Nokea
The nurse is educating a 24-year-old female patient who was newly diagnosed with polycystic ovary syndrome (PCOS). The patient was prescribed an antidiabetic medication. Which medication effects should the nurse educate the patient about? Select all that apply.
- A. A period of initial weight gain
- B. A change in her integumentary system
- C. Low blood sugar until her hormones stabilize
- D. Decreased likelihood of pregnancy
Correct Answer: A
Rationale: A. A period of initial weight gain: The nurse should educate the patient about the potential for initial weight gain when starting an antidiabetic medication. This can be a common side effect, and it is important for the patient to be aware of it to avoid unnecessary concern. Weight gain may occur due to factors such as fluid retention or changes in metabolism.
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A 55-year-old postmenopausal female patient presents to the family practice clinic for her annual examination. The nurse notes that the patient has lost inch in height. Upon further investigation, the nurse discovers that the patient has a slow-healing fracture of the left radius. What screening will most likely be initiated at this time for the patient?
- A. Assessment for domestic violence
- B. Dual-energy x-ray absorptiometry scan
- C. Follicle-stimulating hormone
- D. Serum levels of calcium and vitamin D
Correct Answer: B
Rationale: In this scenario, the postmenopausal female patient who has lost height and has a slow-healing fracture of the left radius presents with concerning factors for osteoporosis. The most appropriate screening to initiate in this case would be a dual-energy x-ray absorptiometry (DEXA) scan. DEXA scan is the gold standard for diagnosing osteoporosis by measuring bone mineral density. Given the patient's age, postmenopausal status, height loss, and fracture history, assessing bone health through a DEXA scan is crucial to determine the presence of osteoporosis and guide appropriate management and treatment strategies.
A nurse who works in the emergency department (ED) is assigned to a patient who is experiencing heavy vaginal bleeding at 12 weeks’ gestation. An ultrasound has confirmed the absence of a fetal heart rate, and the patient is scheduled for a dilation and evacuation of the pregnancy. The nurse refuses to provide any further care for this patient based on moral principles. What is the nurse manager’s initial response to the nurse?
- A. “I recall you sharing that information in your interview. I will arrange for another nurse to take report on this patient.”
- B. “Because we are shorthanded today, you have to continue to provide care. There is no one else available to provide care for this patient.”
- C. “I understand your point of view. You were hired to work here in the ED so you had to know this situation was possible.”
- D. “Abandonment is a serious issue. I have to advise you to continue to provide care for this patient.”
Correct Answer: D
Rationale: The nurse manager's initial response should prioritize patient care and safety. In this situation, the patient requires urgent medical attention due to heavy vaginal bleeding and the need for a dilation and evacuation procedure. The nurse's refusal to provide care based on personal moral principles can be considered as patient abandonment, which is a serious ethical and legal issue in healthcare. The nurse manager must advise the nurse to continue providing care for the patient to ensure that the patient's needs are met and to prevent harm resulting from abandonment. The nurse manager should also address the nurse's concerns separately through appropriate channels, such as discussing ethical considerations, providing support, and exploring options for accommodation or transfer if necessary.
What hormonal medication can be used in a premenopausal patient without the concurrent use of ovarian suppression?
- A. letrozole (Femara)
- B. exemestane (Aromasin)
- C. elacestrant (Orserdu)
- D. tamoxifen (Soltamox)
Correct Answer: D
Rationale: Tamoxifen is a hormonal medication that can be used in premenopausal patients without the concurrent use of ovarian suppression. It is a selective estrogen receptor modulator (SERM) that acts by blocking estrogen receptors in breast tissue, thereby inhibiting the growth of hormone-sensitive breast cancer cells. Tamoxifen is commonly prescribed for hormone receptor-positive breast cancer in both premenopausal and postmenopausal women. Unlike aromatase inhibitors (e.g., letrozole and exemestane) which require ovarian suppression in premenopausal patients, tamoxifen can be used as monotherapy in premenopausal patients due to its different mechanism of action. Elacestrant is a selective estrogen receptor degrader (SERD) and not commonly used in clinical practice for this indication.
Which nursing intervention is an independent function of the professional nurse?
- A. Administering oral analgesics
- B. Requesting diagnostic studies
- C. Teaching the patient perineal care
- D. Providing wound care to a surgical incision
Correct Answer: A
Rationale: Administering oral analgesics is an independent function of the professional nurse. Independent nursing interventions are those that a nurse is licensed to initiate based on their knowledge and skills without needing an order from a healthcare provider. Nurses are educated and trained in medication administration, including oral analgesics, and can independently assess the need for and safely administer them within their scope of practice. While requesting diagnostic studies, teaching perineal care, and providing wound care are essential nursing interventions, they typically require some form of healthcare provider's order or supervision, making them more interdependent activities.
The nurse is providing preoperative education on the laparoscope-assisted vaginal hysterectomy. Which statement by the patient verifies understanding of the procedure?
- A. I will use a mild douche solution to keep the surgical area clean.
- B. I'm relieved that I won't have any visible scars on my abdomen.
- C. I understand that there will be some light vaginal bleeding for several days.
- D. I understand that I must remain on bedrest until cleared by the surgeon.
Correct Answer: B
Rationale: The correct statement by the patient that demonstrates understanding of the laparoscope-assisted vaginal hysterectomy procedure is "I'm relieved that I won't have any visible scars on my abdomen." This is a relevant and accurate statement as the procedure involves minimal scarring due to the use of small incisions in the abdomen rather than a large incision. It shows understanding of one of the benefits of this surgical approach. The other statements are not accurate or relevant to the procedure.