Nursing Elites

1. In menopausal women, what is the primary goal of estrogen therapy?

• A. To relieve menopausal symptoms
• B. To prevent osteoporosis
• C. To increase calcium absorption
• D. To maintain bone strength

Correct answer: B

Rationale: The primary goal of estrogen therapy in menopausal women is to prevent osteoporosis by maintaining bone density. Estrogen helps in preserving bone mass and reducing the risk of fractures. While estrogen therapy may alleviate some menopausal symptoms, such as hot flashes, its primary focus is on bone health rather than symptom management. Increasing calcium absorption and maintaining bone strength are outcomes of preventing osteoporosis rather than the primary goal of estrogen therapy.

2. What signs and symptoms most likely prompted this patient to initially seek care?

• A. Malaise and fatigue
• B. Severe diarrhea
• C. Intermittent fever
• D. Dizziness and confusion

Correct answer: B

Rationale: The correct answer is B: Severe diarrhea. A patient who has recently returned from a trip to Nepal with a nongovernmental organization and is seeking care for amebiasis would most likely have been prompted by the symptom of severe diarrhea. Amebiasis is an infection caused by the parasite Entamoeba histolytica, commonly transmitted through contaminated food or water sources in developing countries like Nepal. The hallmark symptom of amebiasis is dysentery, which is characterized by severe diarrhea with blood or mucus in the stool. Malaise and fatigue (choice A) are nonspecific symptoms that may accompany many illnesses and are not specific to amebiasis. Intermittent fever (choice C) is not a typical presenting symptom of amebiasis, which primarily manifests with gastrointestinal symptoms. Dizziness and confusion (choice D) are also not typical symptoms associated with amebiasis.

3. In a postmenopausal woman, what condition can be prevented by administering estradiol (Estraderm)?

• A. Endometriosis
• B. Amenorrhea
• C. Osteoporosis
• D. Uterine cancer

Correct answer: C

Rationale: The correct answer is C: Osteoporosis. Estradiol, a form of estrogen, is used to prevent osteoporosis in postmenopausal women by maintaining bone density. Choice A, Endometriosis, is incorrect as estradiol is not used to prevent or treat this condition. Choice B, Amenorrhea, is not prevented by estradiol but rather may result from hormonal changes. Choice D, Uterine cancer, is not directly prevented by estradiol; in fact, long-term unopposed estrogen use can increase the risk of uterine cancer.

4. A 45-year-old woman has been prescribed conjugated estrogens (Premarin) for the treatment of menopausal symptoms. What should the nurse include in the patient teaching?

• A. Increase fluid intake to prevent dehydration.
• B. Avoid smoking while taking this medication.
• C. Increase the intake of high-calcium foods.
• D. Take the medication at bedtime to prevent insomnia.

Correct answer: B

Rationale: The correct answer is to 'Avoid smoking while taking this medication' because patients taking conjugated estrogens should avoid smoking due to the increased risk of cardiovascular events. Increasing fluid intake to prevent dehydration is a good practice but not specifically related to conjugated estrogens. Increasing the intake of high-calcium foods may be beneficial for bone health but is not directly related to the medication. Taking the medication at bedtime to prevent insomnia is not a specific teaching point for conjugated estrogens.

5. A patient being treated for tuberculosis is determined to be drug resistant. Which of the following medications will the patient be resistant to in the treatment of tuberculosis?

• A. Isoniazid (INH) and rifampin
• B. Carbamazepine (Tegretol) and phenytoin (Dilantin)
• C. Dextroamphetamine (Dexedrine) and doxapram (Dopram)
• D. Propranolol (Inderal) and sotalol (Betapace)

Correct answer: A

Rationale: In the treatment of tuberculosis, drug resistance commonly develops against medications like Isoniazid (INH) and rifampin. These two drugs are key components of the standard anti-tuberculosis treatment regimen. Choices B, C, and D are unrelated medications that are not used in the treatment of tuberculosis. Carbamazepine and phenytoin are anticonvulsants, dextroamphetamine is a stimulant, and propranolol and sotalol are used for cardiovascular conditions.

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