A 51-year-old woman will be taking selective estrogen receptor modulators (SERMs) as part of treatment for postmenopausal osteoporosis. The nurse reviews potential contraindications, including which condition?

Venous thromboembolism

Breast cancer

Hypocalcemia

Stress fractures

Answer and Explanation

The Correct Answer is A

Choice A reason: Venous thromboembolism is a contraindication for taking SERMs. SERMs are drugs that act like estrogen in some tissues and block estrogen in others. They can help prevent bone loss and fractures in postmenopausal women, but they can also increase the risk of blood clots in the veins, such as deep vein thrombosis and pulmonary embolism. Therefore, women who have a history of or are at high risk for venous thromboembolism should not take SERMs.

Choice B reason: Breast cancer is not a contraindication for taking SERMs. In fact, some SERMs, such as tamoxifen and raloxifene, are used to treat or prevent breast cancer in women who have estrogen receptor-positive tumors. These SERMs block the effects of estrogen in the breast tissue and reduce the growth of cancer cells.

Choice C reason: Hypocalcemia is not a contraindication for taking SERMs. Hypocalcemia is a low level of calcium in the blood. SERMs do not affect calcium levels directly, but they can help prevent calcium loss from the bones by mimicking the effects of estrogen in the bone tissue. However, women who take SERMs should also take adequate calcium and vitamin D supplements to maintain bone health.

Choice D reason: Stress fractures are not a contraindication for taking SERMs. Stress fractures are small cracks in the bones that result from repeated stress or overuse. SERMs can help prevent stress fractures by strengthening the bones and reducing the risk of osteoporosis. However, women who take SERMs should also avoid excessive or inappropriate physical activity that can cause stress fractures.

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Correct Answer is B

Explanation

Choice A reason: This is incorrect because NPH insulin is normally cloudy and should be gently mixed before use. However, the nurse should discard the solution if it has clumps, flakes, or crystals.

Choice B reason: This is correct because NPH insulin is an intermediate-acting insulin that has a slower onset and longer duration than short-acting or rapid-acting insulins. The nurse should explain to the client that NPH insulin provides basal coverage and may need to be combined with other types of insulin to control blood glucose levels.

Choice C reason: This is incorrect because freezing insulin can damage its potency and effectiveness. The nurse should instruct the client to store unopened insulin vials in the refrigerator and opened vials at room temperature.

Choice D reason: This is incorrect because shaking insulin can cause air bubbles and frothing, which can affect the accuracy of the dose. The nurse should instruct the client to roll the insulin vial between the palms of the hands to mix it gently.

A. Increased intestinal peristalsis B. Bronchial constriction C. Increased heart rate D. Constricted pupils

Correct Answer is C

Explanation

Choice A reason: Increased intestinal peristalsis is not an effect of adrenergic agonist drugs, but rather of cholinergic drugs, which stimulate the parasympathetic nervous system. Adrenergic agonist drugs activate the sympathetic nervous system, which decreases intestinal motility.

Choice B reason: Bronchial constriction is also not an effect of adrenergic agonist drugs, but rather of cholinergic drugs, which cause bronchoconstriction and increased secretions. Adrenergic agonist drugs cause bronchodilation and decreased secretions.

Choice C reason: Increased heart rate is an effect of adrenergic agonist drugs, which stimulate the beta-1 receptors in the heart, causing increased cardiac output and blood pressure. This is why adrenergic agonist drugs are used to treat conditions such as shock, cardiac arrest, and heart failure.

Choice D reason: Constricted pupils is not an effect of adrenergic agonist drugs, but rather of cholinergic drugs, which cause miosis or pupil constriction. Adrenergic agonist drugs cause mydriasis or pupil dilation.

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A 51-year-old woman will be taking selective estrogen receptor modulators (SERMs) as part of treatment for postmenopausal osteoporosis. The nurse reviews potential contraindications, including which condition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if their blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

Correct Answer is B

Explanation

When a patient is taking an adrenergic agonist drug, the nurse expects to observe which effect?

Correct Answer is C

Explanation

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