Nokea
Which information should a nurse recognize as a contraindication for hormone replacement therapy?
- A. family history of stroke
- B. ovaries removed before age 45
- C. frequent hot flashes and/or night sweats
- D. unexplained vaginal bleeding
Correct Answer: D
Rationale: The correct answer is D: unexplained vaginal bleeding. This is a contraindication for hormone replacement therapy as it may indicate underlying conditions that need to be addressed before starting hormone therapy to avoid potential risks. Vaginal bleeding could be a sign of endometrial hyperplasia or cancer, which can be exacerbated by hormone therapy. Choices A, B, and C are not contraindications for hormone replacement therapy. Family history of stroke may influence the choice of therapy but not necessarily contraindicate it. Ovaries removed before age 45 and frequent hot flashes/night sweats are common indications for hormone replacement therapy to alleviate symptoms of menopause.
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A man has been admitted to the observation unit after having been treated for a large cut on his foreheaAs the nurse works through the interview, one of the standard questions has to do with alcohol, tobacco, and drug use. When the nurse asks him about tobacco use, he states, "I quit smoking after my wife died 7 years ago." However, the nurse notices an open packet of cigarettes in his shirt pocket. If using confrontation as a response, the nurse could say:
- A. Mr. K., you have said that you don't smoke, but I see that you have an open packet of cigarettes in your pocket.
- B. Mr. K., come on, tell me how much you smoke.
- C. Mr. K., I didn't realize your wife had dieIt must be difficult for you at this time. Please tell me more about that.
- D. Mr. K., I know that you are lying.
Correct Answer: D
Rationale: The correct answer is D because using confrontation in this situation involves addressing the discrepancy between the patient's statement and observed behavior without being aggressive or judgmental. By stating, "Mr. K., I know that you are lying," the nurse directly addresses the inconsistency, encouraging honesty and open communication. This approach can help build trust and facilitate a more honest discussion about the patient's tobacco use.
Choice A is incorrect as it is too direct and may come across as accusatory. Choice B is also incorrect as it does not acknowledge the discrepancy and may not lead to a productive conversation. Choice C is incorrect as it avoids addressing the issue and focuses on the patient's personal situation instead of the behavior in question.
A nurse is caring for a patient with a history of heart failure. The nurse should monitor for which of the following signs of fluid overload?
- A. Weight loss and increased appetite.
- B. Increased urine output and dehydration.
- C. Swelling in the legs and shortness of breath.
- D. Nausea and vomiting.
Correct Answer: C
Rationale: The correct answer is C: Swelling in the legs and shortness of breath. In heart failure, the heart is unable to pump effectively, leading to fluid accumulation in the body. Swelling in the legs (edema) is a classic sign of fluid overload as the fluid pools in the lower extremities. Shortness of breath occurs due to fluid accumulating in the lungs, causing difficulty in breathing. Weight loss and increased appetite (A) are not typical signs of fluid overload. Increased urine output and dehydration (B) are more indicative of fluid deficit. Nausea and vomiting (D) can occur in various conditions but are not specific to fluid overload in heart failure.
A nurse is teaching a patient about managing diabetes. Which of the following actions would the nurse emphasize as most important in preventing complications from diabetes?
- A. Monitoring blood glucose levels regularly.
- B. Limiting physical activity to prevent injury.
- C. Maintaining a low-fat, high-protein diet.
- D. Taking insulin as prescribed regardless of blood sugar levels.
Correct Answer: A
Rationale: Step-by-step rationale for why choice A is correct:
1. Monitoring blood glucose levels regularly allows for timely adjustments in treatment.
2. It helps in preventing hypoglycemia or hyperglycemia complications.
3. Enables the patient to understand how their lifestyle choices impact their blood sugar levels.
4. Empowers the patient to make informed decisions regarding their diabetes management.
Summary of why the other choices are incorrect:
B: Limiting physical activity can lead to complications like obesity and decreased insulin sensitivity.
C: Diet should focus on balanced nutrition, not just low-fat or high-protein, to manage diabetes effectively.
D: Taking insulin regardless of blood sugar levels can result in hypoglycemia or poor blood sugar control.
Which disease is least likely to be associated with increased potential for bleeding?
- A. metastatic liver cancer
- B. gram-negative septicemia
- C. pernicious anemia
- D. iron-deficiency anemia
Correct Answer: C
Rationale: The correct answer is C: pernicious anemia. Pernicious anemia is caused by vitamin B12 deficiency, leading to impaired red blood cell production but does not directly affect clotting factors. Metastatic liver cancer (A) can cause liver dysfunction and decreased production of clotting factors, increasing bleeding risk. Gram-negative septicemia (B) can lead to disseminated intravascular coagulation and excessive bleeding. Iron-deficiency anemia (D) can result in microcytic red blood cells and decreased oxygen delivery but does not directly increase bleeding potential.
Which organ is responsible for the extensive metabolism of acetaminophen?
- A. Liver
- B. Kidneys
- C. Lungs
- D. Pancreas
Correct Answer: A
Rationale: The correct answer is A: Liver. The liver is responsible for the extensive metabolism of acetaminophen through various pathways, including glucuronidation, sulfation, and oxidation. It converts acetaminophen into less toxic metabolites for elimination. The kidneys (B) primarily filter blood and regulate fluid balance; the lungs (C) are involved in gas exchange; and the pancreas (D) produces digestive enzymes and insulin, not involved in acetaminophen metabolism. Therefore, the liver is the correct choice for this question.