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1, 3, 5
Adverse effects of clomiphene, an ovarian stimulant, include anxiety, dizziness, blurred vision, tachycardia, deep vein thrombosis, nausea, constipation, urticaria, and others. Hirsutism, bradycardia, and increased diuresis are not known adverse effects associated with clomiphene.
Answer: B
Before advising a client about oral contraceptives, the nurse needs to assess the client for signs and symptoms of hypertension. Clients who have hypertension, thrombophlebitis, obesity, or a family history of cerebral or cardiovascular accident are poor candidates for oral contraceptives. In addition, women who smoke, are older than 40 years of age, or have a history of pulmonary disease should be advised to use a different method. Iron-deficiency anemia, dysmenorrhea, and acne are not contraindications for the use of oral contraceptives. Iron-deficiency anemia is a common disorder in young women. Oral contraceptives decrease the amount of menstrual flow and thus decrease the amount of iron lost through menses, thereby providing a beneficial effect when used by clients with anemia. Low-dose oral contraceptives to prevent ovulation may be effective in decreasing the severity of dysmenorrhea (painful menstruation). Dysmenorrhea is thought to be caused by the release of prostaglandins in response to tissue destruction during the ischemic phase of the menstrual cycle. Use of oral contraceptives often improves facial acne
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A patient is receiving intravenous methylergonovine after a vaginal delivery. Which postpartum assessment is the nurse's priority to prevent complications of therapy?
Hypertension
Hypoglycemia
Decreased lochia
Uterine contractions
Hypertension
Question
During a postpartum assessment, the nurse notes a boggy uterus and increased uterine bleeding. Which drug should the nurse anticipate will be prescribed?
Oxytocin
Terbutaline
Clomiphene
Prostaglandin E
Oxytocin
Which medication helps reduce postpartum uterine hemorrhage? Methylergonovine
Megestrol
Raloxifene
Clomiphene
Methylergonovine
A 6-year-old child who has chickenpox also has a fever of 102.9* F (39.4 C). The child's mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse?
"It's best to wait to see if the fever gets worse."
"You can use the aspirin, but watch for worsening symptoms."
"Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin."
"You can use aspirin, but be sure to follow the instructions
on the bottle."
"Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin."
The current immunization for tetanus and diphtheria toxoids and pertussis, Tdap, is administered to people in which age range?
Under 6 years of age
11-12 years of age and older
Any age range
In the first two years of life.
11-12 years of age and older
What is the priority nursing assessment to monitor when administering vaccinations?
Anaphylaxis
Pain at the injection site
Signs and symptoms of infection Myalgias
Anaphylaxis
A 12-month-old infant has received an MMR II (measles, mumps, and rubella virus vaccine), and her mother calls the clinic that afternoon to ask about helping her fussy infant to "feel better."
What will the nurse suggest?
Apply an ice pack to the injection site.
Apply warm compresses to the injection site.
Observe the site for further swelling and redness.
Bring the infant in to the emergency department for an immediate examination.
Apply warm compresses to the injection site.
An allergy to which substance is listed as a contraindication to the administration of an immunizing drug?
Soy
Corn
Wheat
Egg
Egg
What teaching would the nurse provide to a patient receiving tetanus toxoid?
"Increase fluid and fiber in your diet to prevent constipation."
"Soreness at the injection site is a common reaction."
"You will have lifetime immunity from this injection. This medication must be repeated weekly for four weeks."
"Soreness at the injection site is a common reaction"
A nurse instructor is about to administer a vitamin K injection to a newborn. The student nurse asks the instructor regarding the purpose of the injection. The appropriate response would be:
"The vitamin K provides active immunity
The vitamin K will prevent the occurrence of hyperbilirubinemia.
The vitamin K will protect the newborn from bleeding.
The vitamin K will serve as protection against
jaundice and anemia
The vitamin K will protect the newborn from bleeding.
A patient arrives at the clinic with a wound inflicted by a rusty nail. After checking the patient's history, the nurse finds that the patient last received the tetanus booster about 10 years earlier. What is the most approriate nursing action in this situation?
Administer Tdap.
Administer DTAP.
Administer immunoglobulin
Administer polyvalent vaccine
Administer Tdap.
The nursing instructor asks a nursing student to describe the procedure for administering erythromycin ointnent to the eyes of a newborn, Which student statement indicates that FURTHER teaching is needed?
"I will flush the eyes after instilling the ointment."
"I will clean the newborn's eyes before instilling ointment."
"I need to administer the eye
ointment within 1 hour after delivery."
"I will instill the eye ointment into each of the newborn's conjunctival sacs."
"I will flush the eyes after instilling the ointment."
Which vaccination is recommended in the prevention of a virus that is known to cause cervical cancer?
Herpes zoster vaccine
Human papillomavirus vaccine
Pneumococcal vaccine
Hepatitis B virus vaccine
Human papillomavirus vaccine
A nurse is assessing an athlete who has been admitted for cardiac arrest. The investigation reports reveal increased blood viscosity. Which drug did the patient likely receive?
Folic acid
Ferrous fumarate
Epoetin alfa
Cyanocobalamin (vitamin B12)
Epoetin alfa
What instructions are given to a patient who is
prescribed oral iron tablets?
"Take the iron tablet in a powdered form."
"Take an iron tablet just before going to bed.
"Take the iron tablet after dissolving it in water using a straw."
"Take the iron tablet with plenty of fluids."
"Take the iron tablet with plenty of fluids."
The nurse is assessing a patient who has been taking warfarin and vitamin K1 for the past week. The lab reports reveal
that the patient has developed venous thromboembolism. What vitamin ingestion may be the reason for this finding?
Vitamin A
Vitamin D
Vitamin E
Vitamin K
Vitamin K
A patient with warfarin toxicity is prescribed vitamin K. Which nursing assessment ensures patient safety?
Assess the site for intramuscular drug delivery.
Assess the white blood cell count of the patient.
Assess the amount
of blood loss in the patient.
Assess the prothrombin time of the patient.
Assess the prothrombin time of the patient.
The nurse is monitoring a patient receiving alteplase for treatment of an arterial embolism in the left leg. Which finding indicates that the therapy is effective?
2+ pitting edema
Faint posterior tibial pulse
Left leg warm to touch
Numbness in left leg
Left leg warm to touch
The nurse assesses the patient's activated partial thromboplastin time (APTT) to determine the effectiveness of the heparin regimen and notes that it is 35 seconds. How will the nurse interpret this value?
The The aPTT is inadequate to evaluate treatment.
The APTT is significantly decreased.
The APTT is significantly elevated.
The aPTT is within normal limits.
The aPTT is significantly decreased.
The nurse is caring for a patient who is prescribed long-term aspirin therapy to prevent a stroke. Which parameters should the nurse assess as a result of this prescription? Select all that apply.
Heart rate
Hemoglobin
Respirations
Platelet Count
Blood Pressure
Activated partial thromboplastin time (APTT)
Hemoglobin
Platelet Count
Activated partial
thromboplastin time (APTT)
A patient who has been receiving an intusion of heparin has an activated partial thromboplastin time (APTT) of 120 seconds. What is the nurse's first action?
Assess for bleeding
Shut off the heparin drip
Keep the patient on bed rest
Call the health care provider
Shut off the heparin drip
Which statement, made by the
patient, demonstrates a knowledge deficit regarding colestipol (Colestid)?
The medication may cause constipation, so I will increase fluid and fiber in my diet."
"I should take this medication 1 hour after or 4 hours before my other medications."
"I might need to take fat-soluble vitamins to supplement my diet."
"I should mix and stir the powder in a small amount of fluid as possible in order to maintain potency of the medication."
"I should mix and stir the powder in a small amount of fluid as possible in order to maintain potency of the medication."
What education and discharge information for a patient receiving an antilipemic medication would the nurse include for the patient?
"This medication will take over for other interventions you have been trying to decrease your cholesterol."
"It is important for you to double your dose if you miss one in order to maintain
therapeutic blood levels."
"Stop taking the medication if it causes nausea and vomiting."
"Continue your exercise program, and maintain a diet high in omega-3 fatty acids."
"Continue your exercise program, and maintain a diet high in omega-3 fatty acids."
The nurse is providing postpartum care for a female patient who is prescribed methylergonovine. Which aspect of the patient's medical history would be a
contraindication for receiving this drug?
Hypertension
Uterine atony
Nausea and vomiting
Pelvic inflammatory disease
Pelvic inflammatory disease
Which monitoring parameter should be evaluated for drug effectiveness for a patient in labor who is receiving oxytocin? Select all that apply.
Fetal heart rate
Fetal movement
Uterine hyperactivity
The patient's blood pressure and pulse
Complete blood cell count
Fetal heart rate
Fetal movement
The patient's blood pressure and pulse
Which mechanism of action of raloxifene would the nurse include when conducting patient teaching?
Promotes bone absorption of calcium
Inhibits osteoclast-mediated bone reabsorption
Contains estrogen which stimulates bone reabsorption
Stimulates estrogen receptors on the bone to increase bone
density
Stimulates estrogen receptors on the bone to increase bone density
Which assessment finding indicates that a patient is a suitable candidate for oxytocin therapy?
Vaginal bleeding at 38 weeks' gestation
Ineffective contractions in a full-term pregnancy
Absence of cervical ripening at 42 weeks' gestation
Radiographic confirmation of cephalopelvic disproportion
Ineffective contractions in a full-term pregnancy
A patient with menopausal symptoms is seeking hormone replacement therapy During the assessment, the nurse finds that the patient has a history of endometrial cancer and is a smoker. Which information would the nurse provide to the patient?
"The therapy may cause thromboembolic events." "
"You may need to stop smoking during the therapy."
"The treatment should be started as soon as possible."
"The
treatment is likely to cause endometrial cancer."
"The therapy may cause thromboembolic events."
The nurse is assessing a female patient who has osteoporosis. The nurse finds that the patient is prescribed a bisphosphonate instead of calcitonin. Which aspect of the patient's medical history may be a reason for this prescription?
Breast cancer
Current smoker
Allergy to salmon
Joint
pain
Allergy to salmon
Which statement made by the patient indicates that ospemifene is effective?
"I no longer experience hot flashes."
"I have not experienced any uterine bleeding."
"I am no longer experiencing painful intercourse."
"I have seen a great improvement in my sexual desire."
"I am no longer experiencing painful intercourse."
Which medications listed in a patient's medical history concern the nurse for a patient prescribed raloxifene? Select all that apply.
Warfarin
Atenolol
Levothyroxine
Multivitamin
Cholestyramine
Warfarin
Cholestyramine
Which statement made by the nurse regarding the hormonal activity during the monthly menstrual cycle needs correction?
"Estrogen levels inhibit the release
of follicle-stimulating hormone."
"High progesterone levels inhibit the release of luteinizing hormone."
"Decreased Gn-RH suppresses the release of follicle-stimulating hormone."
"Surges of Gn-RH, follicle-stimulating hormone, and luteinizing hormone stimulate ovulation."
"High progesterone levels inhibit the release of luteinizing hormone."
The obstetrics nurse reviews a postpartum patient's
history. The patient is prescribed methylergonovine for control of postpartum hemorage. Which are essential nursing interventions for a pateint recieving this med? Select all that apply.
Monitor the patient for blurred vision.
Administer it before placenta delivery.
Monitor blood pressure during administration.
Assess for pelvic inflammatory disease.
Question the prescription if the patient has liver disease.
Monitor the patient for blurred
vision.
Monitor blood pressure during administration.
Assess for pelvic inflammatory disease.
Question the prescription if the patient has liver disease.
A female patient using contraceptives complains of headaches. Which contraceptive is the patient likely using?
Medroxyprogesterone
Cervical cap with spermicidal jelly
Norethindrone and ethinyl estradiol
Male condom with spermicidal jelly
Norethindrone and ethinyl estradiol
A 46-year-old female patient who complains of hot flashes, fatigue, and sleep disorders unwilling to start hormonal therapy. Which nursing intervention is appropriate for this patient?
Persuade the patient to start the therapy.
Ask the patient to include soy in her diet.
Advise the patient to engage in quiet activities.
Inform the patient about the benefits and risks of the therapy.
Ask the patient to include soy in her diet.
The clinical reports of a patient taking fertility drugs indicate an increase in prolactin concentrations, which leads to impaired fertility. Which information would the nurse obtain from the patient?
Current smoking status
Presence of abnormal uterine bleeding
Current use of medications for depression
Compliance with the fertility drugs
Presence of abnormal uterine bleeding
A female patient is taking estrogen with progesterone. To facilitate monitoring of the risks associated with this therapy, which instruction would the nurse include in patient teaching?
"Have a yearly mammogram."
"Have tests for serum cholesterol."
"Perform weight-bearing exercise."
"Report missed menstrual periods."
"Have a yearly mammogram."
The clinical report of a patient who is undergoing estrogen therapy indicates thrombosis. Which event may the nurse suspect as the cause of thrombosis?
Cigarette use
Low fluid intake
Use of herbal supplements
Current tricyclic antidepressant use
Cigarette use
The clinical reports of a patient taking a bisphosphonate and calcium supplement indicate poor therapeutic levels of the
bisphosphonate. Which changes in the medication administration will the nurse need to encourage the patient to implement?
"Discontinue the calcium supplement."
"Space the medications 1 to 2 hours apart."
"Replace the bisphosphonate with calcitonin."
"Obtain a prescription for increasing the bisphosphonate dose." supplements
"Space the medications 1 to 2 hours apart."
The labor and delivery nurse
is caring for a patient in preterm labor who is receiving indomethacin. The patient develops hypotension. Which action would the nurse perform?
Place the patient on her left side.
Immediately discontinue intravenous (IV) fluids.
Administer phentolamine mesylate.
Instruct the patient to bear down and push.
Place the patient on her left side.
Which condition is a contraindication to the use of oral
contraceptives?
Renal failure
Ovarian failure
Pulmonary embolism
Abnormal vaginal bleeding
Pulmonary embolism
The nurse is about to administer dinoprostone to a patient. Which condition is this medication used for?
Premature labor
Accelerated labor
Postpartum hemorrhage
Termination of pregnancy
Termination of pregnancy
What is the purpose of giving estrogen therapy in combination with progestins?
To treat ovarian cancer
To treat breast cancer
To prevent endometrial cancer
To reduce the chances of vaginal cancer
To prevent endometrial cancer
A pregnant patient is receiving magnesium sulfate to inhibit uterine contractions. The patient develops depressed reflexes and confusion. Which
medication does the nurse anticipate administering?
Epinephrine
Protamine sulfate
Calcium gluconate
Atropine
Calcium gluconate
The nurse at the fertility clinic is instructing a patient about the adverse effects of clomiphene. Which effects would the nurse instruct the patient to report to the health care provider? Select all that apply.
Anxiety
Hirsutism
Dizziness
Bradycardia
Blurred vision Increased diuresis
Anxiety
Dizziness
Blurred vision
Which medication may decrease the effectiveness of norethindrone and ethinyl estradiol?
Rifampin
Furosemide
Calcium citrate
Acetaminophen
Rifampin
Which statement indicates that the patient understands the benefit of continUous
administration of progestin with an estrogen regimen?
"Endometrial cancer risk can be reduced by adding progestin."
"The progestin in the regimen will help prevent breast cancer."
"The progestin in the regimen will help prevent ovarian cancer."
"Vaginal cancer is prevented by adding progestin to the regimen."
"Endometrial cancer risk can be reduced by adding progestin."
What is the reason for
prescribing dinoprostone to a patient who is at 38 weeks' gestation of pregnancy?
To terminate pregnancy
To induce cervical ripening
To treat gestational hypertension
To treat pelvic inflammatory disease
To induce cervical ripening
The nurse is assessing a patient who is prescribed estrogen replacement therapy. A history of which medical condition would be a contraindication to this therapy?
Weight loss
Dysmenorrhea
Uterine bleeding
Deep vein thrombosis
Deep vein thrombosis
Which black box warning for oral contraceptives would the nurse teach to a patient? Select all that apply.
Dementia Breast cancer
Ovarian cancer
Cigarette smoking
Cardiovascular disease
Serious cardiovascular events
Dementia
Breast cancer
Cigarette
smoking
Cardiovascular disease
Serious cardiovascular events
Which adverse reaction may occur as a result of raloxifene use during perimenopause?
Hot flashes
Loss of hair
Brown discoloration of face
Yellow undertone to the skin
Hot flashes
During a postpartum assessment, the nurse notes a boggy uterus and increased uterine bleeding. Which
drug would the nurse anticipate will be prescribed?
Oxytocin
Terbutaline
Clomiphene
Prostaglandin E
Oxytocin
Which hormone is responsible for initiating activity in the ovary?
Luteotropic hormone
Luteinizing hormone (LH)
Follicle-stimulating hormone (FSH)
Interstitial cell-stimulating hormone
Follicle-stimulating hormone (FSH)
Which medication is contraindicated in a patient who has osteoporosis and a history of deep vein thrombosis?
Raloxifene
Denosumab
Risedronate
Alendronate
Raloxifene
The nurse observes that a female patient is at risk for postpartum uterine hemorrhage. Which medication would the nurse discuss with the health care provider to initiate?
Estradiol
Megestrol
Alendronate
Methylergonovine
Methylergonovine
Which medication is used to treat hypogonadism?
Megestrol
Alendronate
Esterified estrogens
Medroxyprogesterone
Esterified estrogens
Which clinical manifestations can be observed in a patient who is receiving teriparatide therapy? Select all that apply.
Vertigo
Joint pain
Chest pain
Hot flashes
Loss of appetite
Vertigo
Joint pain
Chest pain
Which phase of the menstrual cycle involves the release of an unfertilized ovum?
Phase 1
Phase 2
Phase 3
Phase 4
Phase 3
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