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The nurse is caring for a 52-year-old woman whose aunt and mother died of breast cancer. The patient states, My doctor and I talked about Tamoxifen to help prevent breast cancer. Do you think it will work? What would be the nurses best response?
- A. Yes, its known to have a slight protective effect.
- B. Yes, but studies also show an increased risk of osteoporosis.
- C. You wont need to worry about getting cancer as long as you take Tamoxifen.
- D. Tamoxifen is known to be a highly effective protective measure.
Correct Answer: A
Rationale: The nurse's best response should be to provide accurate information and manage the patient's expectations realistically. Tamoxifen is known to have a slight protective effect in reducing the risk of developing breast cancer in high-risk individuals like the patient in the scenario. However, it is not a guarantee against developing breast cancer. It is essential for the nurse to convey this information to the patient to ensure that she understands the benefits and limitations of Tamoxifen therapy. Additionally, discussing potential side effects and risks associated with Tamoxifen, such as an increased risk of osteoporosis, is important for the patient to make an informed decision about her health care.
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A nurse is asked how many kcal per gram fats provided. How should the nurse answer?
- A. 3
- B. 4
- C. 6
- D. 9
Correct Answer: D
Rationale: Fats, also known as lipids, are the most calorie-dense nutrient, providing 9 kcal per gram. This high calorie content is due to the structure of fats, which contain more carbon-hydrogen bonds, making them more energy-dense compared to carbohydrates and proteins. Carbohydrates and proteins, on the other hand, provide 4 kcal per gram each. This makes fats an important source of energy in the diet, but they should be consumed in moderation to maintain a healthy balance of nutrients.
The nurse is caring for a patient receiving total parenteral nutrition (TPN). Which action will the nurse take?
- A. Run lipids for no longer than 24 hours.
- B. Take down a running bag of TPN after 36 hours.
- C. Clean injection port with alcohol 5 seconds before and after use.
- D. Wear a sterile mask when changing the central venous catheter dressing.
Correct Answer: D
Rationale: When caring for a patient receiving total parenteral nutrition (TPN), it is crucial to maintain strict aseptic technique to prevent infection. Wearing a sterile mask when changing the central venous catheter dressing helps to reduce the risk of introducing pathogens into the catheter site, which can lead to serious bloodstream infections. It is essential to use sterile gloves, a sterile mask, and to assess the insertion site for any signs or symptoms of infection during central venous catheter dressing changes. Additionally, to prevent infection, TPN infusion tubing should be changed every 24 hours, and no single container of TPN should be hung for longer than 24 hours, with lipids not running for longer than 12 hours.
A female patient with HIV has just been diagnosed with condylomata acuminata (genital warts). What information is most appropriate for the nurse to tell this patient?
- A. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually.
- B. The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days.
- C. The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
- D. The human papillomavirus (HPV), which causes condylomata acuminata, cannot be transmitted during oral sex.
Correct Answer: A
Rationale: The most appropriate information for the nurse to tell the patient is option A, which states that this condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually. Condylomata acuminata, or genital warts, is caused by the human papillomavirus (HPV). Certain strains of HPV, specifically types 16 and 18, are considered high-risk strains that can lead to cervical cancer in women. Therefore, regular Pap tests are crucial for early detection of any cervical changes that could indicate pre-cancerous or cancerous lesions. It is important for the patient to be informed about this risk and the importance of regular screening to monitor her cervical health.
A physician explains to the patient that he has an inflammation of the Cowper glands. Where are the Cowper glands located?
- A. Within the epididymis
- B. Below the prostate, within the posterior aspect of the urethra
- C. On the inner epithelium lining the scrotum, lateral to the testes
- D. Medial to the vas deferens
Correct Answer: B
Rationale: The Cowper glands, also known as bulbourethral glands, are a pair of small exocrine glands located below the prostate gland, within the posterior aspect of the male urethra. These glands are responsible for producing a clear, viscous fluid that helps lubricate the urethra, neutralize acidic urine remnants, and provide a conducive environment for sperm to survive in the urethra. Inflammation of the Cowper glands can result in conditions such as urethritis or other discomfort related to the male reproductive system.
A patient is being discharged home from the ambulatory surgical center after cataract surgery. In reviewing the discharge instructions with the patient, the nurse instructs the patient to immediately call the office if the patient experiences what?
- A. Slight morning discharge from the eye
- B. Any appearance of redness of the eye
- C. A scratchy feeling in the eye
- D. A new floater in vision
Correct Answer: B
Rationale: Redness of the eye after cataract surgery can be a sign of infection or inflammation, which are serious complications that require immediate medical attention. Redness may be accompanied by pain, swelling, or discharge, and if left untreated, it can lead to complications that may affect the surgical outcome and the patient's vision. Therefore, it is crucial for the patient to contact the office immediately if they notice any redness in their eye following cataract surgery.