Nokea
The 54-year-old female client with severe menopausal symptoms is prescribed hormone replacement therapy (HRT). Which secondary health screening activity should the nurse recommend for HRT?
- A. A Pap smear every six (6) months.
- B. A yearly mammogram.
- C. A bone density test every three (3) months.
- D. A serum calcium level monthly.
Correct Answer: B
Rationale: HRT increases breast cancer risk; yearly mammograms are recommended for screening, per ACOG guidelines. Other tests are not standard.
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A client is receiving digitalis. The nurse should instruct the client to report which of the following side effects?
- A. Nausea, vomiting, fatigue
- B. Rash, dyspnea, edema
- C. Polyuria, thirst, dry skin
Correct Answer: A
Rationale: Nausea, vomiting, fatigue. Side effects of digitalis toxicity include fatigue, nausea, vomiting, anorexia, and bradycardia. Digitalis inhibits the sodium potassium ATPase, which makes more calcium available for contractile proteins, resulting in increased cardiac output.
The nurse is teaching a group of women in a community clinic about prevention of osteoporosis. Which of the following over-the-counter medications should the nurse recognize as having the most elemental calcium per tablet?
- A. Calcium chloride
- B. Calcium citrate
- C. Calcium gluconate
- D. Calcium carbonate
Correct Answer: D
Rationale: Calcium carbonate. Calcium carbonate contains 400 mg of elemental calcium in 1 gram of calcium carbonate.
The client diagnosed with adult-onset asthma is being discharged. Which medication would the nurse expect the health-care provider to prescribe?
- A. A nonsteroidal anti-inflammatory medication.
- B. An antihistamine medication.
- C. An angiotensin-converting enzyme inhibitor.
- D. A proton pump inhibitor.
Correct Answer: None
Rationale: Asthma typically requires bronchodilators (e.g., albuterol) or steroids, not listed. None of the options are standard asthma treatments.
The nurse is to administer a subcutaneous (SC) injection. Which technique is correct?
- A. Pull the skin taut. Insert a 21-gauge needle at a 90-degree angle.
- B. Pinch the skin. Insert a 25-gauge needle at a 45-degree angle.
- C. Stretch the skin taut. Insert a 27-gauge needle at a 10-degree angle.
- D. Pinch the skin. Insert a 21-gauge needle at a 60-degree angle.
Correct Answer: B
Rationale: The skin should be pinched, and a 25-gauge needle should be inserted at a 45-degree angle. Answer 1 describes an IM injection. Answer 3 describes an intradermal injection.
An 80 year-old client is admitted with a diagnosis of malnutrition. In addition to physical assessments, which of the following lab tests should be closely monitored?
- A. Urine protein
- B. Urine creatinine
- C. Serum calcium
- D. Serum albumin
Correct Answer: D
Rationale: Serum albumin. Serum albumin is a valuable indicator of protein deficiency and, later, nutritional status in adults. A normal reading for an elder's serum albumin is between 3.0-5.0 g/dl.