Scenario:

A nurse is caring for a 32-year-old female client who was recently diagnosed with endometriosis. The client is in the clinic for a follow-up visit after beginning nafarelin treatment.

Setting: Clinic

Exhibits

Which of the following manifestations reported by the client should the nurse identify as a therapeutic effect of the nafarelin? (Select all that apply.)

CNS manifestations

Pain level during sexual intercourse

Nasal mucosa changes

Breast changes

Missed previous month's menstrual cycle

Dermatological manifestations

Answer and Explanation

Correct Answer : B,E

Choice A rationale: CNS manifestations such as headaches are not a therapeutic effect of nafarelin. These are side effects of the medication. Nafarelin, a gonadotropin-releasing hormone (GnRH) agonist, works by reducing the production of estrogen in the body. This can lead to a variety of side effects, including headaches. While these side effects can be bothersome, they do not indicate that the medication is effectively treating the endometriosis.

Choice B rationale: The reduction in pain level during sexual intercourse, or dyspareunia, is a therapeutic effect of nafarelin. Endometriosis can cause painful sexual intercourse, and one of the goals of treatment with nafarelin is to reduce this pain. The client’s report of decreased dyspareunia suggests that the nafarelin is effectively treating the endometriosis.

Choice C rationale: Changes in the nasal mucosa, such as irritation, are not a therapeutic effect of nafarelin. These are side effects of the medication. Nafarelin is administered intranasally, which can lead to irritation of the nasal mucosa. While this side effect can be bothersome, it does not indicate that the medication is effectively treating the endometriosis.

Choice D rationale: Changes in breast size are not a therapeutic effect of nafarelin. These are side effects of the medication. Nafarelin can cause a variety of side effects, including changes in breast size. While this side effect can be bothersome, it does not indicate that the medication is effectively treating the endometriosis.

Choice E rationale: The absence of menstruation, or amenorrhea, is a therapeutic effect of nafarelin. Nafarelin works by reducing the production of estrogen in the body, which can lead to a temporary halt in menstruation. This is a therapeutic effect as it can help to reduce the pain and other symptoms associated with endometriosis.

Choice F rationale: Dermatological manifestations such as increased acne are not a therapeutic effect of nafarelin. These are side effects of the medication. Nafarelin can cause a variety of side effects, including increased acne. While this side effect can be bothersome, it does not indicate that the medication is effectively treating the endometriosis.

Nursing Test Bank

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Correct Answer is D

Explanation

Choice A rationale

Vitamin K is not the antidote for heparin. It is used to reverse the effects of warfarin, which is a vitamin K antagonist.

Choice B rationale

Iron is not related to the reversal of heparin. It is a mineral that is crucial for many bodily functions, including the transport of oxygen in the blood.

Choice C rationale

Glucagon is a hormone that raises the level of glucose in the blood. It is not used as an antidote for heparin.

Choice D rationale

Protamine is the correct choice. Protamine sulfate is a drug that reverses the anticoagulant effects of heparin by binding to it and forming a stable complex, thereby neutralizing its anticoagulant activity.

A. I will stop taking orlistat and call my doctor if my urine gets darker in color. B. I will take my dose of orlistat every morning an hour before breakfast. C. I will feel less hungry during meals while I am taking orlistat. D. I will eat a no-fat diet to prevent side effects from the medication.

Correct Answer is A

Explanation

Choice A rationale

Orlistat works by inhibiting the absorption of dietary fats in the body, which are then excreted in the stool. One of the side effects of this process can be changes in bowel habits, including an increase in the frequency of bowel movements and an oily discharge. Dark urine can be a sign of liver damage, which is a rare but serious side effect of orlistat. Therefore, if a patient notices their urine getting darker in color while taking orlistat, they should stop taking the medication and call their doctor immediately.

Choice B rationale

Orlistat should be taken with a meal that contains fat, not necessarily before breakfast. If a meal is missed or contains no fat, the dose of orlistat should be skipped.

Choice C rationale

Orlistat does not directly affect hunger signals or the feeling of fullness. It works in the digestive system to block about one-third of the fat in the food you eat from being digested.

Choice D rationale

While it’s important to maintain a balanced, reduced-calorie diet while taking orlistat, a no-fat diet is not recommended. Orlistat works by blocking the absorption of some of the fat from meals. If a meal contains no fat, there is no fat for orlistat to block.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient who is receiving heparin by continuous IV infusion.Which of the following medications should the nurse plan to administer in the event of an overdose?

Correct Answer is D

Explanation

A nurse is educating a patient with binge eating disorder and morbid obesity who has been prescribed orlistat. Which of the following statements, if made by the patient, would indicate that they understand the teaching?

Correct Answer is A

Explanation

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