A 55-year-old woman has not had menstrual periods for 5 years and ...

[WWatsford]

A 55-year-old woman has not had menstrual periods for 5 years and tells the primary care nurse practitioner (NP) that she is having increasingly frequent vasomotor symptoms.
 
  She has no family history or risk factors for coronary heart disease (CHD) or breast cancer but is concerned about these side effects of hormone therapy (HT). The NP should: a. tell her that starting HT now may reduce her risk of breast cancer.
  b. advise a short course of HT now that may decrease her risk for CHD.
  c. tell her that HT will not help control her symptoms during postmenopause.
  d. recommend herbal supplements for her symptoms to avoid HT side effects.

Question 2

A 70-year-old patient has low back pain and will begin taking metaxalone (Skelaxin). The primary care NP should counsel this patient to:
 
  a. drink extra fluids.
  b. avoid taking NSAIDs.
  c. get up from a chair slowly.
  d. take care to avoid slips and falls.

[Ksanderson1296]

Answer to Question 1

A
The current gap hypothesis regarding breast cancer supports initiating HT 5 years or more after menopause. To decrease risk for CHD, HT should begin at the time of menopause. HT will relieve vasomotor symptoms at all stages of menopause. Herbal supplements have estrogenizing effects and carry the same risks as estrogen therapy.

Answer to Question 2

D
Use of any muscle relaxant puts elderly patients at risk for falls, so patients should be advised to take precautions. It is not necessary to increase fluids or avoid NSAIDs. This drug does not have hypotensive effects, so it is not necessary to provide the caution to rise out of chairs slowly.

[WWatsford]

Excellent

[dantucker]

TYSM