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NAMS Certification QUESTIONS WITH COMPLETE VERIFIED SOLUTIONS 2024/2025, Exams of Health sciences

Chamberlain College of NursingHealth sciences

NAMS Certification QUESTIONS WITH COMPLETE VERIFIED SOLUTIONS 2024/2025

Typology: Exams

2023/2024

Available from 07/28/2024

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NAMS Certification QUESTIONS WITH
COMPLETE VERIFIED SOLUTIONS
2024/2025
Physiology of VMS
-thermoregulatory center altered by increase in KNDy neurons
-activation of NK3R causes hot flashes
-blockade of NK3R reduces/eliminates hot flashes
-may also be affected by: serotonin, epinephrine, and norepinephrine; parasympathetic nerve activity
Off label rx for VMS
-SSRIs
-SNRIs
-Gabapentinoids
-Clonidine
-Oxybutynin
Studies on Fractional Co2 Laser for GSM
-not FDA approved
-vaginal symptoms and sexual function scores increased significantly at 3 mon; noted continued
improvement at 1y
Ospemifene (Osphena) indications and MOA
-for treatment of dyspareunia
-decreases vaginal pH
-improves vaginal dryness
-shifts vaginal maturational index to superficial cells
-estrogen agonist/antagonist
Ospemifene (Osphena) adverse effects
-increase in uterine polyps
-proliferative endometrium
-slight increased risk of hemorrhagic stroke and VTE
-can increase VMS
treatment of urge incontinence
-behavioral modifications
-overactivity of the detrusor muscle
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Download NAMS Certification QUESTIONS WITH COMPLETE VERIFIED SOLUTIONS 2024/2025 and more Exams Health sciences in PDF only on Docsity!

NAMS Certification QUESTIONS WITH

COMPLETE VERIFIED SOLUTIONS

Physiology of VMS

  • thermoregulatory center altered by increase in KNDy neurons
  • activation of NK3R causes hot flashes
  • blockade of NK3R reduces/eliminates hot flashes
  • may also be affected by: serotonin, epinephrine, and norepinephrine; parasympathetic nerve activity Off label rx for VMS
  • SSRIs
  • SNRIs
  • Gabapentinoids
  • Clonidine
  • Oxybutynin Studies on Fractional Co2 Laser for GSM
  • not FDA approved
  • vaginal symptoms and sexual function scores increased significantly at 3 mon; noted continued improvement at 1y Ospemifene (Osphena) indications and MOA
  • for treatment of dyspareunia
  • decreases vaginal pH
  • improves vaginal dryness
  • shifts vaginal maturational index to superficial cells
  • estrogen agonist/antagonist Ospemifene (Osphena) adverse effects
  • increase in uterine polyps
  • proliferative endometrium
  • slight increased risk of hemorrhagic stroke and VTE
  • can increase VMS treatment of urge incontinence
  • behavioral modifications
  • overactivity of the detrusor muscle
  • antimuscarinics: oxybutynin
  • nerve stimulation
  • botox pelvic floor muscles - superficial
  • transverse perineal
  • bulbospongiosus,
  • ischiocavernosus pelvic floor muscles - deep
  • pubococcygeus
  • iliococcygeus
  • obturator internus
  • coccygeus What is low-tone pelvic floor dysfunction?
  • weak, underactive and hypotonic muscles that cannot maintain adequate contraction What is high-tone Pelvic Floor Dysfunction?
  • weak pelvic floor muscles cannot attain or maintain adequate relaxation
  • muscles are overactive, hypertonic, spastic, shortened What are the symptoms of low-tone PFD?
  • heaviness
  • pressure
  • pelvic organ prolapse
  • incontinence
  • altered sexual sensation What are the symptoms of high-tone PFD?
  • urinary retention
  • frequency
  • urgency
  • dysuria
  • fecal retention/constipation
  • penetrative dyspareunia and/or vaginismus Vaginal dilators for PFD
  • Choose size that does not cause pain
  • Show how to insert with a mirror
  • Apply lubricant to dilator, insert dilator as far as is comfortable, leave dilator in place for 5-10 min 1-2 times daily
  • Use each for 4 wk before progressing to a size similar to partner size HRT and cognition - natural menopause
  • Rash on palms/soles
  • Mucous membrane lesions
  • Lymphadenopathy
  • Malaise
  • Fever latent (tertiary) syphilis symptoms
  • Brain damage, dementia and mental health problems
  • Heart disease
  • Movement disorders and muscle problems
  • Nerve damage
  • Seizures
  • Tumors, usually on the bones and skin
  • Vision problems prevalence of osteoporosis
  • of 10 million adults with osteoporosis, 8 million are women
  • prior low-trauma/fragility fracture is a diagnosis of osteoporosis regardless of DEXA result *excludes fingers, toes, face, skull or pathologic traumatic fractures When do women reach peak bone mass? age 20 What accounts for 50-85% of variance in BMD? genetics What is the difference between T-score and Z-score? Z-scores are for premenopausal women; match age/sex/race-based criteria T-scores are for postmenopausal women Criteria to dx osteopenia T-score - 1.0 to - 2. Criteria to dx osteoporosis T-score less than - 2. Criteria for normal bone density per WHO T-score above - 1. What race has the highest bone density? Black women What conditions qualify a patient for pharmacologic therapy for osteoporosis?
  • osteoporosis on T-score (<2.5%)
  • 10 - yr FRAX risk overall > 20%
  • 10 - yr FRAX risk for hip > 3%
  • h/o low trauma fracture

Secondary causes of osteoporosis

  • Type 1 DM
  • vitamin D deficiency
  • hyperthyroidism
  • hypercalciuria
  • RA
  • UC
  • medications that affect bone loss (AIs) Criteria for DEXA age > 65 < 65 if FRAX is greater than 8.4% HT and CVD HT initiated within 10 yrs of menopause or in women <60y lowers all-cause mortality and does not increase risk of coronary events HT initiated later in menopause increases risk of CVD HT and stroke Stroke risk is NOT increased if HT started within 10 yr of menopause or age <60y Aspirin and CVD Secondary prevention: ASA 81mg prevents recurrence of MI and stroke in women with established CVD Primary prevention: 40-69y IF high risk of CVD and low risk of bleeding; use shared decision making When to avoid aspirin patients > 70 risk of bleeding ASCVD risk categories for 10yr risk Low........................<5% Borderline..........5-7.4% Intermediate.....7.5- 19 .9% High......................>20% Relationship between apoB lipoproteins and menopause apoB lipoproteins increase rapidly in the first year after menopause Goal of treatment for hyperlipidemia lower the risk of future ASCVD events, not to hit a target LDL goal high intensity statin therapy indications very high risk ASCVD goal is to reduce LDL by 50%

no, contraindicated causes of severe triglyceride elevations (>1000mg/dL) monogenetic disorders associated with pancreatitis What is metabolic syndrome? A state of insulin resistance Cluster of conditions that increase the risk of heart disease, stroke, and diabetes. Diagnosing Metabolic Syndrome 3 or more Waist circumference ≥35 in (88 cm) in women Triglycerides >150 mg/dL OR Drug treatment for elevated triglycerides HDL-C <50 mg/dL in women OR Drug treatment for reduced HDL cholesterol BP ≥130/85 OR Drug treatment for hypertension Fasting blood glucose ≥110 mg/dL OR Drug treatment for elevated glucose When to screen for DM begin at 45 y/o and q 3 years OR earlier if risk factors

  • BMI > 25
  • first degree relative with DM
  • high-risk ethnicity (Native American, Black, Hispanic, Asian)
  • h/o CVD
  • HTN
  • HDL < 35
  • TG >
  • PCOS
  • sedentary lifestyle First line drugs for DM metformin Second line drugs for DM with known CVD

liraglutide empagliflozin canagliflozin Second line drugs for DM WITHOUT known CVD sulfonylureas dipeptidyl peptidase-4 inhibitor sodium glucose cotransporter 2 inhibitors GLP-1 receptor agonist drugs Risk of breast cancer in BRCA 1 or 2 72% lifetime risk Chemoprevention for breast cancer Tamoxifen 20mg/5yrs Risk: emboli, endometrial cancer, Raloxifene with decreased complications AIs VMS treatment for women with h/o breast cancer gabapentin sertraline venlafaxine What cancer has the highest mortality rate in women? lung cancer