Review Medications and Indications:
Tamoxifen/Breast Cancer (med surg ch 58)
The nurse is caring for a 52-year-old woman whose aunt and mother died of breast cancer. The
patient states, My doctor and I talked about Tamoxifen to help prevent breast cancer. Do you
think it will work? What would b...
review medications and indications tamoxifenbreast cancer med surg ch 58 the nurse is caring for a 52 year old woman whose aunt and mother died of breast cancer the patient state
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3/27/2019 Blueprint & Test Bank Questions - Google Docs
MATERNAL NEWBORN
Review Medications and Indications:
Tamoxifen/Breast Cancer (med surg ch 58)
The nurse is caring for a 52-year-old woman whose aunt and mother died of breast cancer. The
patient states, My doctor and I talked about Tamoxifen to help prevent breast cancer. Do you
think it will work? What would be the nurses best response?
A) Yes, its known to have a slight protective effect.
B) Yes, but studies also show an increased risk of osteoporosis.
C) You wont need to worry about getting cancer as long as you take Tamoxifen.
D) Tamoxifen is known to be a highly effective protective measure.
Ans:
D
Feedback:
Tamoxifen has been shown to be a highly effective chemopreventive agent. However, it cannot
reduce the risk of cancer by 100%. It also acts to prevent osteoporosis.
Vibramycin/Pregnancy
The nurse is seeing clients in the womens clinic. Which client should be treated with ceftriaxone
IM and doxycycline orally?
1. A pregnant client with gonorrhea and a yeast infection
2. A nonpregnant client with gonorrhea and chlamydia
3. A pregnant client with syphilis
4. A nonpregnant client with chlamydia and trichomoniasis
Answer: 2
Explanation: 2. The combined treatment of ceftriaxone IM and doxycycline orally provides dual
treatment for gonorrhea and chlamydia, which frequently occur together.
Danazol/Endometriosis
The nurse is caring for a client diagnosed with endometriosis. Which statement by the client
would require a need for perhaps another treatment option?
1. I am having many hot flashes since I had the Lupron injection.
2. The pain I experience with intercourse is becoming more severe.
3. I have vaginal dryness, reduced libido, and my clitoris has become larger since taking
danazol. Is this normal?
4. Ive noticed I have not had my period on a regular basis since being on the GnRH analogs.
Answer: 3
Explanation: 3. Danazol is a testosterone derivative that suppresses ovulation and causes
amenorrhea. It is intended for short-term therapy. Because of adverse effects, many clinicians
have moved away from danazol to other treatment options.
,3/27/2019 Blueprint & Test Bank Questions - Google Docs
Metronidazole/Bacterial infections
A nonpregnant client is diagnosed with bacterial vaginosis (BV). What does the nurse expect to
administer?
1. Penicillin G 2 million units IM one time
2. Zithromax 1 mg p.o. b.i.d. for 2 weeks
3. Doxycycline 100 mg p.o. b.i.d. for a week
4. Metronidazole 500 mg p.o. b.i.d. for a week
Answer: 4
Explanation: 4. The nonpregnant woman who is diagnosed with bacterial vaginosis (BV) is
treated with metronidazole 500 mg orally twice a day for 7 days.
Gardisil/HPV immunization
A 12-year-old girl and her mother are at the doctors office for a routine check-up for the
daughter. The mother tells the nurse that she would like the daughter to have the Gardasil
vaccine that is effective against the human papilloma virus. The nurse does some teaching, and
knows it has been successful when the mother makes which statement?
1. The human papilloma virus is spread through casual contact in schools.
2. Gardasil will protect against all types of the human papilloma virus.
3. The human papilloma virus affects a million people in the United States.
4. Gardasil will be given to my daughter in three doses.
Answer: 4
Explanation: 4. This is true. The vaccine is given in three doses.
Penicillin G/PID
Rhogam indications/Rh negative blood
A clinic nurse is planning when to administer Rh immune globulin (RhoGAM) to an Rh-negative
pregnant client. When should the first dose of RhoGAM be administered?
1. After the birth of the infant
2. 1 month postpartum
3. During labor
4. At 28 weeks gestation
Answer: 4
Explanation: 4. When the woman is Rh negative and not sensitized and the father is Rh positive
or unknown, Rh immune globulin is given prophylactically at 28 weeks gestation.
The client with blood type A, Rh-negative, delivered yesterday. Her infant is blood type AB,
Rh-positive. Which statement indicates that teaching has been effective?
1. I need to get RhoGAM so I dont have problems with my next pregnancy.
2. Because my baby is Rh-positive, I dont need RhoGAM.
,3/27/2019 Blueprint & Test Bank Questions - Google Docs
3. If my baby had the same blood type I do, it might cause complications.
4. Before my next pregnancy, I will need to have a RhoGAM shot.
Answer: 1
Explanation: 1. Rh-negative mothers who give birth to Rh-positive infants should receive Rh
immune globulin (RhoGAM) to prevent alloimmunization.
Cefotetan (cephalosporins)
The nurse is caring for a client hospitalized for pelvic inflammatory disease. Which nursing
intervention would have priority?
1. Encourage oral fluids
2. Administer cefotetan IV
3. Enforce bed rest
4. Remove IUC, if present
Answer: 2
Explanation: 2. Administration of medications to treat the disease is the first priority.
Acyclovir/HSV
A client comes to the clinic complaining of difficulty urinating, flu-like symptoms, genital tingling,
and blister-like vesicles on the upper thigh and vagina. She denies having ever had these
symptoms before. The medication the physician is most likely to order would be:
1. Oral acyclovir
2. Ceftriaxone IM
3. Azithromycin p.o.
4. Penicillin G IM
Answer: 1
Explanation: 1. Malaise, dysuria, and tingling or painful vesicles are indicative of a primary
herpes simplex outbreak. Acyclovir treats herpes.
Topics for Review:
Functions of the placenta (chapter 10)
During a prenatal examination, an adolescent client asks, How does my baby get air? What
correct information would the nurse give?
1. The lungs of the fetus carry out respiratory gas exchange in utero similar to what an adult
experiences.
2. The placenta assumes the function of the fetal lungs by supplying oxygen and allowing the
excretion of carbon dioxide into your bloodstream.
3. The blood from the placenta is carried through the umbilical artery, which penetrates the
abdominal wall of the fetus.
, 3/27/2019 Blueprint & Test Bank Questions - Google Docs
4. The fetus is able to obtain sufficient oxygen due to the fact that your hemoglobin
concentration is 50% greater during pregnancy.
Answer: 2
Explanation: 2. The placenta assumes the function of the fetal lungs by supplying oxygen and
allowing the excretion of carbon dioxide into the maternal bloodstream.
The client has read that the placenta produces hormones that are vital to the function of the
fetus. It is evident that that the client understands the function of the placenta when she states
that which hormone is primarily responsible for the maintenance of pregnancy past the 11th
week?
1. Human chorionic gonadotropin (hCG)
2. Human placental lactogen (hPL)
3. Estrogen
4. Progesterone
Answer: 4
Explanation: 4. Progesterone is a hormone essential for pregnancy. After the 11th week, the
placenta produces enough progesterone and estrogen to maintain pregnancy.
The nurse teaching the expectant parents about the placenta also talks about the circulation
and how the fetus gets its oxygen. She will include in this teaching which important fact?
1. The placenta functions as the lungs for the fetus.
2. The fetus obtains its oxygen from the amniotic fluid.
3. The fetus receives its oxygen by osmosis from the mothers bloodstream.
4. Fetal circulation delivers the highest amount of oxygen to the abdomen and lower body of the
fetus.
Answer: 1
Explanation: 1. Most of the blood supply bypasses the fetal lungs because they do not carry out
respiratory gas exchange. The placenta assumes the function of the fetal lungs by supplying
oxygen and allowing the fetus to excrete carbon dioxide into the maternal bloodstream.
Presumptive, Probable and Positive Signs of Pregnancy
14) The client in the prenatal clinic tells the nurse that she is sure she is pregnant because she
has not had a menstrual cycle for 3 months, and her breasts are getting bigger. What response
by the nurse is best?
1. Lack of menses and breast enlargement are presumptive signs of pregnancy.
2. The changes you are describing are definitely indicators that you are pregnant.
3. Lack of menses can be caused by many things. We need to do a pregnancy test.
4. Youre probably not pregnant, but we can check it out if you like.
Answer: 3
Explanation: 3. This is a true statement, and addresses that these changes could be caused by
conditions other than pregnancy.
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