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A patient with a history of venous thromboembolism is prescribed hormone replacement therapy (HRT). What should the nurse discuss with the patient regarding the risks of HRT?
- A. HRT is associated with an increased risk of venous thromboembolism, so the patient should be aware of the signs and symptoms of blood clots.
- B. HRT can decrease the risk of osteoporosis, but the patient should also be aware of the increased risk of venous thromboembolism.
- C. HRT may increase the risk of breast cancer, so the patient should undergo regular breast exams.
- D. HRT can improve mood and energy levels, but it also carries a risk of cardiovascular events.
Correct Answer: A
Rationale: The correct answer is A. Hormone replacement therapy (HRT) is indeed associated with an increased 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 although HRT may decrease the risk of osteoporosis, the focus of concern in this case is the increased risk of venous thromboembolism. Choice C is incorrect as it mentions the risk of breast cancer, which is not the primary concern when discussing HRT with a patient with a history of venous thromboembolism. Choice D is also incorrect as it mentions cardiovascular events, which are not the main focus of risk associated with HRT in this scenario.
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Which individual is likely to have the best prognosis for recovery from his or her insult to the peripheral nervous system? An adult:
- A. client who developed rhabdomyolysis and ischemic injury after a tourniquet application.
- B. who suffered a bone-depth laceration to the shoulder during a knife attack.
- C. who had his forearm partially crushed by gears during an industrial accident.
- D. client who had nerves transected during surgery to remove a tumor from the mandible.
Correct Answer: C
Rationale: The correct answer is C. Crushing-type injuries to the peripheral nervous system generally have a better prognosis compared to nerve transections or lacerations. In the scenario provided, the individual who had his forearm partially crushed by gears during an industrial accident is likely to have a better chance of recovery compared to nerve transection (choice D) or laceration (choice B). Rhabdomyolysis and ischemic injury after tourniquet application (choice A) are not directly related to peripheral nerve injury and do not indicate a better prognosis for recovery.
A patient is hospitalized due to nonadherence to an antitubercular drug treatment. Which of the following is most important for the nurse to do?
- A. Observe the patient taking the medications.
- B. Administer the medications parenterally.
- C. Instruct the family on the medication regimen.
- D. Count the number of tablets in the bottle daily.
Correct Answer: A
Rationale: In this scenario, the most crucial action for the nurse to take is to observe the patient taking the medications. This ensures that the patient is actually consuming the prescribed antitubercular drugs, addressing the issue of nonadherence directly. Administering the medications parenterally (intravenously or intramuscularly) is not necessary unless there are specific medical reasons requiring this route of administration. Instructing the family on the medication regimen is important for support but may not directly address the patient's nonadherence. Counting the number of tablets in the bottle daily is not as effective as directly observing the patient taking the medications to ensure compliance.
What condition can be caused by an excessive amount of growth hormone released by the pituitary gland in childhood?
- A. Acromegaly
- B. Gigantism
- C. Syndrome of inappropriate antidiuretic hormone
- D. Dwarfism
Correct Answer: B
Rationale: Gigantism is the correct answer. It is a condition caused by excessive growth hormone release before the epiphyseal plates close, leading to abnormal growth. Acromegaly (choice A) is caused by excess growth hormone after the epiphyseal plates close, resulting in enlargement of bones and tissues. Syndrome of inappropriate antidiuretic hormone (choice C) is characterized by the excessive release of antidiuretic hormone, leading to water retention and dilutional hyponatremia. Dwarfism (choice D) is a condition characterized by significantly below-average height.
What serious adverse effect should the nurse monitor for during testosterone therapy?
- A. Testosterone therapy increases the risk of cardiovascular events, so regular monitoring is essential.
- B. Testosterone therapy can cause liver dysfunction, so liver function tests should be monitored regularly.
- C. Testosterone therapy can lead to prostate cancer, so regular screenings are recommended.
- D. Testosterone therapy can lead to bone fractures, so bone density should be monitored.
Correct Answer: A
Rationale: The correct answer is A. Testosterone therapy is associated with an increased risk of cardiovascular events. Therefore, the nurse should monitor the patient for cardiovascular complications. While monitoring liver function tests (choice B) and bone density (choice D) may be important in some cases, the primary concern during testosterone therapy is the risk of cardiovascular events. Prostate cancer screenings (choice C) are not directly related to testosterone therapy's adverse effects.
A female client with bone metastases secondary to lung cancer is admitted for palliative radiation treatment and pain control. The client is currently experiencing pain that she rates at 9 out of 10. Which of the following nonpharmacologic treatments is most likely to be a useful and appropriate supplement to pharmacologic analgesia at this point?
- A. Teaching the client guided imagery and meditation
- B. Initiating neurostimulation
- C. Heat therapy
- D. Relaxation and distraction
Correct Answer: D
Rationale: In the scenario described, the client is experiencing high pain levels, rated at 9 out of 10. Relaxation and distraction techniques are effective nonpharmacologic interventions for managing pain. Teaching the client guided imagery and meditation (Choice A) can also be beneficial; however, in this acute situation of severe pain, relaxation and distraction techniques are more likely to provide immediate relief. Initiating neurostimulation (Choice B) and heat therapy (Choice C) may not be suitable for immediate pain relief in this scenario and are not as commonly used for managing high pain levels in palliative care settings.