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What long-term risks should the nurse discuss with a patient being treated with hormone replacement therapy (HRT) for menopausal symptoms?
- A. HRT may increase the risk of cardiovascular events and breast cancer.
- B. HRT may decrease the risk of osteoporosis.
- C. HRT may improve mood and energy levels.
- D. HRT may increase the risk of venous thromboembolism.
Correct Answer: A
Rationale: The correct answer is A. Long-term hormone replacement therapy (HRT) is associated with increased risks of cardiovascular events and breast cancer. These risks should be discussed with the patient to ensure they are aware of the potential adverse effects. Choice B is incorrect because HRT does not decrease the risk of osteoporosis; in fact, it has been linked to an increased risk of this condition. Choice C is incorrect as while HRT may have positive effects on mood and energy levels for some individuals, the focus here is on the long-term risks that need to be addressed. Choice D is incorrect as HRT is indeed associated with an increased risk of venous thromboembolism, but the primary focus of the question is on cardiovascular events and breast cancer.
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A patient is prescribed tadalafil (Cialis) for erectile dysfunction. What critical contraindication should the nurse discuss with the patient?
- A. Use of nitrates
- B. Use of antihypertensive medications
- C. History of hypertension
- D. History of peptic ulcer disease
Correct Answer: A
Rationale: The correct answer is A: Use of nitrates. Tadalafil (Cialis) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates potentiate the hypotensive effects of tadalafil, leading to a potentially life-threatening drop in blood pressure. Choices B, C, and D are incorrect because antihypertensive medications, history of hypertension, and history of peptic ulcer disease are not critical contraindications for tadalafil use. While caution may be needed in patients with certain conditions, the highest priority is addressing the interaction with nitrates.
The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?
- A. Has your child received all recommended vaccinations?
- B. Has your child been feeding poorly or showing signs of constipation?
- C. Has your child been exposed to any sick individuals?
- D. Has your child been displaying signs of respiratory distress?
Correct Answer: B
Rationale: The correct answer is B. Poor feeding and constipation are common early symptoms of infant botulism, which is caused by a neurotoxin that impairs muscle function. Option A is unrelated to the presentation of botulism. Option C does not directly relate to the symptoms of botulism. Option D is more indicative of respiratory issues rather than the constellation of symptoms seen in botulism.
The neurotransmitter GABA mainly functions to trigger inhibitory postsynaptic potentials (IPSPs). Therefore, when explaining this to a group of nursing students, the nurse will state:
- A. It takes at least three chemical substances (amino acids, neuropeptides, and monoamines) to stimulate any activity between the cells.
- B. There is a symbiotic relationship; therefore, the end result will be depolarization of the postsynaptic membrane.
- C. The combination of GABA with a receptor site is inhibitory since it causes the local nerve membrane to become hyperpolarized and less excitable.
- D. The neurotransmitters will interact with cholinergic receptors to bind to acetylcholine in order to produce hypopolarization within the cell.
Correct Answer: C
Rationale: When GABA binds with a receptor site, it causes hyperpolarization of the local nerve membrane, making it less excitable. This hyperpolarization leads to inhibition of nerve cell activity. Choice A is incorrect because GABA is a neurotransmitter itself and does not require three chemical substances to stimulate activity between cells. Choice B is incorrect as GABA triggers inhibitory postsynaptic potentials (IPSPs), leading to hyperpolarization, not depolarization, of the postsynaptic membrane. Choice D is also incorrect as it describes a process involving cholinergic receptors and acetylcholine, which is unrelated to GABA's mechanism of action.
What long-term risks should the nurse discuss with a patient starting on hormone replacement therapy (HRT)?
- A. HRT is associated with increased risks of cardiovascular events and breast cancer, so these risks should be discussed with the patient.
- B. HRT can improve mood and energy levels, but it also increases the risk of osteoporosis.
- C. HRT can increase the risk of venous thromboembolism, so patients should undergo regular screening.
- D. HRT decreases the risk of fractures, but it also increases the risk of developing diabetes.
Correct Answer: A
Rationale: The correct answer is A. When starting on hormone replacement therapy (HRT), the nurse should discuss the increased risks of cardiovascular events and breast cancer with the patient. These risks are important to consider to make an informed decision. Choice B is incorrect as HRT does not increase the risk of osteoporosis; in fact, it may help prevent it. Choice C is incorrect as while HRT can increase the risk of venous thromboembolism, regular screening is not the primary focus for discussion. Choice D is incorrect as HRT does not decrease the risk of fractures and is not primarily associated with an increased risk of developing diabetes.
A woman with severe visual and auditory deficits is able to identify individuals by running her fingers lightly over her face. Which source is most likely to provide the input that allows for the woman's unique ability?
- A. Special somatic afferent fibers
- B. General somatic afferents
- C. Special visceral afferent cells
- D. General visceral afferent neurons
Correct Answer: C
Rationale: The correct answer is C, special visceral afferent cells. These cells are responsible for functions like taste and smell. In individuals with severe visual and auditory deficits, their other sensory abilities, such as touch, can be heightened. Special somatic afferent fibers (choice A) are involved in sensations like touch and vibration from the skin and muscles, but they are not specific to the face. General somatic afferents (choice B) transmit sensory information from the skin, muscles, and joints, but they are not specialized for the unique ability described. General visceral afferent neurons (choice D) are responsible for transmitting sensory information from internal organs, not relevant to the woman's ability to identify individuals through touch on her face.