A 34-year-old patient has come to the office for follow-up after ...

[awywial]

A 34-year-old patient has come to the office for follow-up after a left-sided mastectomy for breast cancer.
 
  The prescriber tells her that she will be started on tamoxifen (Nolvadex) to prevent the recurrence of breast cancer. The nurse provides patient education and answers questions about the drug treatment. Which statement made by the patient best demonstrates the need for further teaching?
  a. I may experience hot flashes.
  b. I will have an increased risk of osteoporosis.
  c. This medication may reduce the fat in my blood (serum lipids).
  d. This medication may increase my risk of endometrial cancer.

Question 2

The nurse receives an order to give 1 mg of dexamethasone at 2300. At 0800 the next morning, plasma cortisol levels are drawn and reveal higher than normal levels. The patient asks the nurse what the lab results indicate.
 
  The nurse would be correct to tell the patient that the overnight dexamethasone suppression test is used to diagnose
  a. adrenal crisis.
  b. secondary adrenal insufficiency.
  c. primary adrenal insufficiency.
  d. Cushing's syndrome.

[pami445]

Answer to Question 1

ANS: B
Tamoxifen protects against osteoporosis; this statement indicates a need for further teaching.
Tamoxifen produces hot flashes; no further teaching is necessary.
Tamoxifen has a favorable effect on serum lipids; no further teaching is necessary.
Tamoxifen increases the risk of endometrial cancer and thromboembolism; no further teaching is necessary.

Answer to Question 2

ANS: D
The overnight dexamethasone suppression test is used to diagnose Cushing's syndrome.
The test is not used to diagnose adrenal crisis or primary or secondary adrenal insufficiency.

[awywial]

Excellent

[Kedrick2014]

Gracias!