NURS 167 EXAM 1 CLINICAL REASONING
COMPENDIUM: FULL QUESTION PORTFOLIO
AND CRITICALLY VETTED INTERVENTION
DATA 2026
⫸ The clinical report of a patient who is undergoing estrogen therapy
indicates thrombosis. Which event may the nurse suspect as the cause
of thrombosis?
1 The patient smokes cigarettes.
2 The patient's fluid intake is low.
3 The patient takes herbal supplements.
4 The patient takes tricyclic antidepressants. Answer: 1 The patient
smokes cigarettes.
Smoking causes thrombosis in patients who undergo estrogen therapy.
Thrombosis is not caused by a decrease in fluids. Herbal medicines
such as St. John's wort decrease the estrogenic effect of drugs. The
use of estrogen therapy with tricyclic antidepressants causes toxicity
of the antidepressant.
⫸ What monitoring parameter should be evaluated for drug
effectiveness for a patient in labor who is receiving oxytocin? Select
all that apply.
1 Fetal heart rate
,2 Asking no questions about fetal movement
3 Continuing the agent if uterine hyperactivity occurs
4 The patient's blood pressure and pulse during administration of the
oxytocic agent Answer: 1, 4
Before administering uterine stimulants (e.g., oxytocin or
prostaglandins), the nurse should determine the fetal heart rate and
contraction-related fetal heart rates and document findings. The nurse
should also assess and document the patient's blood pressure, pulse,
and respiration. Continuing the agent if uterine hyperactivity occurs is
not safe. Asking no questions about fetal movement will not reveal
anything useful for assessment.
Test-Taking Tip: Be alert for grammatical inconsistencies. If the
response is intended to complete the stem (an incomplete sentence)
but makes no grammatical sense to you, it might be a distractor rather
than the correct response. Question writers typically try to eliminate
these inconsistencies.
⫸ Which phase of the menstrual cycle involves the release of an
unfertilized ovum?
1. Phase 1
2. Phase 2
3. Phase 3
4. Phase 4 Answer: 3. Phase 3
,The menstrual cycle has four phases. The unfertilized ovum is
released from the ovum during phase 3, which is the ovulation phase.
Phase 1 is referred to as the menstruation phase. The phase initiates
the cycle and lasts 5 to 7 days. Phase 2 is known as the follicular
phase. During this phase, the mature ovum develops from the ovarian
follicle. Phase 4 is the luteal phase. During this phase, the corpus
luteum is formed from the ruptured ovarian follicle.
⫸ The nurse is explaining the effects of estrogen therapy to a patient.
Which effect mentioned by the patient indicates a need for additional
teaching?
1 Prevention of breast cancer
2 Treatment of prostate cancer
3 Decrease in vasomotor symptoms
4 Improvement of atrophic vaginitis Answer: 1. Prevention of breast
cancer
Estrogen therapy increases the chances of breast cancer in women.
Estrogen therapy leads to improvement of atrophic vaginitis, female
hypogonadism, insufficient primary ovarian function, abnormal
uterine bleeding, and severe vasomotor symptoms in women. It is also
used to treat prostate cancer.
⫸ A patient tests positive for pregnancy even though she has been
taking oral contraceptives. What is a possible cause of this unintended
pregnancy?
1 The patient has diabetes.
2 The patient has hypertension.
, 3 The patient takes anticonvulsants.
4 The patient is on antibiotic therapy. Answer: 4 The patient is on
antibiotic therapy.
Antibiotics reduce the effectiveness of oral contraceptives; hence, the
nurse needs to instruct patients to use alternative birth control
methods during antibiotic therapy. Diabetes does not reduce the effect
of oral contraceptives. Hypertension may be an adverse effect of oral
contraceptives. The effectiveness of anticonvulsants is reduced when
taken with oral contraceptives.
Test-Taking Tip: Many times the correct answer is the longest
alternative given, but do not count on it. Item writers (those who write
the questions) are also aware of this and attempt to avoid offering you
such "helpful hints."
⫸ Which medication is used to induce labor?
1 Oxytocin
2 Terbutaline
3 Methylergonovine
4 Magnesium sulfate Answer: 1 Oxytocin
Oxytocin is a uterine stimulant that is used to induce uterine
contractions for labor. Terbutaline is a medication used to arrest
preterm labor. Methylergonovine is used to treat postpartum
hemorrhage. Magnesium sulfate is used to treat gestational
hypertension.
COMPENDIUM: FULL QUESTION PORTFOLIO
AND CRITICALLY VETTED INTERVENTION
DATA 2026
⫸ The clinical report of a patient who is undergoing estrogen therapy
indicates thrombosis. Which event may the nurse suspect as the cause
of thrombosis?
1 The patient smokes cigarettes.
2 The patient's fluid intake is low.
3 The patient takes herbal supplements.
4 The patient takes tricyclic antidepressants. Answer: 1 The patient
smokes cigarettes.
Smoking causes thrombosis in patients who undergo estrogen therapy.
Thrombosis is not caused by a decrease in fluids. Herbal medicines
such as St. John's wort decrease the estrogenic effect of drugs. The
use of estrogen therapy with tricyclic antidepressants causes toxicity
of the antidepressant.
⫸ What monitoring parameter should be evaluated for drug
effectiveness for a patient in labor who is receiving oxytocin? Select
all that apply.
1 Fetal heart rate
,2 Asking no questions about fetal movement
3 Continuing the agent if uterine hyperactivity occurs
4 The patient's blood pressure and pulse during administration of the
oxytocic agent Answer: 1, 4
Before administering uterine stimulants (e.g., oxytocin or
prostaglandins), the nurse should determine the fetal heart rate and
contraction-related fetal heart rates and document findings. The nurse
should also assess and document the patient's blood pressure, pulse,
and respiration. Continuing the agent if uterine hyperactivity occurs is
not safe. Asking no questions about fetal movement will not reveal
anything useful for assessment.
Test-Taking Tip: Be alert for grammatical inconsistencies. If the
response is intended to complete the stem (an incomplete sentence)
but makes no grammatical sense to you, it might be a distractor rather
than the correct response. Question writers typically try to eliminate
these inconsistencies.
⫸ Which phase of the menstrual cycle involves the release of an
unfertilized ovum?
1. Phase 1
2. Phase 2
3. Phase 3
4. Phase 4 Answer: 3. Phase 3
,The menstrual cycle has four phases. The unfertilized ovum is
released from the ovum during phase 3, which is the ovulation phase.
Phase 1 is referred to as the menstruation phase. The phase initiates
the cycle and lasts 5 to 7 days. Phase 2 is known as the follicular
phase. During this phase, the mature ovum develops from the ovarian
follicle. Phase 4 is the luteal phase. During this phase, the corpus
luteum is formed from the ruptured ovarian follicle.
⫸ The nurse is explaining the effects of estrogen therapy to a patient.
Which effect mentioned by the patient indicates a need for additional
teaching?
1 Prevention of breast cancer
2 Treatment of prostate cancer
3 Decrease in vasomotor symptoms
4 Improvement of atrophic vaginitis Answer: 1. Prevention of breast
cancer
Estrogen therapy increases the chances of breast cancer in women.
Estrogen therapy leads to improvement of atrophic vaginitis, female
hypogonadism, insufficient primary ovarian function, abnormal
uterine bleeding, and severe vasomotor symptoms in women. It is also
used to treat prostate cancer.
⫸ A patient tests positive for pregnancy even though she has been
taking oral contraceptives. What is a possible cause of this unintended
pregnancy?
1 The patient has diabetes.
2 The patient has hypertension.
, 3 The patient takes anticonvulsants.
4 The patient is on antibiotic therapy. Answer: 4 The patient is on
antibiotic therapy.
Antibiotics reduce the effectiveness of oral contraceptives; hence, the
nurse needs to instruct patients to use alternative birth control
methods during antibiotic therapy. Diabetes does not reduce the effect
of oral contraceptives. Hypertension may be an adverse effect of oral
contraceptives. The effectiveness of anticonvulsants is reduced when
taken with oral contraceptives.
Test-Taking Tip: Many times the correct answer is the longest
alternative given, but do not count on it. Item writers (those who write
the questions) are also aware of this and attempt to avoid offering you
such "helpful hints."
⫸ Which medication is used to induce labor?
1 Oxytocin
2 Terbutaline
3 Methylergonovine
4 Magnesium sulfate Answer: 1 Oxytocin
Oxytocin is a uterine stimulant that is used to induce uterine
contractions for labor. Terbutaline is a medication used to arrest
preterm labor. Methylergonovine is used to treat postpartum
hemorrhage. Magnesium sulfate is used to treat gestational
hypertension.
