a patient with breast cancer is prescribed tamoxifen nolvadex what should the nurse emphasize during patient education

ATI RN

Final Exam Pathophysiology

1. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What should the nurse emphasize during patient education?

A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be aware of the signs and symptoms of blood clots.
B. Tamoxifen may cause weight gain, so patients should monitor their diet.
C. Tamoxifen may cause hot flashes and other menopausal symptoms.
D. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, a serious side effect. Therefore, patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, and redness in the legs, and advised to seek immediate medical attention if they occur. Choice B is incorrect because weight gain is not a significant side effect of tamoxifen. Choice C is incorrect because hot flashes and menopausal symptoms are common side effects of tamoxifen but are not as critical to address as venous thromboembolism. Choice D is incorrect because tamoxifen does not decrease the risk of osteoporosis; in fact, it may increase the risk of bone loss in premenopausal women.

2. A patient is starting on oral contraceptives. What should the nurse emphasize about the importance of taking the medication at the same time each day?

A. Taking the medication at the same time each day helps maintain stable hormone levels and ensures effectiveness.
B. Taking the medication at the same time each day reduces the risk of breakthrough bleeding.
C. Taking the medication at the same time each day ensures consistent absorption and effectiveness.
D. Taking the medication at the same time each day is important, but missing a dose occasionally is not a concern.

Correct answer: A

Rationale: The correct answer is A. Taking oral contraceptives at the same time each day helps maintain stable hormone levels and ensures their effectiveness in preventing pregnancy. Choice B is incorrect because the primary emphasis of consistent timing is on hormone levels and effectiveness, not on reducing breakthrough bleeding. Choice C is incorrect because while consistent absorption is a factor, the main focus is on maintaining stable hormone levels. Choice D is incorrect as missing doses can significantly impact contraceptive efficacy.

3. Which of the following steps occurs first during hemostasis?

A. Vascular spasm
B. Platelet plug
C. Coagulation
D. Dissolution of the clot

Correct answer: A

Rationale: Vascular spasm is the initial step in hemostasis, where blood vessels constrict to reduce blood flow to the injured area. This constriction helps limit blood loss until further steps like platelet plug formation and coagulation can take place. Platelet plug formation and coagulation occur after the vascular spasm, making them incorrect choices. Dissolution of the clot happens much later in the healing process, after the injury has sufficiently healed.

4. A client with cystic fibrosis is admitted with a pulmonary exacerbation. Which intervention should the nurse prioritize?

A. Administer a high-calorie, high-protein diet.
B. Initiate airway clearance techniques.
C. Encourage the client to maintain an active lifestyle.
D. Monitor for signs of respiratory distress.

Correct answer: B

Rationale: During a pulmonary exacerbation in cystic fibrosis, the priority intervention is to initiate airway clearance techniques. These techniques help clear mucus from the airways, improving ventilation and reducing the risk of respiratory complications. Administering a high-calorie, high-protein diet is beneficial for overall nutrition but is not the priority during an exacerbation. Encouraging an active lifestyle is important for long-term health but does not address the immediate need for managing exacerbations. Monitoring for signs of respiratory distress is important, but initiating airway clearance techniques takes precedence in the management of pulmonary exacerbations in cystic fibrosis.

5. Which of the following is a complication of compartment syndrome?

A. Hemorrhage
B. Pain and tissue damage
C. Increased limb function
D. Chronic kidney disease

Correct answer: B

Rationale: The correct answer is B: Pain and tissue damage. Compartment syndrome occurs due to increased pressure within the muscle compartments, leading to pain and tissue damage. Hemorrhage (choice A) is not a typical complication of compartment syndrome. Increased limb function (choice C) is not a complication but rather a potential improvement if the condition is managed appropriately. Chronic kidney disease (choice D) is unrelated to compartment syndrome.