Nursing Elites

1. A woman has been prescribed Climara, a transdermal estradiol patch. Which of the following should she be instructed by the nurse regarding the administration?

• A. Avoid prolonged sun exposure at the patch site due to increased plasma concentrations.
• B. The application of heat at the patch site will decrease effectiveness and result in pregnancy.
• C. The medication, when exposed to sunlight, can increase the risk of breast cancer.
• D. Exposure of the medication to occasional cold will increase effectiveness with application.

Correct answer: A

Rationale: The correct answer is A. The Climara patch delivers estradiol transdermally, and patients should be instructed to avoid prolonged sun exposure at the patch site due to increased plasma concentrations. Sun exposure can accelerate the absorption of the medication, leading to higher systemic levels than intended. Choices B, C, and D are incorrect because heat at the patch site does not result in pregnancy but may alter absorption rates, there is no direct link between sunlight exposure and breast cancer risk related to this medication, and exposure to cold does not increase effectiveness of the transdermal patch.

2. What specific instructions should the nurse provide to ensure proper administration of alendronate (Fosamax) for the treatment of osteoporosis?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• B. Take the medication at bedtime to ensure absorption during sleep.
• C. Take the medication with milk to enhance calcium absorption.
• D. Take the medication with food to prevent gastrointestinal upset.

Correct answer: A

Rationale: The correct answer is to take the medication with a full glass of water and remain upright for at least 30 minutes. This is important to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because alendronate should be taken in the morning on an empty stomach, at least 30 minutes before eating or drinking anything other than water. Choice C is incorrect because alendronate should not be taken with milk as it can interfere with its absorption. Choice D is incorrect because alendronate should be taken on an empty stomach, not with food.

3. What aspect of this woman's current health status would contraindicate the use of oral contraceptives?

• A. The woman has a diagnosis of type 2 diabetes.
• B. The woman has asthma and uses inhaled corticosteroids and bronchodilators.
• C. The woman has a family history of breast cancer.
• D. The woman takes an antiplatelet medication for coronary artery disease.

Correct answer: A

Rationale: The correct answer is A. Women with type 2 diabetes are at higher risk of developing cardiovascular complications. Oral contraceptives further increase this risk due to their potential effects on blood pressure, lipid metabolism, and clotting factors. Choice B is incorrect as inhaled corticosteroids and bronchodilators do not contraindicate the use of oral contraceptives. Choice C is incorrect as a family history of breast cancer does not directly contraindicate the use of oral contraceptives. Choice D is also incorrect as taking an antiplatelet medication for coronary artery disease does not necessarily contraindicate the use of oral contraceptives.

4. A patient has been prescribed raloxifene (Evista) for the prevention of osteoporosis. What effect should the nurse include in the teaching plan regarding the action of this medication?

• A. Decreases calcium excretion by the kidneys.
• B. Increases intestinal absorption of calcium.
• C. Stimulates bone formation by increasing osteoblast activity.
• D. Selectively binds to estrogen receptors, decreasing bone resorption.

Correct answer: D

Rationale: The correct answer is D: Selectively binds to estrogen receptors, decreasing bone resorption. Raloxifene is a selective estrogen receptor modulator (SERM) that works by binding to estrogen receptors, thereby decreasing bone resorption. This action helps in the prevention and treatment of osteoporosis by preserving bone density. Choices A, B, and C are incorrect because raloxifene does not directly affect calcium excretion by the kidneys, intestinal absorption of calcium, or stimulate bone formation by increasing osteoblast activity.

5. What is a critical point the nurse should include in patient education for a patient prescribed tamoxifen (Nolvadex)?

• A. Tamoxifen may increase the risk of venous thromboembolism.
• B. Tamoxifen may decrease the risk of osteoporosis.
• C. Tamoxifen may cause hot flashes and other menopausal symptoms.
• D. Tamoxifen may cause weight gain and fluid retention.

Correct answer: A

Rationale: The critical point the nurse should include in patient education for a patient prescribed tamoxifen is that it may increase the risk of venous thromboembolism. This is crucial information because tamoxifen is known to promote blood clot formation, and patients need to be aware of the signs and symptoms of blood clots to seek prompt medical attention. Choices B, C, and D are incorrect as tamoxifen is not associated with decreasing the risk of osteoporosis, causing hot flashes and other menopausal symptoms, or directly causing weight gain and fluid retention.

Similar Questions