Nursing Elites

1. What long-term risks should the nurse discuss with a patient starting on hormone replacement therapy (HRT)?

• A. HRT is associated with increased risks of cardiovascular events and breast cancer, so these risks should be discussed with the patient.
• B. HRT can improve mood and energy levels, but it also increases the risk of osteoporosis.
• C. HRT can increase the risk of venous thromboembolism, so patients should undergo regular screening.
• D. HRT decreases the risk of fractures, but it also increases the risk of developing diabetes.

Correct answer: A

Rationale: The correct answer is A. When starting on hormone replacement therapy (HRT), the nurse should discuss the increased risks of cardiovascular events and breast cancer with the patient. These risks are important to consider to make an informed decision. Choice B is incorrect as HRT does not increase the risk of osteoporosis; in fact, it may help prevent it. Choice C is incorrect as while HRT can increase the risk of venous thromboembolism, regular screening is not the primary focus for discussion. Choice D is incorrect as HRT does not decrease the risk of fractures and is not primarily associated with an increased risk of developing diabetes.

2. What specific instructions should the nurse provide for proper administration of alendronate (Fosamax) in a patient with osteoporosis?

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

Correct answer: B

Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper drug absorption. Choice A is incorrect as alendronate should not be taken with milk due to potential interactions. Choice C is incorrect as there is no need to take the medication at bedtime specifically. Choice D is incorrect as taking alendronate with food can decrease its absorption.

3. 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.

4. Which condition is characterized by a lack of antidiuretic hormone (ADH)?

• A. Diabetes mellitus
• B. Diabetes insipidus
• C. Cushing's disease
• D. Hyperthyroidism

Correct answer: B

Rationale: The correct answer is B, Diabetes insipidus. Diabetes insipidus is characterized by a lack of antidiuretic hormone (ADH), leading to excessive urination and thirst. Choice A, Diabetes mellitus, is a different condition characterized by high blood sugar levels. Choice C, Cushing's disease, is caused by prolonged exposure to high levels of cortisol. Choice D, Hyperthyroidism, involves an overactive thyroid gland producing excess thyroid hormones.

5. A patient is prescribed estradiol (Estrace) for hormone replacement therapy. What should the nurse monitor during this therapy?

• A. Blood pressure
• B. Blood glucose levels
• C. Liver function tests
• D. Kidney function tests

Correct answer: C

Rationale: During estradiol therapy, the nurse should monitor liver function tests. Estradiol can potentially impact liver function, making it essential to assess for any signs of liver dysfunction. Monitoring blood pressure (Choice A) is not directly related to estradiol therapy. While blood glucose levels (Choice B) should be monitored in patients taking certain medications like corticosteroids or antipsychotics, it is not typically necessary for patients on estradiol therapy. Kidney function tests (Choice D) are not the priority for monitoring during estradiol therapy, as the liver is more commonly affected.

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