Exam 4- Osteoporosis, GD, Menopause

A nurse is caring for a middle-aged adult female client who reports that her menstrual periods have become irregular and she has been having hot flashes. The nurse should expect the client to have which of the following manifestations associated with early menopause? a. Urinary retention b. Decreased blood pressure c. Dryness with intercourse d. Elevation in body temperature above 37.8° C (100° F)

C

A 54-year-old woman who recently reached menopause and has a family history of osteoporosis is diagnosed with osteopenia following densitometry testing. In teaching the woman about her osteoporosis, the nurse explains that a. estrogen replacement therapy must be started to prevent rapid progression to osteoporosis. b. continuous, low-dose corticosteroid treatment is effective in stopping the course of osteoporosis. c. with a family history of osteoporosis, there is no way to prevent or slow gradual bone resorption. d. calcium loss from bones can be slowed by increasing calcium intake and weight-bearing exercise.

D

A nurse is teaching a client about preventing osteoporosis. Which of the following statements by the client indicates a need for further teaching? a. "I will reduce my intake of sodium." b. "I will decrease my intake of caffeine." c. "I will limit my intake of soft drinks." d. "I will reduce my intake of vitamin K-rich foods."

D

A 22-year-old tells the nurse that she has not had a menstrual period for the last 2 months. Which action is most important for the nurse to take? a. Obtain a urine specimen for a pregnancy test. b. Ask about any recent stressful lifestyle changes. c. Measure the patients current height and weight. d. Question the patient about prescribed medications.

A

A 56-year-old woman is concerned about having a moderate amount of vaginal bleeding after 4 years of menopause. The nurse will anticipate teaching the patient about a. endometrial biopsy. b. endometrial ablation. c. uterine balloon therapy. d. dilation and curettage (D&C).

A

A nurse is providing discharge teaching to a client following an abdominal hysterectomy. Which of the following information should the nurse include in the teaching? a. "You should refrain from sexual intercourse for at least 4 weeks." b. "You should expect to have burning with urination for the first week." c. "You should soak in a warm tub bath to ease incisional pain." d. "You should limit lifting to objects of 20 pounds or less."

A

An assessment finding for a 55-year-old patient that alerts the nurse to the presence of osteoporosis is a. a measurable loss of height. b. the presence of bowed legs. c. the aversion to dairy products. d. a statement about frequent falls.

A

A 54-year-old patient is on the surgical unit after a radical abdominal hysterectomy. Which finding is most important to report to the health care provider? a. Urine output of 125 mL in the first 8 hours after surgery b. Decreased bowel sounds in all four abdominal quadrants c. One-inch area of bloody drainage on the abdominal dressing d. Complaints of abdominal pain at the incision site with coughing

A The decreased urine output indicates possible low blood volume and further assessment is needed to assess for possible internal bleeding.

A nurse is providing teaching to a client who has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine cancer. Which of the following instructions should the nurse include in the teaching? a. A Papanicolaou (Pap) test should be performed every 6 months. b. Artificial lubrication can be used to treat vaginal itching and dryness. c. Increased vaginal drainage typically occurs 5 days following surgery. d. Resume sexual intercourse in 2 to 3 weeks.

B

Alendronate (Fosamax) is prescribed for a patient with osteoporosis. The nurse teaches the patient that a) the drug must be taken with food to prevent GI side effects. b) bisphosphonates prevent calcium from being taken from the bones. c) lying down after taking the drug prevents light-headedness and dizziness. d) taking the drug with milk enhances the absorption of calcium from the bowel.

B

When administering alendronate (Fosamax) to a patient with osteoporosis, the nurse will a. ask about any leg cramps or hot flashes. b. assist the patient to sit up at the bedside. c. be sure that the patient has recently eaten. d. administer the ordered calcium carbonate.

B

Which assessment finding in a woman who recently started taking hormone therapy (HT) is most important for the nurse to report to the health care provider? a. Breast tenderness b. Left calf swelling c. Weight gain of 3 lb d. Intermittent spotting

B Unilateral calf swelling may indicate deep vein thrombosis caused by the changes in coagulation associated with HT and would indicate that the HT should be discontinued.

A 47-year-old woman asks whether she is going into menopause if she has not had a menstrual period for 3 months. The best response by the nurse is which of the following? a. Have you thought about using hormone replacement therapy? b. Most women feel a little depressed about entering menopause. c. What was your menstrual pattern before your periods stopped? d. Since you are in your mid-40s, it is likely that you are menopausal.

C

A 49-year-old woman is considering the use of combined estrogen-progesterone hormone replacement therapy (HT) during menopause. Which information will the nurse include during their discussion? a. Use of estrogen-containing vaginal creams provides most of the same benefits as oral HT. b. Increased incidence of colon cancer in women taking HT requires more frequent colonoscopy. c. HT decreases osteoporosis risk and increases the risk for cardiovascular disease and breast cancer. d. Use of HT for up to 10 years to prevent symptoms such as hot flashes is generally considered safe.

C

Which patient would be at greatest risk for developing osteoporosis? a) A 73-year-old man who has five alcoholic drinks per week and limits sun exposure to prevent recurrence of skin cancer. b) An 84-year-old man who has recently been diagnosed with hypothyroidism and is prescribed levothyroxine (Synthroid). c) A 69-year-old woman who had a renal transplant 5 years ago and has been taking prednisone to prevent organ rejection. d) A 55-year-old woman who recently had a hysterectomy with bilateral salpingo-oophorectomy and refuses estrogen therapy.

C

An 18-year-old requests a prescription for birth control pills to control severe abdominal cramping and headaches during her menstrual periods. Which should the nurse take first? a. Determine whether the patient is sexually active. b. Teach about the side effects of oral contraceptives. c. Take a personal and family health history from the patient. d. Suggest nonsteroidal antiinflammatory drugs (NSAIDs) for relief.

C Oral contraceptives may be appropriate to control this patients symptoms, but the patients health history may indicate contraindications to oral contraceptive use.

A nurse is presenting educational materials for a group of middle-aged clients about menopausal hormone therapy following total hysterectomy. Which of the following information should the nurse include in the information? a. Take at different times of the day. b. Take an extra dose if missed a day. c. Prevents from having a cerebral hemorrhage. d. Prevents osteoporotic fractures.

D

Which menu choice by a patient with osteoporosis indicates that the nurses teaching about appropriate diet has been effective? a. Pancakes with syrup and bacon b. Whole wheat toast and fresh fruit c. Egg-white omelet and a half grapefruit d. Oatmeal with skim milk and fruit yogurt

D

A 49-year-old woman tells the nurse that she is postmenopausal but has occasional spotting. Which initial response by the nurse is most appropriate? a. A frequent cause of spotting is endometrial cancer. b. How long has it been since your last menstrual period? c. Breakthrough bleeding is not unusual in women your age. d. Are you using prescription hormone replacement therapy?

D In postmenopausal women, a common cause of spotting is hormone therapy (HT).