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 teenage client is admitted to the hospital because of acetaminophen (Tylenol) overdose. Overdoses of acetaminophen can precipitate life-threatening abnormalities in which of the following organs?
- A. lungs
- B. liver
- C. kidneys
- D. adrenal glands
Correct Answer: B
Rationale: Acetaminophen is extensively metabolized in the liver. Choices A, C, and D are incorrect because prolonged use of acetaminophen might result in an increased risk of renal dysfunction, but a single overdose does not precipitate life-threatening problems in the respiratory system, renal system, or adrenal glands.
If a client has chronic renal failure, which of the following sexual complications is the client at risk of developing?
- A. retrograde ejaculation
- B. decreased plasma testosterone
- C. hypertrophy of testicles
- D. state of euphoria
Correct Answer: B
Rationale: Untreated chronic renal failure causes decreased testosterone levels, atrophy of testicles, and decreased spermatogenesis. Retrograde ejaculation is not a complication of chronic renal failure. It is a complication of transurethral resection of the prostate. In chronic renal failure, the testicles atrophy; they do not hypertrophy. Chronic renal failure produces a state of depression, not euphoria.
A client's central venous access device (CVAD) becomes infected. Why might the physician order antibiotics to be given through the line rather than through a peripheral IV line?
- A. to prevent infiltration of the peripheral line
- B. to reduce the pain and discomfort associated with antibiotic administration in a small vein
- C. to lessen the chance of an allergic reaction to the antibiotic
- D. to attempt to eliminate microorganisms in the catheter and prevent having to remove it
Correct Answer: D
Rationale: Microorganisms that infect CVADs are often coagulase-negative staphylococci, which can be eliminated by antibiotic administration through the catheter. If unsuccessful in eliminating the microorganism, the CVAD must be removed. CVAD use lessens the need for peripheral IV lines and thus the risk of infiltration. In this case, however, the antibiotics are given to eradicate microorganisms from the CVAD. CVAD use has the effect described in Choice 2, but in this case, the antibiotics are given through the CVAD to eliminate the infective agent. The route does not prevent an allergic reaction.
The nurse is caring for a postpartum woman who has relinquished her baby for adoption. The care plan for the client should include which of the following priority strategies?
- A. Make a referral for grief counseling
- B. Allow the woman to see her baby initially, and then discourage further visits
- C. Provide opportunities for the woman to express her feelings
- D. Inform the woman she has the right to change her mind about relinquishment
Correct Answer: C
Rationale: Providing opportunities to express feelings addresses the immediate emotional needs of grief, loneliness, and guilt, which is a priority for supporting the woman's psychological well-being.
Metformin (Glucophage) is administered to clients with type II diabetes mellitus. Metformin is an example of:
- A. an antihyperglycemic agent.
- B. a hypoglycemic agent.
- C. an insulin analogue.
- D. a pancreatic alpha cell stimulant.
Correct Answer: A
Rationale: This antihyperglycemic agent prevents hyperglycemia by reducing hepatic glucose output and decreasing glucose absorption from the gut. A hypoglycemic drug stimulates insulin production. Metformin is not a type of insulin. Metformin is not a stimulant of any pancreatic cell.