A postmenopausal patient who has had a hysterectomy and who has a family history of coronary heart disease reports experiencing vaginal dryness and pain with intercourse but tells the nurse that she does not want to take hormones because she is afraid of adverse effects. The nurse will suggest that the woman ask her provider about:

Correct Answer: D

Rationale: In this scenario, the nurse should suggest that the postmenopausal patient with vaginal dryness and pain during intercourse ask her provider about option D) Premarin vaginal. Premarin is a vaginal estrogen cream that can help alleviate symptoms of vaginal atrophy without systemic absorption, reducing the risk of adverse effects associated with oral hormone therapy. Option A) Depo Provera is a contraceptive injection containing medroxyprogesterone, not an estrogen therapy for vaginal atrophy. Option B) Estraderm is a transdermal estrogen patch used for systemic hormone replacement therapy, which the patient wants to avoid due to fear of adverse effects. Option C) low-dose estrogens is a general term and lacks specificity compared to the targeted treatment with Premarin vaginal. Educationally, it is crucial to understand the different options for managing symptoms of menopause, considering patient preferences, risks, and benefits of each therapy. Providing tailored information empowers patients to make informed decisions about their health and well-being. It is essential for nurses to stay updated on current evidence-based practice guidelines to offer the best recommendations to patients.

Correct Answer: D

Rationale: Tadalafil, a PDE-5 inhibitor, is contraindicated with nitrates (e.g., Nitro-tab) due to profound hypotension risk from enhanced vasodilation. Other drugs (A, C: beta-blockers; B: antibiotic) may require caution but aren’t absolute contraindications, making option D the critical finding necessitating discontinuation.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Hyperglycemia. Isoproterenol is a beta-adrenergic agonist that can stimulate the beta-2 receptors in the body, leading to the relaxation of uterine smooth muscle and delaying preterm labor. However, one of the side effects of beta-adrenergic agonists like isoproterenol is an increase in blood glucose levels. Option A) Bronchospasm is not the expected side effect of isoproterenol. Isoproterenol primarily affects the beta-2 receptors in the uterus and does not significantly impact the beta-1 receptors in the lungs, which are associated with bronchospasm. Option B) Decreased urine output is not a typical side effect of isoproterenol. In fact, beta-2 agonists like isoproterenol can lead to vasodilation and increased blood flow to the kidneys, potentially resulting in increased urine output. Option D) Hypotension is not the expected side effect of isoproterenol. Isoproterenol, by stimulating beta receptors, usually causes vasodilation and an increase in heart rate, which can lead to increased blood pressure rather than hypotension. Educationally, understanding the pharmacological effects and side effects of medications used in pregnancy is crucial for nurses caring for pregnant patients with comorbidities. It is essential to know the potential impacts of medications on both the mother and the developing fetus to provide safe and effective care.

Correct Answer: B

Rationale: In the context of pharmacology education, the correct answer, B) "the pt. will demonstrate self-administration of med using a pre-load syringe into the subcutaneous tissue of thigh, prior to discharge," represents an appropriate outcome established during the planning phase. This outcome is specific, measurable, achievable, relevant, and time-bound (SMART), which is crucial in goal-setting for patient education. Option A is not as specific as option B because teaching a patient to recognize and respond to adverse effects is important but doesn't directly measure the patient's ability to self-administer medication. Option C focuses solely on preparing the dose of medication, which may not encompass the full scope of medication administration. Option D is vague and lacks the specificity needed for a well-defined outcome in the planning phase. Educationally, it is essential to set clear, achievable outcomes to guide patient education effectively. By focusing on specific tasks like self-administration of medication, educators can ensure that patients acquire the necessary skills to manage their medications safely and effectively, leading to improved health outcomes. This approach also empowers patients to take an active role in their healthcare, promoting autonomy and adherence to medication regimens.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Diflucan interacts with certain antidiabetic medications, causing hypoglycemia. When a diabetic patient taking fluconazole, a medication used to treat fungal infections, is also on antidiabetic medications such as insulin or sulfonylureas, there is a risk of drug interaction leading to hypoglycemia (low blood sugar). This interaction can potentiate the effects of antidiabetic medications, resulting in dangerously low blood glucose levels. Option A is incorrect because fluconazole does not antagonize the effects of antidiabetic medications to cause hyperglycemia. Option C is incorrect because fluconazole itself does not directly cause hyperglycemia. Option D is incorrect because fluconazole does not typically cause hypoglycemia on its own, but rather through interactions with antidiabetic medications. Educationally, understanding drug interactions is crucial in pharmacology across the lifespan to ensure the safe and effective management of conditions like diabetes. Healthcare providers must be vigilant in monitoring patients, especially those with complex medication regimens, to prevent adverse events such as hypoglycemia in diabetic patients taking fluconazole. Regular blood glucose monitoring is essential to detect and manage any fluctuations promptly.