After 12 months of cessation of menses, which of the following assessment findings in a client who is taking hormone replacement therapy should the nurse report to the physician immediately?
Answer(s): D
Uterine bleeding on combination hormone replacement therapy, after 12 months of menses cessation, indicates an increased risk of carcinoma and should be reported to the physician immediately.Breast tenderness, weight gain, and fluid retention are all routine side effects of hormone replacement therapy. They should be noted in the record and reported to the physician, but they are not urgent.
When a client wishes to improve her appearance by removing excess skin from her face and neck, the nurse should provide teaching regarding which of the following procedures?
Rhytidectomy is the procedure for removing excess skin from the face and neck. It is commonly called a face- lift.Dermabrasion involves the spraying of a chemical to cause light freezing of the skin, which is then abraded with sandpaper or a revolving wire brush. It is used to remove facial scars, severe acne, and pigment from tattoos. Rhinoplasty is performed to improve the appearance of the nose and involves reshaping the nasal skeleton and overlying skin.Blepharoplasty is the procedure that removes loose and protruding fat from the upper and lower eyelids.
All of the following are clinical manifestations indicating male climacteric except ______________.
Answer(s): B
The likelihood of fathering children does decrease with aging and decreased testosterone production, but men do not lose their ability to reproduce during the climacteric.Many men do not experience any physical symptoms of climacteric but some men do report hot flashes, headaches, and heart palpitations, among other symptoms.
When a middle-age woman says to the nurse, “I’m really worried about menopause. When my mom went through it, she got really depressed.”The nurse’s best response is ______________.
Answer(s): C
Choice “It sounds like you are worried that you might become depressed during menopause.” not only acknowledges the client’s fear but invites more disclosure and discussion. Reflective listening is very therapeutic and in this case acknowledges the woman’s unspoken fear that she might become depressed like her mother. When her fears have been acknowledged and she feels that the nurse understands, she will be more open to the teaching or interventions to follow.It is a myth that menopause causes depression, but to say that to this client does not acknowledge the fear she shared with the nurse and gives the impression the nurse doesn’t care about her concern. It closes down communication.It is also true that menopause is a normal developmental process. This can certainly be used in teaching but not to address her immediate concern; the client might feel the nurse doesn’t think her concern is appropriate because menopause is normal.If women experience depression during menopause, it is usually due to social stresses such as loss of loved ones, loss of roles, caregiver demands, and physical problems. Choice “When women experience depression during menopause it is usually because of social stresses.” is true but is a nontherapeutic response in this situation.
When a woman is receiving postpartum epidural morphine, the nurse should plan to observe for which of the following side effects to occur within the first 3 hours?
A side effect of postpartum epidural morphine is the onset of itching within 3 hours of injection and lasting up to 10 hours.Nausea and vomiting might occur 4-7 hours after injection.Urinary retention is a side effect of postpartum epidural morphine but is not assessed as such within the first 3 hours.Somnolence is a rare side effect.
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