Nokea
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.
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The RN is delegating tasks to the unlicensed assistive personnel (UAP). Which tasks can the nurse delegate? (Select all that apply.)
- A. Teaching the patient about breast care
- B. Assessment of a patient’s lochia and perineal area
- C. Assisting a patient to the bathroom for the first time after birth
- D. Vital signs on a postpartum patient who delivered the night before
Correct Answer: C
Rationale: A. Teaching the patient about breast care typically requires specialized knowledge and is best performed by the nurse.
The nurse is caring for a patient receiving chemotherapy. What nursing intervention would they provide?
- A. Administer antibiotics.
- B. Administer antiemetics.
- C. Encourage physical activity after infusion.
- D. Encourage eating a large meal.
Correct Answer: B
Rationale: Patients receiving chemotherapy often experience nausea and vomiting as common side effects. Antiemetics are medications specifically designed to help manage and prevent these symptoms. By administering antiemetics, the nurse can help the patient feel more comfortable and reduce the risk of dehydration and other complications associated with nausea and vomiting. This intervention is crucial in supporting the patient's overall well-being and enhancing their quality of life during chemotherapy treatment.
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.
Which nursing intervention is written correctly?
- A. Force fluids as necessary.
- B. Observe interaction with the infant.
- C. Encourage turning, coughing, and deep breathing. N R I G B.C M U S N T O
- D. Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6 PM.
Correct Answer: D
Rationale: The correct nursing intervention that is written correctly is option D. The intervention "Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6 PM" is clear, specific, and provides a specific time frame for the activity. It is important in nursing documentation to be precise and clearly state the details of the intervention to ensure effective communication among healthcare team members. This intervention also specifies the frequency and duration of the ambulation activity, which helps in ensuring continuity of care and proper execution of the intervention for the patient.
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.