A nurse is evaluating several patients for possible hormone ...

[hubes95]

A nurse is evaluating several patients for possible hormone therapy to reduce severe symptoms of menopause. For which patient would hormone therapy be recommended?
 
  A.
  53 years old, smoker, estrogen-progestin therapy
  B.
  54 years old, history of endometrial cancer 10 years ago, estrogen only
  C.
  55 years old, history of hysterectomy 4 years ago, estrogen only
  D.
  76 years old, went through menopause 16 years ago, estrogen-progestin

Question 2

A nurse in a family practice clinic sees several generations of the same family. For which family members should the nurse arrange routine screening colonoscopies?
 
  A.
  Daughter, age 52
  B.
  Grandfather, age 80, no history of polyps or cancer
  C.
  Grandmother, age 72, history of polyps
  D.
  Grandson, age 30, no gastrointestinal symptoms

[jsm54321]

Answer to Question 1

ANS: C
Estrogen therapy for women who have had a hysterectomy or estrogen-progestin therapy offers the greatest benefit and smallest risk to those who are within 10 years of menopause. The patient who is 55 and has had a hysterectomy would be the best candidate. The 53-year-old smoker has a double risk for venous thromboembolism (VTE) because smoking increases the risk along with the combination hormone therapy. Estrogen-only therapy increases the risk of endometrial cancer, so it is not used in patients who have a history of endometrial cancer. The smallest risk is seen in women within 10 years of menopause, so the 76-year-old woman is too far removed from menopause to receive hormone therapy.

Answer to Question 2

ANS: A
Individuals aged 50 and older should have screening colonoscopies, so the daughter should be scheduled for this procedure. The CDC does not recommend routine screening for patients aged 75-85 and recommends no screening after age 85, so the grandparents do not need to be screened. For patients with family history of colon polyps or cancer, screening should begin in their 40s, so the grandson does not yet need screening.