A 51-year-old woman presents to the nurse practitioner with a chief complaint of "hot flashes." She describes the following symptoms: perspiration, flushing, chills, clamminess, anxiety, and occasional heart palpitations. Which of the following is the first-line treatment recommended by the American College of Obstetricians and Gynecologists (ACOG)?
Systemic estrogen hormone therapy (HT)
Clonidine (Catapres)
Gabapentin (Neurontin)
Ospemifene (Osphena)
The Correct Answer is A
Choice A reason: This is correct. Systemic estrogen therapy is the first-line treatment for moderate to severe vasomotor symptoms in perimenopausal and postmenopausal women. It effectively reduces hot flashes and associated symptoms.
Choice B reason: Clonidine, an alpha-2 adrenergic agonist, may help with vasomotor symptoms but is less effective and not considered first-line.
Choice C reason: Gabapentin can reduce hot flashes, especially in women who cannot take hormone therapy, but it is second-line.
Choice D reason: Ospemifene is used for dyspareunia related to vulvovaginal atrophy and does not treat vasomotor symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Acute lower back pain may complicate patient positioning or increase discomfort but is not an absolute contraindication to lumbar puncture.
Choice B reason: Osteoporosis increases fracture risk but does not directly contraindicate lumbar puncture; precautions can be taken.
Choice C reason: This is the correct answer. Increased intracranial pressure is a contraindication because removing cerebrospinal fluid in the setting of elevated intracranial pressure can precipitate brain herniation, which is life-threatening.
Choice D reason: Decreased cardiac output may increase procedural risk but is not an absolute contraindication to performing a lumbar puncture.
Correct Answer is D
Explanation
Choice A reason: Industry vs. Inferiority occurs in school-aged children and relates to competence, not isolation or emotional detachment.
Choice B reason: Initiative vs. Guilt occurs in early childhood and primarily influences purposeful action and initiative rather than adult interpersonal relationships.
Choice C reason: Identity vs. Role Confusion occurs in adolescence and relates to self-concept; failure here is associated with identity issues but not specifically with emotional detachment.
Choice D reason: Intimacy vs. Isolation occurs in young adulthood; failure to achieve intimacy can result in social withdrawal, emotional detachment, and difficulty forming close relationships, which is characteristic of schizoid personality disorder.
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