk of breast cancer, so regular mammograms are essential.
Correct Answer: A
Rationale: When a patient is prescribed tamoxifen, a critical piece of information that the nurse should provide during patient education is that tamoxifen may increase the risk of venous thromboembolism. Therefore, patients should be educated about the signs and symptoms of blood clots and advised to seek immediate medical attention if they occur. Choice B is incorrect because tamoxifen does not decrease the risk of osteoporosis. Choice C is incorrect as weight gain is a possible side effect of tamoxifen, but it is not a critical piece of information compared to the risk of venous thromboembolism. Choice D is incorrect because tamoxifen is actually used to treat breast cancer, not increase its risk.
A client is admitted with a suspected aortic dissection. What is the priority nursing intervention?
- A. Administer antihypertensive medications as prescribed.
- B. Prepare the client for emergency surgery.
- C. Administer intravenous fluids to maintain blood pressure.
- D. Monitor the client's urine output closely.
Correct Answer: B
Rationale: The correct answer is B: Prepare the client for emergency surgery. Aortic dissection is a life-threatening emergency that often necessitates immediate surgical intervention to prevent rupture and further complications. Administering antihypertensive medications (choice A) may be necessary but is not the priority over surgical intervention. While maintaining blood pressure with intravenous fluids (choice C) is important, the urgent need for surgery takes precedence. Monitoring urine output (choice D) is essential for assessing renal function but is not the priority in this critical situation.
A patient with a diagnosis of renal failure is being treated with epoetin alfa (Epogen). Frequent assessment of which of the following laboratory values should be prioritized before and during treatment?
- A. AST
- B. C-reactive protein
- C. CBC
- D. ALT
Correct Answer: A
Rationale: The correct answer is AST. Epoetin alfa is a medication used to treat anemia associated with chronic renal failure. During treatment with epoetin alfa, it is crucial to monitor AST levels as this medication can potentially lead to liver toxicity. Assessing AST levels before and throughout treatment helps in early detection of any liver abnormalities. C-reactive protein is not specifically related to the use of epoetin alfa in renal failure. While CBC (Complete Blood Count) monitoring is essential during treatment with epoetin alfa to evaluate the response to therapy, prioritizing AST assessment is more critical due to the potential for liver toxicity. ALT monitoring is also important but AST is prioritized in this scenario.