Nokea
In post menopausal women who are receiving estrogen replacement therapy, medroxyprogesterone is administered concurrently to reduce the risk of:
- A. Atherosclerosis
- B. Endometrial cancer
- C. Hypertension
- D. Osteoporosis
Correct Answer: B
Rationale: Progestins like medroxyprogesterone reduce estrogen-induced endometrial hyperplasia and cancer risk.
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Samantha is taking lamotrigine (Lamictal) for her seizures and requests a prescription for combined oral contraceptives (COCs), which interact with lamotrigine and may cause:
- A. Contraceptive failure
- B. Excessive weight gain
- C. Reduced lamotrigine levels, requiring doubling the dose of lamotrigine
- D. Induction of estrogen metabolism, requiring higher estrogen content OCs be prescribed
Correct Answer: C
Rationale: COCs induce lamotrigine metabolism, lowering its levels and requiring dose adjustment.
Chlorpromazine can block following receptors EXCEPT:
- A. Dopamine
- B. Beta adrenergic
- C. Alpha adrenergic
- D. Muscarinic
Correct Answer: B
Rationale: Chlorpromazine, a typical antipsychotic, blocks dopamine, alpha-adrenergic, and muscarinic receptors but has minimal effect on beta-adrenergic receptors, which are not its primary target.
What does the provider understand about the issue of 'Diabetic Renal Protection' with angiotensin-converting enzyme (ACE) medications? Diabetes mellitus patients:
- A. Have a reduced rate of renal progression, but still need to be discontinued when advanced renal issues present
- B. Who start these medications never progress to renal nephropathy
- C. With early renal dysfunction will see it reverse when on ACE medications
- D. Without renal issues are the only ones who benefit from ACE protection
Correct Answer: A
Rationale: ACE inhibitors slow renal progression in diabetes but are stopped in advanced renal failure.
A home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse tells the client to:
- A. Freeze the insulin.
- B. Refrigerate the insulin.
- C. Store the insulin in a dark, dry place.
- D. Keep the insulin at room temperature.
Correct Answer: B
Rationale: Insulin in unopened vials should be stored under refrigeration until needed. Vials should not be frozen. When stored unopened under refrigeration, insulin can be used up to the expiration date on the vial. Options 1, 3, and 4 are incorrect.
A nurse is administering a Dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication?
- A. Lowered heart rate
- B. Increased myocardial contractility
- C. Decreased conduction through the AV node
- D. Vasoconstriction of renal blood vessel
Correct Answer: B
Rationale: Low-dose dopamine increases contractility via beta-adrenergic effects, improving cardiac output.