Nokea
A patient with breast cancer is prescribed tamoxifen (Nolvadex). What key point should the nurse include in the patient education?
- A. Tamoxifen may increase the risk of venous thromboembolism.
- B. Tamoxifen may cause hot flashes and other menopausal symptoms.
- C. Tamoxifen may cause weight gain and fluid retention.
- D. Tamoxifen may decrease the risk of osteoporosis.
Correct Answer: A
Rationale: The correct answer is A: "Tamoxifen may increase the risk of venous thromboembolism." It is crucial for patients to be aware of the signs and symptoms of blood clots while taking tamoxifen. Choice B is incorrect because hot flashes and menopausal symptoms are common side effects of tamoxifen, but they are not the key point to emphasize. Choice C is incorrect as weight gain and fluid retention are potential side effects of tamoxifen but not the key point for patient education. Choice D is incorrect as tamoxifen does not decrease the risk of osteoporosis; in fact, it may increase the risk of bone loss.
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A male patient is being treated with sildenafil (Viagra) for erectile dysfunction. What condition would contraindicate the use of this medication?
- A. Peptic ulcer disease
- B. History of myocardial infarction
- C. Recent use of antihypertensive medications
- D. Use of nitrates
Correct Answer: D
Rationale: The correct answer is D: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, and the combination can lead to a dangerous drop in blood pressure. Choice A, peptic ulcer disease, is not a contraindication for sildenafil use. Choice B, a history of myocardial infarction, is not a contraindication unless the patient is also taking nitrates. Choice C, recent use of antihypertensive medications, is not a contraindication but requires caution as the combination can lead to additive effects lowering blood pressure.
Which of the following are risk factors for hypertension (HTN)?
- A. High sugar, low-fat diet
- B. Increased physical activity
- C. Tobacco use
- D. Low-fat diet
Correct Answer: C
Rationale: Tobacco use is a well-established risk factor for hypertension (HTN) as it can lead to increased blood pressure. High sugar intake and low-fat diets, as well as increased physical activity, are not directly associated with hypertension. While low-fat diets are generally recommended for overall health, they are not specifically linked to hypertension risk.
Which clients are at highest risk for pneumonia?
- A. Those in their 20s and 30s and generally healthy
- B. Those who exercise regularly and are not exposed to pathogens
- C. Those who are hospitalized and immunocompromised
- D. Those who have adequate respiratory function
Correct Answer: C
Rationale: Clients who are hospitalized and immunocompromised are at the highest risk for pneumonia due to their weakened immune systems. Choice A is incorrect as young and healthy individuals typically have stronger immune systems. Choice B is incorrect because regular exercise can actually boost the immune system and reduce the risk of infections. Choice D is incorrect as having adequate respiratory function does not necessarily correlate with the risk of developing pneumonia.
What symptoms would the nurse expect to see in a client with chronic obstructive pulmonary disease (COPD)?
- A. Dyspnea on exertion
- B. Normal lung sounds
- C. Normal arterial blood gases
- D. Onset of the disease during young adulthood
Correct Answer: A
Rationale: The correct answer is A: Dyspnea on exertion. COPD typically manifests with symptoms like dyspnea on exertion due to impaired lung function. This symptom is a result of the airways being obstructed and the lungs not being able to expel air effectively. Choices B and C are incorrect because in COPD, abnormal lung sounds such as wheezing, crackles, or diminished breath sounds are often heard upon auscultation, and arterial blood gases are usually abnormal, showing low oxygen levels and high carbon dioxide levels. Choice D is incorrect as COPD is more commonly diagnosed in individuals over 40 who have a history of smoking or exposure to lung irritants.
A client with a history of hypertension presents with a severe headache and blurred vision. What is the nurse's priority action?
- A. Administer pain relief medication.
- B. Obtain a stat head CT scan.
- C. Administer antihypertensive medications as prescribed.
- D. Call the healthcare provider immediately.
Correct Answer: C
Rationale: The correct answer is to administer antihypertensive medications as prescribed. In a client with a history of hypertension presenting with severe headache and blurred vision, these symptoms could indicate a hypertensive crisis. The priority action is to lower the blood pressure promptly to prevent complications such as stroke, heart attack, or organ damage. Administering antihypertensive medications is crucial in this situation. Administering pain relief medication (Choice A) may temporarily alleviate symptoms but does not address the underlying issue of elevated blood pressure. Obtaining a stat head CT scan (Choice B) may be necessary to rule out other causes but should not delay the administration of antihypertensive medications. Calling the healthcare provider immediately (Choice D) is important but may not address the immediate need to lower blood pressure in a hypertensive crisis.