Nokea
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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What causes type I diabetes?
- A. Overproduction of insulin from the beta cells of the pancreas
- B. Destruction of the beta cells within the pancreas, resulting in an inability to produce insulin
- C. Loss of insulin receptors on the target cells, resulting in insulin resistance
- D. A pituitary tumor in the brain, resulting in increased antidiuretic hormone production
Correct Answer: B
Rationale: Type I diabetes is caused by the destruction of the beta cells in the pancreas, leading to an inability to produce insulin. This results in a lack of insulin, leading to hyperglycemia. Choice A is incorrect as type I diabetes is characterized by a deficiency of insulin production, not overproduction. Choice C describes the pathophysiology of type 2 diabetes, where insulin receptors become less responsive to insulin. Choice D is unrelated to type I diabetes as it describes a pituitary tumor causing increased antidiuretic hormone production.
What signs and symptoms most likely prompted this patient to initially seek care?
- A. Malaise and fatigue
- B. Severe diarrhea
- C. Intermittent fever
- D. Dizziness and confusion
Correct Answer: B
Rationale: The correct answer is B: Severe diarrhea. A patient who has recently returned from a trip to Nepal with a nongovernmental organization and is seeking care for amebiasis would most likely have been prompted by the symptom of severe diarrhea. Amebiasis is an infection caused by the parasite Entamoeba histolytica, commonly transmitted through contaminated food or water sources in developing countries like Nepal. The hallmark symptom of amebiasis is dysentery, which is characterized by severe diarrhea with blood or mucus in the stool. Malaise and fatigue (choice A) are nonspecific symptoms that may accompany many illnesses and are not specific to amebiasis. Intermittent fever (choice C) is not a typical presenting symptom of amebiasis, which primarily manifests with gastrointestinal symptoms. Dizziness and confusion (choice D) are also not typical symptoms associated with amebiasis.
What property is found in clients with metastatic cancer?
- A. Tumors that are well encapsulated
- B. Tumors with slow, stable growth
- C. Cells that are genetically stable
- D. Cells invading local tissue and overrunning neighboring cells
Correct Answer: D
Rationale: Metastatic cancer is characterized by cells that invade local tissue and overrun neighboring cells. Therefore, the correct answer is D. Choices A, B, and C are incorrect because metastatic cancer is associated with aggressive behavior where cells invade and spread to other parts of the body, rather than being well encapsulated, growing slowly, or being genetically stable.
What is the best way to prevent transmission of infectious agents?
- A. Take antibiotics daily
- B. Call the practitioner for herbal supplements
- C. Wash hands
- D. Avoid public areas as much as possible
Correct Answer: C
Rationale: The correct answer is C: Wash hands. Washing hands is the most effective way to prevent the transmission of infectious agents. Antibiotics are not effective in preventing infections, and their overuse can lead to antibiotic resistance. Calling a practitioner for herbal supplements is not a primary method for preventing the transmission of infectious agents. Avoiding public areas entirely is impractical and not as effective as proper hand hygiene.
How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?
- A. Administer radioactive cobalamin and measure its excretion time
- B. Measure antigen-antibody immune complexes
- C. Measure serum ferritin and total iron-binding capacity
- D. Administer folate and evaluate folate content in a blood serum sample
Correct Answer: A
Rationale: The correct answer is A. To prepare a patient for a Schilling test for pernicious anemia, the nurse should administer radioactive cobalamin and measure its excretion time. This test is specifically designed to assess the absorption of vitamin B12. Choices B, C, and D are incorrect because they do not align with the preparation and procedure of a Schilling test. Measuring antigen-antibody immune complexes, serum ferritin, or total iron-binding capacity, as well as administering folate and evaluating folate content, are not part of the Schilling test protocol.