Chapter 45: Male and Female Hormones PrepU
7 See full question 11s A nurse caring for a client receiving fluoxymesterone for the treatment of inoperable breast carcinoma should weigh the client daily or as ordered by the health care provider and report a change in weight of how many pounds (kilograms) in either direction to the health care provider?
5 lb (2.3 kg) Explanation: A nurse caring for a client receiving fluoxymesterone for the treatment of inoperable breast carcinoma should weigh the client daily or as ordered and report a change in weight of 5 lb (2.3 kg) more or less to the health care provider. Fluctuations of less than 5 lb (2.3 kg) do not need to be reported. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 530. Chapter 45: Male and Female Hormones - Page 530 Add a Note
14 See full question 14s The nurse has administered a prescribed dose of danazol to an adult female client for the purpose of preventing ovulation. When providing care related to the client's underlying diagnosis, what nursing action is most appropriate?
Assess the client's pain frequently Explanation: Danazol may be used in women to prevent or treat endometriosis, a health problem that is associated with chronic pain. For this reason, vigilant pain assessment would be a priority nursing action. There is no reason to believe the client would be at particular risk for infection respiratory complications. There is no indication for a high-protein diet. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 537. Chapter 45: Male and Female Hormones - Page 537 Add a Note
3 See full question 24s A professional athlete has been self-administering anabolic steroids for years and has begun to have health issues. Which body tissues are affected adversely by anabolic steroid use? (Select all that apply.)
Cardiovascular Central nervous system Reproductive system Explanation: Combining administration routes and massive doses of anabolic steroids produces potentially serious adverse effects: cardiovascular disorders, central nervous system disorders, and reproductive system disorders. Anabolic steroid use by adolescents may cause renal damage. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 529. Chapter 45: Male and Female Hormones - Page 529 Add a Note
4 See full question 41s The nurse determines that teaching about testosterone therapy via a transdermal patch is effective when the male client states that he will change the patch in which time frame?
Daily Explanation: A testosterone patch is applied daily. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 530. Chapter 45: Male and Female Hormones - Page 530 Add a Note
2 See full question 27s Which results with the administration of testosterone?
Decreased protein catabolism Explanation: Protein catabolism decreases. Red blood cell production increases. Retention of nitrogen increases. Retention of sodium increases. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 528. Chapter 45: Male and Female Hormones - Page 528 Add a Note
11 See full question 1m 10s A client with a history or perimenopausal symptoms tells the nurse she is taking soy, calcium, and a multivitamin as an alternative to taking hormone replacement pills. What is the nurse's priority response?
Discontinue her calcium supplement. Explanation: The nurse may advise the client to stop using a calcium supplement because soy is not to be taken with calcium, iron, or zinc. However, the client may have to decide whether it would be more beneficial for her to continue the calcium and discontinue the soy if osteoporosis is a concern. Decreasing carbohydrates is a healthy choice, especially for a menopausal woman, but would not be the priority concern. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 532. Chapter 45: Male and Female Hormones - Page 532 Add a Note
13 See full question 6m 25s A male client with cancer has developed cachexia and been prescribed anabolic steroids. The client's most recent laboratory results indicate a hemoglobin levels of 15.8 g/dL (158 g/L). What is the nurse's best action?
Document the therapeutic effects of treatment Explanation: Increased hemoglobin levels are a desired effect of anabolic steroids. For a male, this client's hemoglobin in the high-normal range. Assistance with ADL's is unrelated to this finding, and the client may need less help than before, owing to increased oxygen-carrying capacity. There is no obvious indication for iron supplements. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 530. Chapter 45: Male and Female Hormones - Page 530 Add a Note
1 See full question 9s The client informs the nurse that she had unprotected intercourse last night. The client is considering requesting emergency postcoital contraception. The nurse's best response is:
Emergency contraception is most effective if started within 24 hours and no later than 72 hours after exposure. Explanation: Plan B (levonorgestrel) is the only emergency contraceptive on the market used to avoid pregnancy after unprotected sexual intercourse. It should be used only as a backup method and is not for routine birth control. Emergency contraception is most effective if started within 24 hours and no later than 72 hours after exposure. The drug is believed to act mainly by inhibiting ovulation; the drug may also have an effect on fertilization and implantation. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 536. Chapter 45: Male and Female Hormones - Page 536 Add a Note
12 See full question 1m 40s A client on long term testosterone therapy is at risk for the development of hepatocellular cancer. The nurse explains to the client that a hepatic function test should be done and evaluated on what schedule during the therapy?
Every 6 months Explanation: A potentially life-threatening effect associated with this therapy is hepatocellular cancer. This may occur because of the effect of testosterone on hepatic cells. Patients on long-term therapy should have hepatic function tests monitored regularly— before beginning therapy and every 6 months during therapy. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 530. Chapter 45: Male and Female Hormones - Page 530 Add a Note
10 See full question 34s A child has been prescribed testosterone. Which pretreatment x-rays should be taken to serve as a baseline evaluation reference during the length of the therapy?
Hand and wrist Explanation: Because of the effects of this hormone on epiphyseal closure, children should be closely monitored with hand and wrist radiographs pretreatment and every 6 months. None of the other options are effective for assessing the effects on epiphyseal closure. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 531. Chapter 45: Male and Female Hormones - Page 531 Add a Note
11 See full question 20s And older client has been prescribed long-term androgen therapy. Which preexisting condition should the nurse monitor regularly to identify signs of exacerbation? Select all that apply.
Hypertension Coronary artery disease Heart failure Explanation: Older adults may have problems with androgen therapy because of underlying conditions that are aggravated by the drug effects. Hypertension, heart failure, and coronary artery disease may be aggravated by the fluid retention associated with these drugs. The other options are not associated with this risk. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 532. Chapter 45: Male and Female Hormones - Page 532 Add a Note
19 See full question 13s Which statement correctly identifies the triggering factor associated with benign prostatic hypertrophy (BPH)?
Increase in the dihydrotestosterone (DHT) androgen Explanation: Testosterone undergoes reduction to form the more potent androgen DHT, which has greater affinity for androgen receptors than testosterone. BPH is not triggered by either a decrease in testosterone level or an imbalance of estrogen. Benign prostatic hyperplasia is a normal part of the aging process in men, caused by changes in hormone balance and in cell growth. It is not related to the development of cancer. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 558. Chapter 45: Male and Female Hormones - Page 558 Add a Note
9 See full question 1m 18s The school nurse is teaching a group of adolescent men about the dangers of anabolic steroids and includes what issues? Select all that apply.
Increased risk for suicide Aggressive reactions Liver tumors Explanation: Men who take anabolic steroids may develop severe mental changes ("roid rage"); severe depression and suicidal tendencies; malignant and benign liver tumors; aggressive behavior; inability to concentrate; and personality changes. It is used without prescription to increase muscle mass and strength, thereby causing weight gain, not loss. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 529. Chapter 45: Male and Female Hormones - Page 529 Add a Note
7 See full question 23s A female client is taking hormonal contraceptives to prevent pregnancy. She visits the gynecology clinic and is noted with a blood pressure of 176/102 mm Hg. The client is started on enalapril mesylate 10 mg. In collaboration with the primary care provider, what other client teaching should be provided based on her current medical regimen?
Instruct to discontinue the contraceptives. Explanation: Because of widespread effects on the body tissues and reported adverse reactions, the client should be instructed to discontinue hormonal contraceptives that contribute to hypertension. The client should restrict salt but not eliminate salt. The implementation of relaxation techniques is important but not crucial to the current medical regimen. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 534. Chapter 45: Male and Female Hormones - Page 534 Add a Note
5 See full question 26s In evaluating a plan of care for a client on estrogen therapy, what would be an appropriate part of the evaluation?
Interview and assess for therapeutic and adverse drug effects. Explanation: The nurse should monitor client response to the drug (palliation of signs and symptoms of menopause, prevention of pregnancy, decreased risk factors for coronary artery disease, palliation of certain cancers); adverse effects (liver changes, GI upset, edema, changes in secondary sex characteristics, headaches, thromboembolic episodes, breakthrough bleeding). The other options are client teaching guidelines for those on estrogen or progestin therapy. They are not part of the evaluation process of the care plan. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 531. Chapter 45: Male and Female Hormones - Page 531 Add a Note
20 See full question 14s A client is prescribed sildenafil. Which statement should be included in teaching the client about the medication?
It is prescribed in once-a-day dosing. Explanation: Administration of sildenafil is generally oral. It is important not take sildenafil more than once in a 24-hour period. In older adults, the medication may cause hypotension. A recent high-fat meal may delay drug action. The medication may be taken with or without food. There are interactions with other drugs and herbs, but not St. John's wort.
4 See full question 9s People taking anabolic steroids may experience which adverse effect?
Jaundice Explanation: Like the androgens, the anabolic steroids are well absorbed and widely distributed throughout the body. They are metabolized in the liver and excreted in the urine. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 529. Chapter 45: Male and Female Hormones - Page 529 Add a Note
2 See full question 14s What potentially serious adverse effects do large doses of anabolic steroids produce? Select all that apply.
Jaundice Inability to stop taking the drug Metabolic disorders Explanation: Large doses of anabolic steroids produce potentially serious adverse effects in several body tissues, including liver disorders (neoplasms, jaundice, etc), metabolic disorders (fluid retention, edema, etc), and CNS disorders (aggression, hostility, drug dependence, etc). Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 529. Chapter 45: Male and Female Hormones - Page 529 Add a Note
1 See full question 27s After teaching a group of students about the use of estrogens, the instructor determines that additional teaching is needed when the students identify which as a contraindication?
Metabolic bone disease Explanation: Estrogens should be used cautiously in patients with metabolic bone disease because of the bone conserving effects of estrogen, which could exacerbate the disease. Thromboembolic disorders contraindicate the use of estrogen. Idiopathic vaginal bleeding is a contraindication for the use of estrogens. Breast cancer is a contraindication for the use of estrogens. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, pp. 532-533. Chapter 45: Male and Female Hormones - Page 532-533 Add a Note
3 See full question 36s After teaching a group of students about anabolic steroids, the instructor determines that the teaching was successful when the students identify which agent as an example?
Oxandrolone Explanation: Oxandrolone is an anabolic steroid. Danazol is an androgen. Alprostadil is a prostaglandin. Tadalafil is a phosphodiesterase type 5 receptor inhibitor. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 539. Chapter 45: Male and Female Hormones - Page 539 Add a Note
12 See full question 1m 49s When the nurse learns the male client takes conjugated estrogens, the nurse questions the client about what disorder?
Prostate cancer Explanation: Conjugated estrogen is most commonly taken by men to treat prostate cancer because the estrogen competes with testosterone for binding sites. Although men do get breast cancer and osteoporosis, they would not be treated with estrogen for these disorders. Andropause is caused by a reduction in testosterone so they would get a male hormone replacement and not estrogen. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 529. Chapter 45: Male and Female Hormones - Page 529 Add a Note
13 See full question 21s What cardiovascular condition is associated with the inappropriate use of testosterone? Select all that apply.
Pulmonary emboli (PE) Deep vein thrombosis (DVT) Stroke Myocardial infarction Explanation: Cardiovascular events associated with the use of testosterone includes myocardial infarction (MI) and stroke and venous embolic events, including deep-vein thrombosis (DVT) and pulmonary embolism (PE). Bradycardia is not included among the risks. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 534. Chapter 45: Male and Female Hormones - Page 534 Add a Note
9 See full question 1m 44s The nurse is discussing the plan of care another nurse has developed with the client. What is an appropriate outcome that the nurse and the client may decide on?
The client can verbalize an understanding of preventable adverse drug effects. Explanation: Provide thorough client teaching, including steps to take if a dose is missed or lost, measures to avoid adverse effects, warning signs of signs and symptoms that may indicate a problem, and the need for regular evaluation, to enhance client knowledge about drug therapy and to promote compliance. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 531. Chapter 45: Male and Female Hormones - Page 531 Add a Note
18 See full question 23s What is the primary goal of care for a client in his 50s who has recently been diagnosed with an androgen deficiency?
The client will reestablish masculine characteristics. Explanation: In postpubertal men who become androgen deficient, the goal of testosterone therapy is to reestablish and maintain masculine characteristics and functions. Testicular size and urinary function are not usually focuses of treatment. A particular sperm count may be important for some men, but maintenance of masculine traits is more commonly a priority. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, pp. 530-531. Chapter 45: Male and Female Hormones - Page 530-531 Add a Note
17 See full question 35s Which statement should the nurse share with a client to best describe the rationale for using a 28-day oral contraceptive pack?
This will assist clients to comply with their medication regimen, making it less likely to forget taking their pill every day. Explanation: Dispensers with 28 tablets contain 7 inactive or placebo tablets of a third color. Several combination products and alternative dosage forms are available to help individualize treatment and promote adherence. None of the other options present accurate statements regarding oral contraception packs. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, pp. 535-538. Chapter 45: Male and Female Hormones - Page 535-538 Add a Note
12 See full question 13s The nurse is preparing to give a client an injection of carboprost. What is the nurse's priority action before administering the drug?
Verify that the woman thoroughly understands what will happen. Explanation: Carboprost is an abortifacient and it is important that the woman understand what will happen after the drug is taken and that she cannot change her mind. Contraindications and cautions should have been checked before the drug was prescribed. It is not the nurse's place to share ethical beliefs with the client. After the client's understanding is verified, the drug can be prepared. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 534. Chapter 45: Male and Female Hormones - Page 534 Add a Note
10 See full question 33s The nurse is discussing the androgenic effects a pre-pubescent client can expect. What areas of development should be focused upon? Select all that apply.
Vocal pitch Hair distribution Skin condition Genital development Explanation: Androgenic effects are associated with development of male sexual characteristics and secondary characteristics (e.g., deepening of voice, hair distribution, genital development, acne). Cognitive development is not identified with either primary or secondary sexual characteristics. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 538. Chapter 45: Male and Female Hormones - Page 538 Add a Note
16 See full question 56s The nurse is closely following a client who began treatment with testosterone several months earlier. When assessing the client for potential adverse effects of treatment, the nurse should prioritize which assessment?
assessment of serum calcium levels Explanation: In the client taking testosterone, the nurse should monitor serum calcium levels and observe for signs of hypercalcemia (e.g., kidney stones, polyuria, abdominal pain, nausea, vomiting, and depression). ABGs, respiratory function, and skin integrity are not typically affected by testosterone. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 530. Chapter 45: Male and Female Hormones - Page 530 Add a Note
8 See full question 1m 8s A client taking hormonal contraceptives will soon turn 35 years of age. She is moderately obese and has smoked for 15 years. Which action should the nurse encourage the client to take to best minimize risk for complications associated with contraception use?
beginning smoking cessation Explanation: Women older than 35 years of age who smoke cigarettes are at greater risk for thromboembolic disorders. The client should be instructed on smoking cessation. The client should not begin an exercise regime unless prescribed by her health care provider. The client should not begin daily aspirin therapy unless prescribed by her health care provider. The client should not begin daily aspirin or diuretic therapy unless prescribed by her health care provider. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 534. Chapter 45: Male and Female Hormones - Page 534 Add a Note
14 See full question 26s A 34-year-old woman has presented to the clinic for the first time, and the nurse learns that she has been taking medroxyprogesterone for the past 13 years. This aspect of the woman's medical history should prompt what assessment?
bone density testing Explanation: There is a black box warning regarding the use of medroxyprogesterone that relates to its being associated with the loss of stored calcium from bones, which increases the risk of broken bones and osteoporosis, especially after menopause. There is a greater risk of bone loss with long-term use. Consequently, bone density testing may be warranted. There is no particular indication for this client to undergo stress testing, renal ultrasound, or triglyceride testing. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 532. Chapter 45: Male and Female Hormones - Page 532 Add a Note
19 See full question 23s A client is prescribed androgen therapy to be given by IM injection. The nurse would select which site for administration?
gluteal muscle Explanation: When androgens are administered IM, the injection is administered by deep IM injection into the gluteal muscle. The other muscles are not as large. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, pp. 530-535. Chapter 45: Male and Female Hormones - Page 530-535 Add a Note
2 See full question 6s After teaching a group of nursing students about testosterone, the nurse determines that additional teaching is needed when they identify that testosterone can be given by which route?
intravenous Explanation: Testosterone is not given intravenously. Testosterone does come in the forms of oral buccal, topical gel, injectable, pellet for subcutaneous administration, transdermal, and spray. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, pp. 530-531. Chapter 45: Male and Female Hormones - Page 530-531 Add a Note
15 See full question 12s A 37-year-old woman has a 10 pack/year smoking history and has been using oral contraceptives for the past 2 years. The nurse should plan health education interventions in the knowledge that this client faces a priority increased risk of:
myocardial infarction. Explanation: For women 35 years of age and older who smoke, there is an increased risk of myocardial infarction and other cardiovascular disorders, even with low-dose oral contraceptives. The increase in this risk supersedes that of osteoporosis, dementia, or DVT. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 534. Chapter 45: Male and Female Hormones - Page 534 Add a Note
6 See full question 16s A nurse is preparing to administer an anabolic steroid. Which would the nurse most likely be administering?
nandrolone Explanation: Nandrolone is an example of an anabolic steroid. Fluoxymesterone is an androgen that can be used to treat hypogonadism. Dutasteride inhibits the conversion of testosterone to dihydrotestosterone (DHT). DHT is the androgen primarily responsible for the initial development and subsequent enlargement of the prostate gland. Testosterone is a potent androgen that produces signs of puberty in young male adolescents such as hair growth and organ growth. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 539. Chapter 45: Male and Female Hormones - Page 539 Add a Note
16 See full question 20s A nurse is teaching a young adult client about oral contraceptives, which the client will soon begin taking. The client's primary concern is the effectiveness of the medication in preventing pregnancy. The nurse should teach the client that oral contraceptives, when taken consistently, are how effective in preventing pregnancy?
nearly 100% Explanation: When taken correctly, estrogen-progestin contraceptive preparations are nearly 100% effective in preventing pregnancy. Genetics do not significantly affect treatment. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 532. Chapter 45: Male and Female Hormones - Page 532 Add a Note
17 See full question 1m 2s The etiology of secondary hypogonadism may involve which condition?
pituitary dysfunction Explanation: Secondary hypogonadism results from a problem in the hypothalamus or the pituitary gland, areas of the brain that signal the testicles to produce testosterone. Unlike primary hypogonadism, this disorder does not involve direct insult to the testicles themselves. Addisonian crisis does not cause hypogonadism. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 529. Chapter 45: Male and Female Hormones - Page 529 Add a Note
17 See full question 42s When assessing a woman prescribed a contraception that contains the progestin drospirenone, the nurse should prioritize the assessment of what laboratory value?
serum potassium Explanation: Contraceptives that contain the progestin drospirenone can increase serum potassium levels. Potassium monitoring may thus be indicated. Sodium, red cell, and white cell indices are not normally affected. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 532. Chapter 45: Male and Female Hormones - Page 532 Add a Note
15 See full question 8s An 8-year-old boy has been diagnosed with a sex hormone deficiency and has begun a course of treatment with testosterone. What change in the boy's health status would necessitate a stop to the course of treatment?
signs of puberty Explanation: If premature puberty occurs in a boy being treated with androgens (e.g., precocious sexual development, enlarged penis), it is necessary to stop the drug. Changes in blood pressure, increased growth, and urinary tract infections are unlikely causes for the cessation in treatment. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, pp. 528-529. Chapter 45: Male and Female Hormones - Page 528-529 Add a Note
8 See full question 1m 51s A nurse is caring for a female client receiving anabolic steroids for controlling metastatic breast cancer. The nurse would be alert for the development of which adverse reactions? Select all that apply.
suicidal tendencies aggressive behavior personality changes Explanation: Adverse effects seen with anabolic steroid therapy include aggressive behavior, personality changes, and suicidal tendencies. Diarrhea, rather than constipation, may be seen with anabolic steroids. Anabolic steroid therapy may lead to anorexia and not to an increase in appetite. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 529. Chapter 45: Male and Female Hormones - Page 529 Add a Note
4 See full question 15s A nurse is caring for clients receiving androgen therapy. For which conditions may androgen therapy be given as replacement therapy? Select all that apply.
testosterone deficiency delayed puberty testicular development failure Explanation: Androgen therapy may be prescribed for treating testosterone deficiency, delayed puberty, and failure of development of the testes. Male-pattern baldness and symptoms of benign prostatic hypertrophy can be treated with the use of androgen hormone inhibitors and not androgen therapy. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 529. Chapter 45: Male and Female Hormones - Page 529 Add a Note
20 See full question 13s A client, prescribed finasteride, asks the nurse how the medication works. Which statement best addresses the client's question?
"Decreases proliferative prostatic cells." Explanation: Over time, testosterone undergoes reduction to the more potent androgen DHT, which has greater affinity for ndrogen receptors than testosterone. Finasteride, a 5-alpha reductase inhibitor, inhibits the mechanism of testosterone. This causes decreased proliferation of prostatic cells, which reduces the enlargement of the prostate gland and mechanical obstruction to the urethra. Finasteride does not activate testosterone, decrease the acute inflammation of the urethra, or initiate the DHT androgen.
19 See full question 20s Which statement made by an adult man prescribed sildenafil suggests that the nurse's teaching has been ineffective?
"I know that sildenafil can cause hypertension if I use my angina medicine." Explanation: Sildenafil-nitrate combination can cause severe hypotension resulting in dizziness, syncope, heart attack, or stroke. The onset of action is 20 to 60 minutes, and the drug does not protect against infections. It should not be taken more than once in any 24-hour period. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018. Add a Note
6 See full question 14s The nurse is caring for a male client with cryptorchidism who is 28 years old and taking testosterone to treat his problem. What statement by this client would lead the nurse to believe that he has understood the teaching?
"My body hair may increase." Explanation: Androgenic effects include acne, edema, hirsutism (increased hair distribution), deepening of the voice, oily skin and hair, weight gain, decrease in breast size, and testicular atrophy. Testosterone does not make the skin clear and soft, it does not make the voice higher, and it does not cause decreased sexual desire. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 538. Chapter 45: Male and Female Hormones - Page 538 Add a Note
18 See full question 32s A new client telephones the clinic requesting a renewal prescription for contraceptives she has been taking for 4 years. It has been more than a year since her last health care visit, but she is unable to come into the clinic until next month. She insists she is "doing fine" on this medication and must have her prescription now. Considering the circumstances and related safety issues, how should the clinic nurse respond?
*"Before the drugs are prescribed, a complete medical history, physical examination, Pap test, urinalysis, and weight and blood pressure measurements are recommended." Explanation: Because estrogens, progestins, and hormonal contraceptives are often taken for years and may cause adverse reactions, clients taking these drugs need continued supervision by a health care provider. Before the drugs are prescribed, a complete medical history; a physical examination including breast and pelvic examinations and a Pap test; urinalysis; and weight and blood pressure measurements are recommended. These examinations should be repeated at least annually if the client is taking the drugs. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, pp. 534-537. Chapter 45: Male and Female Hormones - Page 534-537 Add a Note
13 See full question 23s A client's anemia has not responded to conservative treatments, so the client has been prescribed oxymetholone 2.5 mg/kg PO per day. The client weighs 154 lbs. How many 50 mg tablets should the client take each day?
3.5 Explanation: The client's weight should first be converted to kilograms: 154 lbs ÷ 2.2 = 70 kg. The daily dose is 2.5 mg/kg/day, and 2.5 x 70 = 175 mg. The drug is available in 50 mg tablets, and 175 mg ÷ 50 mg/tablet = 3.5 tablets. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 539. Chapter 45: Male and Female Hormones - Page 539 Add a Note
7 See full question 11s Which client who is taking progesterone would a nurse monitor most carefully for potential adverse effects?
A 32-year-old woman with epilepsy Explanation: Progesterone therapy may result in fluid retention. Clients with pathologies that may be adversely affected by fluid retention, such as epilepsy, migraines, asthma, cardiac dysfunction, and renal dysfunction, need to be given progesterone with extra caution. Clients with hypotension, those who are HIV-positive, and clients who have hepatitis would not require as careful monitoring directly related to progesterone therapy as the client with epilepsy. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 534. Chapter 45: Male and Female Hormones - Page 534 Add a Note
6 See full question 1m 46s A woman has been prescribed anabolic steroids. What effect related to the administration of anabolic steroids will result?
Amenorrhea Explanation: Women who are prescribed anabolic steroids will experience amenorrhea. They will experience breast atrophy, diminished bone growth, and decrease in hair. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 529. Chapter 45: Male and Female Hormones - Page 529 Add a Note
10 See full question 2m 12s Which of the following medications, when administered concomitantly with oral contraceptives, can decrease the effect of the contraceptives?
Anticonvulsants Explanation: Anticonvulsants may decrease the effects of oral contraceptives by inducing enzymes that accelerate metabolism of estrogens and progestins. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 534. Chapter 45: Male and Female Hormones - Page 534 Add a Note
18 See full question 19s A man in his early 70s has prided himself in maintaining good health for his entire adult life. For this reason, his recent diagnosis of benign prostatic hypertrophy (BPH) is a source of frustration, and he asks, "I don't understand why I got this because I've always taken such good care of my body." What fact should be the basis for the nurse's response to the client?
BPH is thought to be a normal part of the male aging process. Explanation: It is thought that BPH is a normal element of the male aging process. Stress, hypertension, high cholesterol levels, and genetic factors are not usually implicated in the etiology of BPH. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018. Add a Note
8 See full question 12s A female client has been prescribed estrogen therapy. Which will the nurse advise the client is a common adverse effect of estrogen therapy?
Breakthrough bleeding Explanation: The nurse will advise the client that common adverse effects include breakthrough bleeding, changes in menstrual flow, dysmenorrhea, premenstrual-like syndrome, headache, nausea and vomiting, bloating, abdominal cramps, chloasma, and photosensitivity. Migraine headaches, dizziness, and changes in libido are less common adverse effects. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 539. Chapter 45: Male and Female Hormones - Page 539 Add a Note
14 See full question 16s The nurse is caring for a client who is extremely agitated about finding out she is pregnant and wants to take an abortifacient that will have the fastest possible action. What drug will the nurse expect to be ordered?
Carboprost Explanation: Carboprost is available as an intramuscular injection with an onset of 15 minutes and a 2-hour duration of effect. Mifepristone takes 5 to 7 days to produce the desired effect so would not be appropriate for this client. Prostin 15 is only available in Europe. Bepridil is a calcium channel blocker and would not be used as an abortifacient. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 536. Chapter 45: Male and Female Hormones - Page 536 Add a Note
9 See full question 17s Which of the following mood disorders can result from estrogen therapy?
Depression Explanation: Mental depression is a potential adverse effect of estrogens. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 538. Chapter 45: Male and Female Hormones - Page 538 Add a Note
1 See full question 42s In older adult men, anabolic steroids may be prescribed for a deficiency condition. If hypertensive, what might be the cause for an increase in blood pressure?
Increased fluid and sodium retention Explanation: Sodium and water retention are associated with androgen and anabolic steroid use, which aggravates hypertension. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 530. Chapter 45: Male and Female Hormones - Page 530 Add a Note
11 See full question 3m 41s The nurse is discussing the addition of testosterone gel (Androgel) to a male client who has a decreased libido related to a low testosterone level. The client currently takes imipramine (Tofranil) for treatment of depression. Which behavior does the nurse advise the client might occur because of this drug interaction?
Paranoid behavior Explanation: The interaction of imipramine and androgen can cause an increased risk of paranoid behavior, so it is important that a family member be given the information as well as the client. This interaction does not cause hallucinations, manic, or dissociative behaviors. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 529. Chapter 45: Male and Female Hormones - Page 529 Add a Note
16 See full question 33s When considering serious adverse effects, oral contraceptive use would most likely be contraindicated in which client?
a 38-year-old client who smokes 1 to 1½ packs of cigarettes per day Explanation: Oral contraception contains estrogen as an active ingredient. The most serious adverse effect of estrogen use is the increased risk of thromboembolic conditions. Thromboembolic disorders are most likely to occur in women older than 35 years of age who take oral contraceptives and smoke cigarettes, postmenopausal women taking long-term estrogen and progestin therapy, and men or women who receive large doses of estrogens for cancer treatment. None of the other clients have unusually high risks for thromboembolic conditions. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 534. Chapter 45: Male and Female Hormones - Page 534 Add a Note
20 See full question 26s A client is receiving estrogen therapy. The nurse would assess the client for which as an adverse reaction? Select all that apply.
abdominal bloating breakthrough bleeding breast pain Explanation: Abdominal bloating, breakthrough bleeding, and breast pain are adverse reactions associated with estrogens. Mental depression and insomnia are associated with progestins.
15 See full question 17h 46m 39s An adult woman began using oral contraceptives several months ago and has presented for an appointment to discuss recent worrisome changes in her health status. Which change in the woman's health may the nurse potentially attribute to the use of oral contraceptives?
frequent high blood pressure readings Explanation: It is very important to monitor for adverse drug effects such as high blood pressure, gallbladder disease, and blood-clotting disorders, which may be associated with oral contraceptive use. Headaches, nausea, and fatigue are not among the more common adverse effects of oral contraceptives. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 534. Chapter 45: Male and Female Hormones - Page 534 Add a Note
3 See full question 10s A client is prescribed oxymetholone (Anadrol-50) for treatment of angioedema. The nurse knows the client has type 2 diabetes and will instruct the client that the combination of oxymetholone with antidiabetic agents may lead to:
hypoglycemia. Explanation: Because of its effects on the liver, stanozolol (Winstrol) may interact with antidiabetic agents to decrease their metabolism and increase their effectiveness, leading to hypoglycemia. The dosage of the antidiabetic agents should be reduced and the client monitored closely. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 529. Chapter 45: Male and Female Hormones - Page 529 Add a Note
5 See full question 18s Which medications can be used to treat anemia associated with renal insufficiency?
oxymetholone Explanation: Oxymetholone is an anabolic steroid that can be used in the treatment of anemia. Fluoxymesterone is an androgen that can be used to treat hypogonadism. Dutasteride inhibits the conversion of testosterone to dihydrotestosterone (DHT). DHT is the androgen primarily responsible for the initial development and subsequent enlargement of the prostate gland. Estradiol is an estrogen used to treat female hypogonadism. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 539. Chapter 45: Male and Female Hormones - Page 539 Add a Note
5 See full question 5s Adult males who use androgens might experience what effects?
Enlargement of the prostate Explanation: In adult men, adverse effects include prostate enlargement. They do not generally include increased breast size, increased output, or hoarseness. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 45: Male and Female Hormones, p. 529. Chapter 45: Male and Female Hormones - Page 529 Add a Note
