A 22-year-old transgender woman presents to your clinic for a routine check-up. She mentions that she’s interested in hormone therapy to feminize her appearance. What is the first step in addressing her request, and why is it essential?

A 38-year-old patient presents to the clinic with a complaint of heavy and prolonged menstrual bleeding. The nurse practitioner suspects an abnormality in the endometrial cycle. During which phase of the endometrial cycle does the thickening and development of the uterine lining occur?

You are working in the Intensive Care Unit (ICU) and are assigned an assigned male at birth (AMAB) patient with a past medical history (PMH) of asthma and diabetes.  The patient initially presented to the Emergency Department with severe dehydration and was immediately transferred to the intensive care unit (ICU) for intravenous (IV) fluids.  Upon reviewing the patient’s labs, which crystalloid solutions would you recommend as an option to the Health Care Provider (HCP)? Labs: Sodium: 158  Potassium: 5.4 Glucose: 210  Creatinine: 1.34  BUN: 42 

While completing your assigned male at birth (AMAB) patient’s physical assessment, you notice various abnormal findings.  You decide to review the patient’s labs that were drawn last week as they were started on new medications at that time.  Which medication do you anticipate that your patient is currently taking based on these abnormal findings? Labs: Lipid Panel Results HDL 22 LDL 210 Triglycerides (TG) 130 Total Cholesterol 367   Physical Assessment: Neurological: Alert and Oriented to person, place, situation and time.  Opens eyes spontaneously.  Respiratory: Clear to auscultation, unlabored, symmetrical chest expansion, no cough, denies shortness of breath (SOB) Perfusion (Cardiac): S1/S2, no murmur, +2 bilateral radial pulses, +1 bilateral pedal pulses, capillary refill less than 2 seconds, mild bilateral extremity edema Musculoskeletal: Strong bilateral finger grasps, moderate bilateral dorsiflexion and plantar flexion with moderate discomfort Gastrointestinal: Bowel sounds normoactive in all 4 quadrants, soft, non-tender, last bowel movement yesterday Genitourinary: Cola-colored, no odor  

The patient presented to the Emergency Department and diagnosed with an ischemic (reduced blood flow to a certain area) stroke.  The nurse is administering alteplase (Activase, tPA) intravenously (IV). The patient asks the nurse what is being done. What is the best response by the nurse?

Match the anticoagulant medication with it’s reversal agent.   Note: Full credit can only be obtained by selecting only all correct choices. Note: Reversal agents can be used more than once. 

A patient that was recently diagnosed with severe asthma is being seen in your clinic for a follow-up appointment.  You review the patient’s medications:  salmeterol (Serevent Diskus) 2 puffs BID albuterol (Proair, Ventolin) 2-4 puffs q 20 mins X 3 PRN ipratropium (Atrovent) 1 puff daily budesonide (Pulmicort) 1 puff daily What statement by the patient would be most concerning to the nurse and warrant further patient education?

The health care provider is seeing an assigned male at birth (AMAB) patient in the clinic for stable angina pectoris (chest pain).  As you are speaking to the patient, which statement made by the patient would you be most concerned about regarding his prescription of nitroglycerine (Nitrostat) sublingual for relief of stable angina pectoris (chest pain).

A patient who was prescribed fenofibrate (Tricor) one week ago contacts the clinic you are working in.  Which statement by the patient would warrant additional patient education by the nurse?

A patient was prescribed ipratropium (Atrovent) two weeks ago. She contacts her primary care office and notifies the nurse that she is going to stop taking the medication because of the bitter taste in her mouth after using the medication. What is the best response by the nurse?