The practical nurse (PN) is obtaining information from a female client who is starting a new prescription for conjugated estrogens 0.625 mg PO daily. Prior to the client taking the first dose of the medication, which information should the PN obtain?

Family history of hypertension

Use of soft lens contacts

Amount of daily sunlight exposure

Cigarette smoking history

Answer and Explanation

The Correct Answer is D

Choice A reason: Family history of hypertension is relevant for cardiovascular risk but less critical than smoking for estrogen therapy. Estrogens increase blood pressure slightly, but smoking directly amplifies thromboembolism risk, a major contraindication, making this choice secondary for immediate safety assessment.

Choice B reason: Soft lens use may cause discomfort with estrogens due to corneal changes, but this is a minor side effect. Thromboembolism risk, heightened by smoking, is far more severe, requiring priority assessment, as lens issues do not pose life-threatening risks.

Choice C reason: Sunlight exposure is unrelated to conjugated estrogens, which do not cause photosensitivity. Hormone therapy affects clotting and cardiovascular risk, not skin reactions to UV light, making this choice irrelevant for assessing safety before initiating estrogen treatment.

Choice D reason: Cigarette smoking history is critical, as smoking increases thromboembolism risk with conjugated estrogens, which promote clotting by altering coagulation factors. This risk is especially high in women over 35, necessitating smoking cessation or alternative therapies to prevent potentially fatal complications.

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Correct Answer is D

Explanation

Choice A reason: Stating that HIV is not cured by antiretrovirals is correct, as these drugs suppress viral replication but do not eradicate the virus. HIV integrates into host DNA, requiring lifelong therapy. This understanding is accurate, requiring no further review from the PN.

Choice B reason: Antiretrovirals reduce AIDS-related complications by suppressing viral load, preserving immune function, and preventing opportunistic infections. This statement is correct, reflecting the drugs’ role in maintaining CD4 counts and immune health, so no additional instruction is needed.

Choice C reason: Antiretrovirals can reduce viral load to undetectable levels, preventing disease progression and transmission risk. This is accurate, as effective therapy lowers plasma HIV RNA, aligning with treatment goals. The statement requires no further review, as it reflects correct understanding.

Choice D reason: Claiming antiretrovirals prevent transmission is inaccurate, as they reduce but do not eliminate transmission risk. Undetectable viral loads lower risk significantly, but transmission is still possible, especially with inconsistent adherence. This misstatement requires review to clarify transmission risks.

A. Stop the drug if nausea, vomiting, and/or prostration occur B. Avoid all sources of alcohol while taking this drug, including cough syrups C. The medication should be taken at the same time each day D. Have weekly blood tests to determine therapeutic drug levels and serum sodium

Correct Answer is B

Explanation

Choice A reason: Stopping disulfiram for nausea or vomiting is incorrect, as these are expected in alcohol reactions, not side effects warranting discontinuation. Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde buildup if alcohol is consumed, leading to these symptoms, which reinforce alcohol avoidance.

Choice B reason: Avoiding all alcohol, including in cough syrups, is critical, as disulfiram causes severe reactions (flushing, nausea) by blocking acetaldehyde metabolism. Even small amounts trigger symptoms, reinforcing abstinence in alcohol dependence treatment, making this the most important instruction for safety and efficacy.

Choice C reason: Taking disulfiram at the same time daily promotes adherence but is less critical than avoiding alcohol, which directly prevents severe reactions. Consistency aids therapeutic levels, but alcohol exposure poses immediate health risks, making this instruction secondary.

Choice D reason: Weekly blood tests are not standard for disulfiram, as therapeutic levels are not routinely monitored, and sodium is unaffected. Liver function may be checked periodically, but alcohol avoidance is the priority to prevent acute reactions, making this choice incorrect.

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The practical nurse (PN) is obtaining information from a female client who is starting a new prescription for conjugated estrogens 0.625 mg PO daily. Prior to the client taking the first dose of the medication, which information should the PN obtain?

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Naxlex Comprehensive Predictor Exams

The practical nurse (PN) is reinforcing information with a client who has been diagnosed with human immunodeficiency virus (HIV) about the antiretroviral medication regimen. Which client statement should the PN recognize as requiring an additional review of the information?

Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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