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NR568 Week 4 Midterm Exam

 

 

Question:
A 67-year-old female patient is concerned about the risks of hormone replacement therapy (HRT), particularly dementia. What should you inform her about the risks of HRT and dementia?

✅ A. Estrogen therapy increases dementia risk in women 65 and older.

1. Progestin therapy alone increases the risk of dementia in women of all ages.
2. Hormone therapy has no impact on dementia risk across the lifespan.
3. Estrogen therapy reduces the risk of dementia in women 65 and older.

Question:
A 35-year-old female presents with symptoms of a urinary tract infection (UTI), including dysuria and increased urinary frequency. A urine culture confirms Escherichia coli susceptible to nitrofurantoin, trimethoprim-sulfamethoxazole (TMP-SMX), and ciprofloxacin. Which is the MOST appropriate first-line treatment?

1. Amoxicillin-clavulanate 875/125 mg twice daily for 7 days

✅ B. Nitrofurantoin 100 mg twice daily for 5 days

1. Ciprofloxacin 500 mg twice daily for 3 days
2. Trimethoprim-sulfamethoxazole 800/160 mg twice daily for 3 days

 

Question:
A 55-year-old female patient with a history of breast cancer is experiencing severe menopausal symptoms. Which of the following is the best management option for her symptoms?

✅ A. Non-hormonal therapy

1. Combined estrogen-progestin therapy
2. Testosterone therapy
3. Estrogen therapy

Question:
A 58-year-old postmenopausal woman has been on systemic hormone therapy for 5 years to manage vasomotor symptoms. She expresses concern about continuing therapy and requests guidance. What is the MOST appropriate recommendation for this patient?

1. Discontinue hormone therapy abruptly and switch to non-hormonal options
2. Switch to an oral contraceptive with lower estrogen content
3. Continue hormone therapy indefinitely for symptom control

✅ D. Gradually taper the hormone therapy while monitoring symptoms

Question:
A 68-year-old male with a history of hypertension and angina is seeking treatment for erectile dysfunction. He is currently prescribed nitroglycerin for angina. Why should PDE-5 inhibitors, such as sildenafil (Viagra), be AVOIDED in this patient?

✅ A. They can cause severe, refractory hypotension when combined with nitrates

1. They interact with CYP3A4 inhibitors like nitroglycerin and increase the risk of death
2. They increase the risk of priapism and tissue necrosis
3. They can exacerbate hypertension, leading to stroke or MI

Question:
A 60-year-old patient with a history of type 2 diabetes presents with itching, redness, and a white, curd-like discharge in the genital area. The diagnosis is confirmed as vulvovaginal candidiasis. Based on evidence-based prescribing guidelines, which treatment strategy is MOST appropriate?

✅ A. Prescribe oral fluconazole 150 mg every 72 hours for three doses

1. Prescribe topical nystatin cream twice daily for 7 days
2. Prescribe oral fluconazole 150 mg as a single dose
3. Recommend over-the-counter clotrimazole cream for 3 days without further follow-up

Question:
Sildenafil should not be used in patients with which condition due to its potential adverse effects?

1. Heart failure
2. Hepatitis
3. Candidiasis

✅ D. Renal insufficiency

Question:
A 19-year-old sexually active female asks if routine chlamydia screening is necessary. Which response is most accurate?

1. Chlamydia screening is only recommended for women who are pregnant or planning pregnancy.

✅ B. You should be screened for chlamydia annually if you are sexually active, regardless of your risk factors.

25. Chlamydia screening is not necessary for women under age 25.
26. You should only be screened if you have symptoms or are at high risk.

Question:
A 50-year-old patient presents with herpes zoster symptoms for 48 hours. Which antiviral medication is MOST appropriate?

1. Acyclovir 400 mg twice daily for 5 days
2. Famciclovir 500 mg once daily for 10 days
3. Oseltamivir 75 mg twice daily for 5 days

✅ D. Valacyclovir 1000 mg three times daily for 7 days

Question:
A patient presents with conjunctivitis related to contact lens use. Which antibiotic is the MOST appropriate treatment?

1. Vancomycin ophthalmic drops
2. Ceftriaxone ophthalmic drops
3. Amoxicillin ophthalmic drops

✅ D. Besifloxacin ophthalmic drops

Question:
A 51-year-old postmenopausal woman is considering estradiol therapy for hot flashes and vaginal dryness. Which response by the nurse practitioner is MOST appropriate?

1. Vaginal creams are the most effective for all menopausal symptoms.
2. Estradiol is only available as an oral pill.
3. The transdermal patch is the only safe option.

✅ D. Estradiol is available as an oral pill, transdermal patch, vaginal cream, or vaginal ring, allowing flexibility depending on symptoms and preferences.

Question:
A 35-year-old female patient is using a transdermal estrogen spray for the first time. What direction should the nurse practitioner provide?

✅ A. Apply the spray at the same time daily.

1. Allow the spray to dry for 2 minutes before dressing.
2. Increase the dose if symptoms persist.
3. Spray it into the vagina for best absorption.

Question:
A 65-year-old male with erectile dysfunction is requesting sildenafil. He takes nitrates for angina. What should the nurse practitioner advise?

1. He should stop nitrates at least 24 hours before taking sildenafil.
2. He should wait at least 2 hours before taking sildenafil.

✅ C. He should not take sildenafil if he is taking nitrates.

1. It is safe to take both medications together.

Question:
A 25-year-old transgender woman is undergoing hormone therapy with estradiol and

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