Nokea
A woman is preparing for a 10 hour trans-Pacific flight. She has been taking the SERM raloxifene for 6 months. The nurse will provide which instructions to this patient?
- A. She needs to stop taking the drug at least 72 hours before the trip.
- B. She must remember to take this drug with a full glass of water each morning.
- C. She will not take the drug while traveling on the plane.
- D. No change in how the drug is taken will be needed.
Correct Answer: A
Rationale: Raloxifene should be stopped 72 hours before prolonged immobility (e.g., long flights) to reduce the risk of thromboembolism. Continuing the drug during travel increases this risk.
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The nurse is providing patient education for a patient taking an oral contraceptive. Which drugs may cause interactions with oral contraceptives? (Select all that apply.)
- A. Cephalexin
- B. Guaifenesin
- C. Warfarin
- D. Ibuprofen
- E. Theophylline
Correct Answer: A,C,E
Rationale: Cephalexin, warfarin, and theophylline can interact with oral contraceptives, reducing their efficacy or altering drug levels. Antibiotics like cephalosporins may decrease contraceptive effectiveness, and contraceptives can affect warfarin and theophylline metabolism.
The nurse recognizes that use of estrogen drugs is contraindicated in which patient?
- A. A patient who has atrophic vaginitis
- B. A patient who has inoperable prostate cancer
- C. A woman who has just given birth and wants to prevent postpartum lactation
- D. A woman with a history of thrombophlebitis
Correct Answer: D
Rationale: Estrogen increases the risk of thromboembolism, making it contraindicated in patients with a history of thrombophlebitis. Atrophic vaginitis and inoperable prostate cancer are indications for estrogen therapy, and it is not used to prevent lactation.
A 51-year-old woman will be taking selective estrogen receptor modulators (SERMs) as part of treatment for postmenopausal osteoporosis. The nurse reviews potential contraindications, including which condition?
- A. Hypocalcemia
- B. Breast cancer
- C. Stress fractures
- D. Venous thromboembolism
Correct Answer: D
Rationale: SERMs like raloxifene are contraindicated in patients with venous thromboembolism (e.g., DVT, PE) due to increased clotting risk. Hypocalcemia, breast cancer, and stress fractures are not contraindications.
The nurse is reviewing the use of uterine tocolytics, such as indomethacin (Indocin). Which statement best describes the indication for these drugs?
- A. Prevention of preterm labor in the 15th week of pregnancy
- B. Prevention of preterm labor in the 22nd week of pregnancy
- C. Stimulation of contractions in prolonged labor
- D. Stimulation of ovulation as part of infertility treatments
Correct Answer: B
Rationale: Tocolytics like indomethacin are used to prevent preterm labor between 20 and 37 weeks, such as at 22 weeks, by relaxing uterine smooth muscle. They do not stimulate contractions or ovulation.
A patient wants to try an oral soy product to relieve perimenopausal symptoms. The nurse will assess the patient's medication history for which potential drug interaction?
- A. Thyroid replacement therapy
- B. Oral anticoagulant therapy
- C. Nonsteroidal anti-inflammatory drugs
- D. Beta blockers
Correct Answer: A
Rationale: Oral soy can interfere with thyroid hormone absorption, reducing its efficacy. It does not significantly interact with anticoagulants, NSAIDs, or beta blockers.