Nokea
During a follow-up visit, a patient who has been on estrogen therapy admits that she has continued to smoke cigarettes. The nurse will remind the patient that smoking while on estrogen may lead to an increase in which of these conditions?
- A. Incidence of nausea
- B. Risk for thrombosis
- C. Levels of triglycerides
- D. Tendency to bleed during menstruation
Correct Answer: B
Rationale: Smoking increases the risk of thrombosis during estrogen therapy due to synergistic effects on coagulation. It does not significantly affect nausea, triglycerides, or menstrual bleeding.
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A patient who is taking the bisphosphonate alendronate has been instructed to lie flat in bed for 2 days after having ophthalmic surgery. Which intervention is appropriate at this time?
- A. She will continue to take the alendronate with water.
- B. She cannot take the alendronate until she can sit up for 30 minutes.
- C. She can take the medication with breakfast.
- D. She will stop taking the medication 72 hours before her surgery.
Correct Answer: B
Rationale: Alendronate requires the patient to remain upright for 30 minutes post-dose to prevent esophageal damage. Lying flat post-surgery necessitates withholding the drug until the patient can sit up.
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.
A patient is being treated for secondary amenorrhea. The nurse expects which drug to be used to treat this problem?
- A. Methylergonovine
- B. Estradiol transdermal
- C. Raloxifene
- D. Medroxyprogesterone
Correct Answer: D
Rationale: Medroxyprogesterone, a progestin, is commonly used to treat secondary amenorrhea by inducing withdrawal bleeding. The other drugs are not indicated for this condition.
The nurse is preparing to administer the contraceptive form of medroxyprogesterone. What route is appropriate?
- A. Subcutaneous
- B. Intramuscular
- C. Vaginal
- D. Transdermal
Correct Answer: B
Rationale: Medroxyprogesterone (Depo-Provera) as a contraceptive is administered intramuscularly for sustained release. Other routes are not appropriate for this formulation.
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.