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 B
Explanation
Choice A reason: This response is overly simplistic and uses the word "cheating," which may sound accusatory and does not accurately explain the clinical rationale. The ADOS aims to assess a child's independent social, communicative, and behavioral functioning, not to catch parents assisting. Using such terminology may increase parental anxiety and reduce cooperation.
Choice B reason: This is the correct response because it clearly explains that the assessment's purpose is to observe the child’s behavior without parental influence. Parental presence can inadvertently alter a child's responses or behavior, potentially masking deficits in social communication or repetitive behaviors that are critical for the diagnosis of autism spectrum disorder. The phrasing reassures parents while providing a clear professional rationale.
Choice C reason: While the test may indeed be challenging, emphasizing the child’s potential inability to complete tasks is not the appropriate rationale for asking parents to leave. This approach may unnecessarily alarm parents and distract from the primary reason for their absence, which is to ensure accurate and unbiased assessment of the child.
Choice D reason: This answer incorrectly assumes that children’s distress is solely due to parental presence. While some children may behave differently with parents around, the main rationale for asking parents to leave is to obtain an independent assessment of the child's skills and behaviors, not simply to prevent emotional upset.
Correct Answer is D
Explanation
Choice A reason: Remdesivir is an antiviral agent without known psychostimulant or mood-elevating properties.
Choice B reason: Albuterol can cause mild nervousness or tachycardia but rarely induces full manic episodes.
Choice C reason: Famotidine is an H2 blocker and has no known association with mania.
Choice D reason: Dexamethasone is a corticosteroid that can induce psychiatric side effects, including mania, agitation, and psychosis, particularly in older adults or those with underlying vulnerability. The timeline and symptoms suggest steroid-induced mania.
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