Nokea
When teaching a woman about possible side effects of hormone replacement therapy, the nurse should include information about all of the following except:
- A. Hypoglycemia in diabetic women.
- B. The possible return of monthly menses when taking combination hormones.
- C. Increased risk of gallbladder disease.
- D. Increased risk of breast, cervical, and ovarian cancer with long-term use.
Correct Answer: A
Rationale: When taking estrogen, there is an increased risk of diabetes or hyperglycemia due to lowered glucose tolerance. It is true that monthly menses might return when taking combination hormones. The progestin is responsible for this. There is also a risk of gallbladder disease. It is also true that there is an increased risk of breast, cervical, and ovarian cancer with long-term hormone replacement therapy.
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A client can receive the mumps, measles, rubella (MMR) vaccine if he or she:
- A. is pregnant.
- B. is immunocompromised.
- C. is allergic to neomycin.
- D. has a cold.
Correct Answer: D
Rationale: A simple cold without fever does not preclude vaccination. Choices 1 and 2 are incorrect because pregnant women and immunocompromised individuals cannot have the MMR vaccine because the rubella component is a live virus and might cause birth defects and/or disease. Choice 3 is incorrect because the American Academy of Pediatrics states, 'Persons who have experienced anaphylactic reactions to topically or systemically administered neomycin should not receive measles vaccine.'
Medication bound to protein can have which of the following effects?
- A. enhancement of drug availability
- B. rapid distribution of the drug to receptor sites
- C. less availability to produce desired medicinal effects
- D. increased metabolism of the drug by the liver
Correct Answer: C
Rationale: Protein-bound drugs are inactive and less available for therapeutic effects until unbound. This does not enhance availability, speed distribution, or increase metabolism.
A nurse doing a home health visit consults with a male patient that has a diagnosis of CAD and COPD. The patient is currently taking Ventolin, Azmacort, Aspirin, and Theophylline. The patient complains of upset stomach, nausea and feeling uncomfortable. The nurse should:
- A. Contact the patient's physician immediately.
- B. Recommend the patient position himself in right sidelying.
- C. Recommend the patient schedule a doctor's visit the next day.
- D. Recommend a hold on the drug-Azmacort.
Correct Answer: A
Rationale: Consult the physician immediately, due to the fact that theophylline toxicity may be occurring.
Mr. Lee comes to the clinic with thick green drainage around his eyelids. The nurse examiner takes his history and performs a physical examination, beginning with an eye history. General information the nurse should seek is:
- A. type of employment.
- B. burning or itchy sensation in the eyes.
- C. position of the eyelids.
- D. existence of floaters.
Correct Answer: A
Rationale: Data belonging in a general health history of the eye includes employment, activities, allergies, medications, lenses, and protective devices used.
A day care center has asked the nurse to provide education for parents regarding safety in the home. What type of preventive care does this represent?
- A. primary
- B. secondary
- C. tertiary
- D. health promotion
Correct Answer: A
Rationale: Primary prevention involves activities that are utilized to promote wellness or prevent illness or injury. There are many dangers in the home for small children. Providing education regarding the need for safety measures to prevent injury in the home is considered primary prevention. Secondary prevention involves early detection of a disease or illness and quick intervention to aid the client in maintenance of the disease or injury. Tertiary prevention involves the reduction of a disability and the promotion of the highest level of functioning for a client in relation to his or her disease or injury. Health promotion is any activity that increases a client's health and wellness.