A patient who sustained a myocardial infarction comes to the clinic for a refill of atorvastatin calcium (Lipitor). The family nurse practitioner recognizes that the medication is prescribed for:

Correct Answer: C

Rationale: The correct answer is C) secondary prevention. In this scenario, the patient who suffered a myocardial infarction is being prescribed atorvastatin calcium (Lipitor) as part of secondary prevention. Secondary prevention involves interventions to prevent further complications or recurrence of a disease after an initial event has occurred. Atorvastatin is a statin medication that helps lower cholesterol levels in the blood, thereby reducing the risk of future cardiac events in individuals who have already experienced a myocardial infarction. Option A) cancer prevention is incorrect because atorvastatin is not indicated for preventing cancer. Options B) primary prevention and D) tertiary prevention are also incorrect in this context. Primary prevention focuses on preventing a disease before it occurs, while tertiary prevention involves managing complications and preventing further deterioration in individuals with established disease. Understanding the principles of client-centered care is crucial for healthcare providers to deliver individualized care that meets the specific needs of each patient. By recognizing the purpose of medications within the framework of preventive care, nurse practitioners can effectively educate patients on the importance of adherence to prescribed treatments to improve health outcomes and quality of life.

Correct Answer: A

Rationale: The main reason for administering a progestational medication to perimenopausal women who use estrogen is to decrease the risk of endometrial hyperplasia. Estrogen alone can stimulate the growth of the endometrial lining, potentially leading to hyperplasia which is a risk factor for endometrial cancer. By adding a progestational medication, it counteracts estrogen's effect on the endometrium, leading to shedding of the lining and reducing the risk of hyperplasia. Option A is correct because it directly addresses the main purpose of administering progestational medication in combination with estrogen therapy in perimenopausal women. Option B, preventing hot flashes, is incorrect as progestational medication is not primarily used for this purpose. Hot flashes are more commonly managed with estrogen therapy alone. Option C, preventing osteoporosis, is also incorrect as progestational medication does not have a direct role in preventing osteoporosis. Estrogen therapy is typically used for this purpose due to its beneficial effects on bone density. Option D, promoting the growth of the uterine lining, is incorrect as this is the opposite of what progestational medication aims to do. Progestational medication works to counteract the proliferative effect of estrogen on the endometrium. Understanding the rationale behind the use of progestational medication in combination with estrogen therapy is crucial for healthcare providers caring for perimenopausal women. It is essential to grasp the pharmacological actions of these medications to provide safe and effective care, minimize risks, and promote optimal health outcomes for patients.

Correct Answer: A

Rationale: The correct answer is A) continue to nurse with both breasts. This is the most appropriate course of action for a nursing mother with postpartum mastitis for several reasons. Firstly, continuing to nurse helps to fully empty the affected breast, which aids in resolving the mastitis by relieving the milk backlog that may be contributing to the infection. Additionally, breastfeeding helps maintain milk supply and prevents engorgement, which can worsen the condition. Option B) pump the unaffected breast with a lactation pump is not the best choice because it does not fully drain the affected breast and may lead to further engorgement and exacerbation of the mastitis. Option C) take cool showers may provide some comfort for the mother but does not address the underlying issue of milk stasis and infection within the breast. Option D) temporarily switch to formula is not recommended as breastfeeding should be continued if possible to maintain milk supply and provide optimal nutrition for the baby. In an educational context, it is important for healthcare providers, especially nurse practitioners, to have a thorough understanding of client-centered care principles when managing postpartum mastitis. By encouraging and supporting the nursing mother to continue breastfeeding with both breasts while also following the prescribed antibiotic regimen, the nurse practitioner is promoting an approach that is evidence-based, safe, and supports the overall well-being of both the mother and the infant. This approach aligns with the principles of client-centered care by considering the individual needs and preferences of the mother while also promoting best practices for managing mastitis.

Correct Answer: A

Rationale: The correct answer is A) Complete blood count (CBC). When an older adult patient is prescribed zidovudine (Retrovir) for HIV infection, it is crucial to monitor for potential side effects, such as bone marrow suppression. A CBC is essential for assessing the patient's red blood cell count, white blood cell count, and platelet count. Specifically, it helps to detect anemia or neutropenia, which are common side effects of zidovudine therapy. Option B) Hemoglobin A1C is a test used to monitor long-term blood sugar control in patients with diabetes. It is not directly related to assessing the side effects of zidovudine. Option C) Immunodeficiency panel is a test that evaluates the function of the immune system, not specifically related to monitoring the side effects of zidovudine. Option D) Serum glucose is a test used to measure the amount of glucose in the blood and is mainly utilized in diagnosing and monitoring diabetes. It is not the most appropriate test for assessing the side effects of zidovudine. Educational Context: Understanding the importance of monitoring medication side effects through appropriate diagnostic tests is crucial in providing client-centered care. In the case of zidovudine therapy for HIV patients, regular monitoring with a CBC helps healthcare providers detect and manage potential adverse effects promptly. This educational rationale highlights the significance of tailored diagnostic assessments in promoting the well-being of older adult patients undergoing complex medical treatments like antiretroviral therapy.

Correct Answer: D

Rationale: The planning step of the nursing process involves setting goals and selecting interventions. This step is crucial in developing a care plan for the patient. Setting goals helps to establish what the desired outcomes of the nursing care should be, while selecting interventions involves determining the appropriate actions that need to be taken to achieve those goals. Assessing and diagnosing are part of the initial steps in the nursing process, while evaluating goal achievement and performing nursing actions and documenting them are steps that come after the planning phase.