Nokea
After reviewing the various contraceptive options with a client, the client opts for the etonogestrel/ethinyl estradiol vaginal ring. After teaching the client about this choice, the nurse determines that the teaching was effective when the client states which of the following?
- A. Once I insert the ring, it won't come out.
- B. The ring should stay in place for 3 weeks.
- C. When bleeding starts, that's the signal to change the ring.
- D. I can reuse the ring several times before discarding it.
Correct Answer: B
Rationale: When using the vaginal ring, the client should insert the ring and keep it in place for 3 weeks and then remove it on the same day of the week it was inserted. The ring can be expelled accidentally, such as with straining on defecation or removing a tampon. Typically, bleeding occurs once the ring is removed. The ring should be discarded after each use.
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A client taking oral contraceptive drugs complains of occasional bloating of the abdomen. Which of the following instructions should the nurse offer the client to help alleviate the condition?
- A. Limit fluid intake with meals.
- B. Take the drug along with food.
- C. Decrease the intake of salt.
- D. Elevate the legs when sitting.
Correct Answer: A
Rationale: The nurse should instruct the client to limit fluid intake with meals if she experiences bloating of the abdomen after oral contraceptive use. Light to moderate exercise also may be helpful. Taking the drug with food alleviates nausea and GI irritation, and not the bloating of the abdomen. A decrease in salt intake causes a decrease in the intake of sodium, which may be beneficial when there is an excess fluid volume, and not when there is bloating of the abdomen. Elevating the legs when sitting prevents thromboembolism seen with oral contraceptive use. It does not prevent bloating of the abdomen.
When caring for a client receiving estrogen replacement therapy for postmenopausal symptoms, the nurse documents a diagnosis of Ineffective Tissue Perfusion. Which of the following conditions is the nurse referring to in the diagnosis?
- A. Thromboembolism
- B. Edema of the feet
- C. Gastrointestinal upset
- D. Chloasma
Correct Answer: A
Rationale: The nursing diagnosis of Ineffective Tissue Perfusion is related to thromboembolism, which is a complication of estrogen replacement therapy. A nurse may note other female hormone-related adverse reactions such as edema of the feet due to excess fluid volume or gastrointestinal upset, which manifests as nausea, vomiting, abdominal cramps, and bloating. Chloasma is a dermatologic reaction due to female hormones, riposo in excessive pigmentation of the skin.
A group of nursing students are reviewing information about male and female hormones. The students demonstrate understanding of the information when they identify which of the following as an anabolic steroid? Select all that apply.
- A. Nandrologe
- B. Oxyrietholone
- C. Oxandrolone
- D. Testosterone
- E. Fluoxymesterone
Correct Answer: A,B,C
Rationale: Anabolic steroids include nandrolone, oxymetholone, and oxandrolone. Testosterone and fluoxymesterone are testosterones. Note: 'Nandrologe' and 'Oxyrietholone' appear to be misspellings in the original document; the correct terms are 'nandrolone' and 'oxymetholone.'
A female client receiving fluoxymesterone for metastatic breast cancer is disturbed by the physical changes seen in her body. The nurse provides support to the client based on assessment of which of the following features the client is experiencing related to this therapy?
- A. Deepening of the voice
- B. Hypopigmentation of the skin
- C. Decrease in clitoris size
- D. Increase in body weight
Correct Answer: A
Rationale: Deepening of the voice may be seen as a feature of virilization following male hormone therapy in a female client. Virilization is the acquisition of male characteristics in the female. Other features of virilization include pigmentation, and not hypopigmentation, of the skin and an increase, not a decrease, in the size of the clitoris. An increase in body weight is not a sign of virilization. It may occur due to impaired nutrition of the body.
A nurse suspects a client might be abusing anabolic steroids. Which of the following signs might a client exhibit that would indicate abuse of anabolic steroids? Select all that apply.
- A. Uncontrolled rage
- B. Jaundice
- C. Inability to concentrate
- D. Acne
- E. Severe depression
Correct Answer: A,B,C,D,E
Rationale: A client abusing anabolic steroids might exhibit the following signs: uncontrolled rage, severe depression, suicidal tendencies, malignant or benign liver tumors, aggressive behavior, inability to concentrate, personality changes, acne, jaundice, anorexia, male-pattern baldness, fluid and electrolyte imbalances, and muscle cramps.