A nurse provides teaching to a group of nursing students about the risks and benefits of hormone therapy (HT), including estrogen therapy (ET) and combination estrogen/progestin therapy (EPT). Which statement by a student indicates understanding of the teaching?

Correct Answer: D

Rationale: Estrogen therapy (ET) is primarily beneficial for suppressing menopausal symptoms like hot flashes and preventing bone loss (not reversing osteoporosis). It does not protect against coronary heart disease—studies show increased risks of stroke and breast cancer—and EPT (estrogen/progestin) is not safer, especially as progestin increases breast cancer risk. Option D correctly identifies the main benefits of ET, aligning with evidence-based teaching.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Metoprolol may mask signs of hypoglycemia, so you need to monitor your blood glucose closely. Explanation: Metoprolol, a beta-blocker, can mask the typical signs and symptoms of hypoglycemia such as tachycardia and tremors. This can lead to a delay in recognizing and treating low blood sugar levels in patients with diabetes, particularly those taking insulin like NPH insulin. Therefore, it is crucial for the patient to monitor their blood glucose levels regularly to catch any potential hypoglycemic episodes promptly. Why the other options are wrong: A) Metoprolol has no effect on diabetes mellitus or on your insulin requirements. - This is incorrect as metoprolol can indeed affect blood glucose levels in patients with diabetes. B) Metoprolol interferes with the effects of insulin, so you may need to increase your insulin dose. - This is incorrect; metoprolol does not directly interfere with insulin's effects. D) Metoprolol may potentiate the effects of the insulin, so the dose should be reduced. - This is incorrect as metoprolol masking hypoglycemic symptoms does not mean the insulin dose should be reduced. Educational context: Understanding the potential interactions between medications is vital for healthcare professionals to ensure patient safety. In the case of patients with diabetes, it is essential to educate them about how certain medications, like metoprolol, can impact their blood glucose levels and the importance of closely monitoring for signs of hypoglycemia. This knowledge empowers patients to take an active role in managing their condition and prevents potentially dangerous situations.

Correct Answer: C

Rationale: The correct answer is C) the patient is suffering from rebound congestion related to excessive use of the Afrin nasal spray. Rebound congestion can occur with prolonged or frequent use of nasal decongestants like Afrin, leading to a worsening of symptoms when the medication wears off. This phenomenon is due to the nasal passages becoming less responsive to the medication over time, resulting in increased congestion. Option A is incorrect because Afrin nasal spray is an effective decongestant when used appropriately. Option B is incorrect as using the medication every 30 minutes would likely lead to overuse and exacerbate the issue. Option D is incorrect as adrenergic decongestants like Afrin can be used to treat acute congestion but should be used judiciously to avoid rebound congestion. In an educational context, this question highlights the importance of patient education and proper use of medications. Healthcare providers must educate patients on the correct use of nasal decongestants to prevent rebound congestion and other potential side effects. Understanding the implications of overusing medications like Afrin is crucial in promoting safe and effective self-care practices.

Correct Answer: C

Rationale: The correct answer is C) acetaminophen (Tylenol) would be contraindicated or used cautiously for a client with a history of hypertension starting drug therapy for rheumatoid arthritis. Acetaminophen can potentially increase blood pressure, which can be problematic for someone with hypertension. A) Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) known to reduce inflammation and pain but is not contraindicated specifically for hypertension unless the person is sensitive to NSAIDs. B) Ibuprofen (Advil, Motrin) and D) Naproxen (Aleve) are both NSAIDs as well, and while they can affect blood pressure, they are not typically contraindicated solely based on a history of hypertension. However, caution should be exercised as they can cause fluid retention and affect kidney function. Educationally, understanding the interactions between medications and pre-existing conditions like hypertension is crucial for safe and effective patient care. It highlights the importance of thorough patient assessment and individualized treatment plans to minimize potential risks and complications.

Correct Answer: B

Rationale: The correct answer is B) the client is experiencing bone marrow suppression and his blood counts are at their lowest point. This finding signifies that the client is at the lowest point in terms of blood counts due to bone marrow suppression. The term "nadir" refers to the lowest point, and in this context, it indicates a decrease in blood cell production. This could lead to complications such as anemia, increased risk of infection, and bleeding tendencies. Option A is incorrect because nadir does not specifically refer to blood pressure but rather to the lowest point in a cycle, such as blood counts in this case. Option C is incorrect as nadir does not relate to nausea being at its peak. Option D is incorrect as nadir does not indicate the immune system being fully recovered. Educationally, understanding the concept of nadir in the context of bone marrow suppression is crucial for nurses caring for clients undergoing treatments that can affect blood cell production. Recognizing the significance of nadir can help nurses anticipate and manage potential complications related to low blood counts in these clients.