chapter 7: prepU assignments

On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which response by the nurse is most appropriate?

"It's important to balance the possible benefits of HRT with the fact that it might increase your risk of heart disease and stroke"

The nurse is caring for a client who has cancer and who until recently took estrogen. The nurse knows that estrogen may have increased the risk of development of which types of cancer? (Select all that apply.)

- breast cancer - endometrial cancer

In an ideal 28-day menstrual cycle, the secretory phase occurs during which days?

15 to 28

A client diagnosed with erectile dysfunction has been advised to take sildenafil. For up to how many hours does the action of the drug persist?

4 hours

After teaching a group of nursing students about drugs used to treat genitourinary problems in the older adult, the instructor determines that the teaching was successful when the students correctly choose which drug(s) as an alpha-adrenergic blocker used to treat BPH? Select all that apply.

Alfuzosin; Tamsulosin

A client has come in for her annual physical examination. During the assessment, the nurse learns the client is now taking carbamazepine after suffering a seizure of unknown etiology. This is concerning for which of the following reasons?

Anticonvulsants increase the metabolism of oral contraceptives.

The nurse is scheduled to administer an oral contraceptive to a client admitted with type 2 diabetes. What is the priority teaching that would be provided regarding this medication?

Call the primary care provider for any sudden onset of chest pain, shortness of breath, or redness, swelling, and pain in a leg.

A nursing instructor is teaching a group of students about estrogens and their use. The instructor determines that the teaching was successful when the students correctly choose which statement(s) as true concerning estrogen? Select all that apply.

Changes in lipids levels occur with the use of estrogens; Estrogens increase a woman's risk for gallbladder disease; Estrogen replacement therapy (ERT) helps to lessen the changes to the aging tissues.

What statement by the client prescribed a combination contraceptive several months ago indicates a need for health education?

It's good to know that the pill protects against some sexually transmitted infections (STIs)

A 20-year-old woman will soon begin taking oral contraceptives for the first time. What advice should the nurse provide to this client?

Make sure to seek care quickly if you experience bad headaches, calf pain, or changes in vision

A patient who is taking oral contraceptives develops an upper respiratory infection for which a tetracycline is ordered. Which instruction would be most important for the nurse to include?

Using an alternative means of contraception while taking the tetracycline

A group of students are reviewing material in preparation for a test on the male and female breasts. The students demonstrate understanding of the material when they state:

a primary function of the female breast is to produce milk

A client has been prescribed transdermal estradiol. What important information does the nurse share with this client?

avoid prolonged sun exposure

A client is prescribed tamsulosin and atenolol. Which assessment would the nurse prioritize when conducting the ongoing assessment?

blood pressure

When considering the hormonal changes that occur, the nurse should encourage which diagnostic screening for a postmenopausal woman?

bone calcium level

A nurse is preparing to administer goserelin to a client with prostate cancer. Which assessment findings should the nurse prioritize on the ongoing assessment?

breast atrophy, sexual dysfunction

What would a nurse attribute to estrogen?

breast growth

A young mother is requesting oral contraceptives at her 6-week postnatal visit. Which of the following would be a contraindication for the use of progestin?

breastfeeding

A 20-year-old woman has been prescribed estrogen. As with all women taking estrogen, the nurse will carefully monitor the client for:

cardiovascular complications

A female client asks the nurse about the use of progestins. The nurse shares with the client that clients who take this medication are at an increased risk for what serious adverse effect?

cardiovascular complications

A nurse is caring for a client with advanced breast cancer who is receiving androgen therapy. Which signs might alert the nurse to the possibility of liver toxicity?

clinical jaundice

What additional warnings or risks should the nurse include in the teaching plan of a client receiving estrogen?

endometrial cancer

The U.S. Food and Drug Administration (FDA) has issued a Black Box Warning concerning estrogen's use and associated increased risk of which of the following?

endometrial carcinoma

A 49-year-old female client is asking the nurse about how her changing hormones relate to menopause. The nurse explains that atrophic vaginitis is a common problem during menopause. The treatment for atrophic vaginitis requires replacing:

estrogen

A client alerts the nurse that they have been in menopause for a couple of months. The nurse teaches the client how menopause occurs. Which statement reflects the teaching has been effective?

estrogen and progesterone diminish

A patient is prescribed estradiol in a vaginal ring form. The nurse would instruct the patient to insert a new vaginal ring at which frequency?

every 3 months

A 37-year-old woman recently underwent a bilateral salpingo-oophorectomy. During the assessment, which of the following situations should the nurse ask about to determine the client's surgical menopausal status?

hot flashes

A 63-year-old client taking estrogen and progestin for several years has recently been changed to estrogen alone. What medical event would prompt such a change in treatment?

hysterectomy

Which statements indicate that a client understands the need for a follow-up after the initial injection of medroxyprogesterone?

i know that this injection lasts for 3 months

Your diabetic patient has been taking Norgestrel, a progestin, for birth control for the past 7 years. What may be an adverse effect of this drug?

it may make diabetes more difficult to control

Which hormone causes ovulation to occur?

luteinizing hormone (LH)

A client with a 28-day cycle reports that she ovulated on May 10. The nurse would expect the client's next menses to begin on:

may 24

A 38-year-old female client has just visited the health care provider and has received a prescription for birth control pills. The client calls the nurse and states that she doesn't need birth control pills because she had voluntary sterilization after her third child. The nurse explains that birth control pills may be used for what other reason?

menstrual disorders

A client with benign prostatic hypertrophy is questioning the nurse about saw palmetto. Which is the best response from the nurse related to the use of this herb

need to be reevaluated after 6 months of use

The nurse is caring for a woman who is receiving estrogen for treatment of amenorrhea. What evidence will the nurse use to indicate that the medication is working properly?

occurrence of menstruation

After teaching a patient who is prescribed estradiol vaginal cream, the nurse determines that the patient has understood the instructions when she states that she will administer the medication at which frequency?

once a day

A client is receiving conjugated estrogens. The nurse would anticipate administering this drug by which route?

oral

A nurse is obtaining a history from an older adult woman. During the interview, the woman states, "When I feel like I have to urinate, the urge is really strong and I go to the bathroom really frequently, often waking up several times during the night to go." The nurse would likely identify this as which condition?

overactive bladder syndrome

Kalie, age 18, is prescribed progesterone for the treatment of primary amenorrhea. Which adverse effect would need to be reported immediately to the health care provider?

pain in one leg

After teaching a group of students about the events that occur with fertilization and implantation of an ovum, the instructor determines that the teaching has been effective when the students identify what as an endocrine structure?

placenta

A nurse has administered estrogen and phenytoin to a client. Which reaction should the nurse plan to monitor the client carefully for?

possibility of breakthrough bleeding

The release of gonadotropin releasing hormone by the hypothalamus signals the onset of:

puberty

A client who is taking estrogen therapy calls the clinic and tells the nurse that she is experiencing sudden, sharp chest pain. The nurse suspects the client is experiencing what adverse reaction related to estrogen therapy?

pulmonary embolism

After teaching a class on the female reproductive system, the nurse determines that the teaching was successful when the class identifies what as a primary function of the ovaries?

secretion of estrogen and progesterone

Patient education is necessary to ensure proper use of exogenous estrogen and to enable the patient to recognize adverse effects. Which of the following should a nurse teach the patient?

self-breast examination

A patient is receiving estrogen therapy. What would the nurse instruct the patient to report immediately?

shortness of breath

A 27-year-old woman is concerned that she is pregnant even though she has been using oral contraceptives. During the assessment, the nurse discovers the client has been using various herbs. Which of the following herbs is contraindicated for use with oral contraceptives?

st. johns wort

A client comes to the emergency department and reports extreme pain. Physical assessment reveals a 6-hour erection. When obtaining the client's medication history, which drug would the nurse expect the client to report using?

tadalafil

The nurse is caring for a female client with a new prescription for oral contraceptives. What outcome would be most important for the nurse to evaluate?

the client can verbalize how and when to take medication even if a pill is missed

The health care provider has ordered a variety of laboratory assessments on a client who will need estrogen replacement. The follow labs are ordered: blood urea nitrogen (BUN), creatinine, and liver function tests (LFTs). What is the nurse's best statement explaining to a client the need to draw the labs?

the labs will identify your bodys ability to filter and excrete medications

After explaining the various contraceptive options with a client, the client opts for the etonogestrel/ethinyl estradiol vaginal ring. After teaching the client about this choice, the nurse determines that the teaching was effective when the client makes which statement?

the ring should stay in place 3 weeks

Women generally do not eat foods high in calcium, which means that women of all ages generally consume less than the recommended amount of calcium. What supplement may be helpful in reducing bone loss?

vitamin D