A 40-year-old woman tells the primary care nurse practitioner ...

[@Brianna17]

A 40-year-old woman tells the primary care nurse practitioner (NP) that she does not want more children and would like a contraceptive. She does not smoke and has no personal or family history of cardiovascular disease.
 
  She has frequent tension headaches. For this patient, the NP should prescribe: a. condoms.
  b. tubal ligation.
  c. monophasic combined oral contraceptive pill (COCP).
  d. low-estrogen COCP.

Question 2

A 55-year-old woman who experienced menopause at age 50 years undergoes central dual-energy x-ray absorptiometry and has a T-score greater than 2.5 . The patient weighs 130 lb and has a body mass index of 22 . She sits at a computer all day at work.
 
  The primary care nurse practitioner (NP) caring for this patient should: a. prescribe a bisphosphonate.
  b. prescribe hormone replacement therapy.
  c. counsel the patient about diet and exercise.
  d. prescribe a selective estrogen receptor modulator.

[laurnthompson]

Answer to Question 1

D
Low-estrogen COCPs are recommended for women older than 40 with or without cardiovascular risk. Monophasic COCPs are recommended for women with migraine headaches. Condoms are more useful for preventing sexually transmitted diseases and not as reliable as contraception. Tubal ligation has surgical risks.

Answer to Question 2

C
The NP should counsel the patient about diet and exercise. Women who are at least 5 years postmenopausal or who have several risk factors should have bone density testing. Osteoporosis is defined as a T-score of less than 2.5, and treatment is indicated for women with T-scores that are 2 or more standard deviations below the normal premenopausal level. It is not necessary to initiate treatment at this time.

[@Brianna17]

TYSM

[yeungji]

Excellent