Which of the following questions is most important to ask a client who might have been exposed to HIV after being sexually assaulted?

Choice a) Raloxifene:
Raloxifene is part of a class of drugs known as selective estrogen-receptor modulators (SERMs). It works by imitating the beneficial effects of the hormone estrogen on your bones, helping to prevent bone loss and improve density. Therefore, it is used in the prevention and treatment of osteoporosis.

Choice b) Calcitonin:
Calcitonin is a hormone that a person’s thyroid gland produces. It helps regulate the amount of calcium in the body. For the treatment of postmenopausal osteoporosis, scientists typically extract calcitonin from salmon. This is because salmon calcitonin has a much higher potency than human calcitonin. Osteoclasts are cells in the body that degrade bone. Calcitonin can inhibit osteoclasts. This helps slow the loss of bone density and increases bone mass, hindering the progression of osteoporosis.

Choice c) Allopurinol:
Allopurinol is primarily used to treat gout and certain types of kidney stones. It is not typically used in the prevention or treatment of osteoporosis.

Choice d) Levothyroxine:
Levothyroxine is used to treat hypothyroidism (underactive thyroid). It is not typically used in the prevention or treatment of osteoporosis. However, if you are prescribed levothyroxine you should have regular blood tests, at least once a year, to ensure your thyroid hormone levels are not too high. Continuous high thyroid hormone levels may lead to developing or worsening of low bone density and osteoporosis.

Choice A reason:
The inability to move toes can be an early sign that a cast is too tight. This symptom may indicate that the cast is impinging on nerves or blood vessels, leading to decreased motor function. It is essential to address this immediately to prevent further complications such as permanent damage or compartment syndrome.

Choice B reason:
Edema, or swelling of the toes, can occur if a cast is too tight, but it may not be the first sign observed. Swelling is a response to increased pressure in the tissues and can develop over time as fluid accumulates. While it is a concern, it often follows other symptoms such as changes in sensation or movement.

Choice C reason:
Pallor of the toes, indicating reduced blood flow, can be a sign of a cast that is too tight. However, pallor may not be as immediately noticeable as the inability to move toes or changes in sensation. It is still a critical sign that requires prompt evaluation and possible adjustment of the cast.

Choice D reason:
A change in the temperature of the toes, such as them becoming cooler to the touch, can suggest impaired blood flow due to a tight cast. This sign, along with pallor, may develop after other symptoms such as numbness or motor impairment.