when obtaining a health history on a menopausal woman which information should a nurse recognize as a contraindication for hormone replacement therapy

NCLEX-PN

Best NCLEX Next Gen Prep

1. When obtaining a health history on a menopausal woman, 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: unexplained vaginal bleeding

Rationale: When considering hormone replacement therapy for a menopausal woman, unexplained vaginal bleeding should be recognized as a contraindication. This is because it could be indicative of a serious underlying condition that needs investigation before initiating hormone therapy. A family history of stroke, by itself, is not a contraindication for hormone replacement therapy, unless the woman herself has a history of stroke or blood-clotting events. Ovaries removed before age 45 may actually increase the likelihood of needing hormone replacement therapy due to early menopause. Frequent hot flashes and night sweats, on the other hand, are symptoms that can be relieved by hormone replacement therapy, making them a potential indication rather than a contraindication.

2. What causes an older female client's hair to turn gray?

A. ''A loss of melanin occurs in the normal aging process.''
B. ''The number of sweat glands and blood vessels decreases in the normal aging process.''
C. ''The skin on the scalp becomes thin, causing moisture to escape.''
D. ''It is caused by hereditary factors.''

Correct answer: ''A loss of melanin occurs in the normal aging process.''

Rationale: The correct answer is 'A loss of melanin occurs in the normal aging process.' Graying hair in older adults is primarily due to a decrease in the number of melanocytes responsible for providing pigment and hair color. This reduction in melanin production leads to gray hair. The other choices are incorrect. While it is true that the skin becomes thinner with aging and the number of sweat glands and blood vessels decreases, these changes are not directly related to graying hair. Additionally, hereditary factors can influence when graying starts, but they do not cause the graying of hair itself.

3. Why is Kleinman’s Explanatory Model of Health and Illness significant?

A. it explains the health beliefs a family is likely to have.
B. it emphasizes the role of culture in shaping health explanations.
C. it discusses the significant role of popular and folk domains of influence.
D. it is structured based on education.

Correct answer: it emphasizes the role of culture in shaping health explanations.

Rationale: Kleinman's Explanatory Model of Health and Illness is significant because it emphasizes the crucial role that popular and folk domains of influence play in shaping individuals' understanding of health and illness. Kleinman distinguishes between disease, which is the biomedical understanding of health problems, and illness, which is the individual's personal interpretation of their health condition. By focusing on the cultural factors that influence these domains of influence, Kleinman's model underscores the impact of cultural beliefs and practices on health perceptions. Choice A is incorrect because the model goes beyond just family health beliefs. Choice B is more precise as it emphasizes the broader influence of culture. Choice C highlights the correct significance of popular and folk domains of influence, making it the correct choice. Choice D is incorrect as the model's significance lies in cultural domains, not educational structure.

4. A nurse is preparing to screen a client’s vision with the use of a Snellen chart. The nurse uses which technique?

A. Tests the right eye, then tests the left eye, and finally tests both eyes together
B. Assesses both eyes together, then assesses the right and left eyes separately
C. Asks the client to stand 40 feet from the chart and read the largest line on the chart
D. Asks the client to stand 40 feet from the chart and read the line that can be read 200 feet away by someone with unimpaired vision

Correct answer: Tests the right eye, then tests the left eye, and finally tests both eyes together

Rationale: To test visual acuity with the use of a Snellen chart, the nurse places the chart in a well-lit spot at the client’s eye level, with the client positioned exactly 20 feet from the chart. The client shields one eye at a time with an opaque card during the test. After testing each eye separately, both eyes are assessed together. The client is asked to read the smallest line of letters visible and encouraged to read the next smallest line as well. Therefore, option A is correct as it describes the correct technique of testing one eye at a time before assessing both eyes together. Option B is incorrect as it assesses both eyes together first, which is not the standard procedure. Options C and D are incorrect as they suggest standing 40 feet from the chart, which contradicts the standard distance of 20 feet for a Snellen chart test.

5. A client with Kawasaki disease has bilateral congestion of the conjunctivae, dry cracked lips, a strawberry tongue, and edema of the hands and feet followed by desquamation of fingers and toes. Which of the following nursing measures is most appropriate to meet the expected outcome of positive body image?

A. administering immune globulin intravenously
B. assessing the extremities for edema, redness, and desquamation every 8 hours
C. explaining progression of the disease to the client and their family
D. assessing heart sounds and rhythm

Correct answer: explaining progression of the disease to the client and their family

Rationale: Explaining the progression of the disease to the client and their family is the most appropriate nursing measure to promote a positive body image. By educating them about when symptoms are expected to improve and resolve, they can understand that there will be no permanent disruption in physical appearance that could negatively impact body image. While administering immune globulin intravenously may be part of the treatment for Kawasaki disease, it does not directly address body image concerns. Assessing the extremities for edema, redness, and desquamation every 8 hours is important for monitoring the disease but does not directly impact body image. Assessing heart sounds and rhythm is crucial for monitoring cardiac effects of Kawasaki disease but is not directly related to promoting a positive body image.