Exam 1
A patient is prescribed sildenafil for erectile dysfunction. Which is the best time to take the dose? Answers: 1 hour before sexual intercourse 2 hours before sexual intercourse 30 minutes before sexual intercourse 10 minutes before sexual intercourse
1 hour before sexual intercourse
A nurse assesses the urine output of a patient receiving oxytocin [Pitocin]. Which finding would require immediate follow-up by the nurse? Answers: 250 mL in the past 8 hours 150 mL in the past hour 400 mL in the past 12 hours 80 mL in the past 4 hours
80 mL in the past 4 hours
The nurse at the fertility clinic is instructing a patient about the adverse effects of clomiphene. Which effects should the nurse instruct the patient to report to the health care provider? Select all that apply. Answers: Anxiety Hirsutism Dizziness Bradycardia Blurred vision Increased diuresis
Anxiety Dizziness Blurred vision Adverse effects of clomiphene, an ovarian stimulant, include anxiety, dizziness, blurred vision, tachycardia, deep vein thrombosis, nausea, constipation, urticaria, and others
A 46-year-old female patient who complains of hot flashes, fatigue, and sleep disorders is unwilling to start hormonal therapy. Which is the best nursing intervention for this patient? Answers: Persuade the patient to start the therapy. Ask the patient to include soy in her diet. Advise the patient to engage in quiet activities. Inform the patient about the benefits and risks of the therapy.
Ask the patient to include soy in her diet. The isoflavones in soy are chemically similar to the female hormone estradiol. It helps to reduce menopausal symptoms in perimenopausal women. Hence, the patient can be asked to include soy in her diet.
Which category of drugs is contraindicated in pregnancy according to the five-category system that will be phased out? Answers: Category A Category C Category D Category X
Category X
A pregnant client is being prepared for labor induction with oxytocin. The nurse concludes that the client has adequate understanding when the client verbalizes the medication will have which action? Select all that apply. Answers: Cause an increase in blood pressure to provide adequate oxygen for the baby Cause the uterus to contract harder and more often Start contractions that will be almost continuous until the baby is born Be given through the intravenous line in small continuous amounts that can be adjusted as needed Cause the client to be in real labor
Cause the uterus to contract harder and more often. Be given through the IV line in small continuous amounts that can be adjusted as needed. Cause the client to be in real labor.
A client is being treated for gonorrhea. Which agent would the nurse expect the physician to prescribe?
Ceftriaxone The microorganism N. gonorrhoeae has become increasingly resistant to penicillin and tetracyclines, and fluoroquinolones (such as levofloxacin). Therefore, the current CDC (2019) recommendation for treating gonorrhea is a single intramuscular dose of a broad-spectrum cephalosporin such as ceftriaxone (Rocephin) or oral dosing with cefixime (Suprax)
The perinatal nurse is assigned to several clients. The nurse anticipates that which client is most likely to be a candidate for drug therapy with terbutaline? Client at 27 weeks' gestation who has regular uterine contractions Client at 41 weeks' gestation with irregular uterine contractions Client with postpartum hemorrhage following delivery Client at 38 weeks" gestation with hypertension and seizures
Client at 27 weeks' gestation who has regular uterine contractions
Several clients in an outpatient clinic have requested prescriptions for sildenafil. The nurse anticipates having to inform which client that the request has been denied by the prescriber? Client diagnosed with Type 2 diabetes mellitus Client taking medication therapy for angina pectoris. Client with BPH who is being managed medically. Client who has chronic sinusitis with flare ups in the spring.
Client taking medication therapy for angina pectoris. Nitrates are the most common drug for angina.
The healthcare provider at an outpatient clinic is considering prescribing sildenafil for a 61 year old client. The nurse would make it a priority to discuss which item in the client's health history with the prescriber? Coronary Artery Disease with nitroglycerine use Renal impairment with elevated creatine level Blurred vision of unknown etiology Gout managed with allopurinol
Coronary Artery Disease with nitroglycerine use. Clients with CAD who take Sildenafil are at risk for sudden cardiac death because of additive hypotension.
Which medication is contraindicated in patients who have osteoporosis and a history of renal dysfunction? Calcitonin Tamoxifen Ibandronate Denosumab
Denosumab Denosumab prevents bone resorption in patients who have osteoporosis; however, it is contraindicated for patients who have a history of renal dysfunction, because it increases the risk for renal failure.
A client with primary syphilis is allergic to penicillin. The nurse would expect the physician to order which agent? (SATA) Answers: Podophyllum resin Ceftriaxone Doxycycline Acyclovir Tetracycline
Doxycycline Tetracycline Clients who are allergic to penicillin are given a 14-day regimen of tetracycline or doxycycline. Acyclovir is used to treat genital herpes. Ceftriaxone may be used for gonorrhea. Podophyllum resin is used to treat genital warts.
The nurse is providing care for a patient receiving androgen therapy for weight gain. Which adverse effect of the medication can be mistaken as weight gain? Hirsutism Fluid retention Roundness of face Peliosis of the liver
Fluid retention
After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment? Syphillis Gonorrhea Genital herpes Chlamydia
Genital Herpes
A client is diagnosed as being in the primary stage of syphilis? Which of the following would the nurse expect as a finding? Genital chancres Palmar rash Development of gummas Development of central nervous system lesions
Genital chancres
A 22-year-old patient has presented to her primary care provider for her scheduled Pap smear. Abnormal results of this diagnostic test may imply infection with: Answers: Chlamydia trachomatis. Candida albicans. human papillomavirus (HPV). Trichomonas vaginalis.
HPV
What primary roles does testosterone play in the male body? Select all that apply. Answers: Helps in production of red blood cells Helps development of facial hair in men Triggers better metabolic bodily functions Helps develop the male sex characteristics Triggers erectile dysfunction (ED), leading to delayed ejaculation
Helps in production of red blood cells Helps in production of facial hair in men Helps develop the male sex characteristics.
A woman comes into the emergency department. She says that she is pregnant and that she is having contractions every 3 minutes but she is "not due yet." She is very upset. While assessing her vital signs and fetal heart tones, what is the most important question the nurse must ask the client? Answers: "What were you doing when the contractions started?" "Are you preregistered at this hospital to give birth?" "How many weeks have you been pregnant?" "Have you felt the baby move yet?"
How many weeks have you been pregnant?
The nurse would question the administration of testosterone (Androderm) to a patient with which condition? Hyponatremia Hypovolemia Hyperkalemia Hypocalcemia
Hyperkalemia Testosterone can cause increased serum potassium levels.
Before advising a 24-year-old client desiring oral contraceptives for family planning, the nurse would assess the client for signs and symptoms of which of the following? Anemia. Hypertension. Dysmenorrhea. Acne vulgaris
Hypertension Before advising a client about oral contraceptives, the nurse needs to assess the client for signs and symptoms of hypertension. Clients who have hypertension, thrombophlebitis, obesity, or a family history of cerebral or cardiovascular accident are poor candidates for oral contraceptives. In addition, women who smoke, are older than 40 years of age, or have a history of pulmonary disease should be advised to use a different method. Iron-deficiency anemia, dysmenorrhea, and acne are not contraindications for the use of oral contraceptives. Iron-deficiency anemia is a common disorder in young women. Oral contraceptives decrease the amount of menstrual flow and thus decrease the amount of iron lost through menses, thereby providing a beneficial effect when used by clients with anemia. Low-dose oral contraceptives to prevent ovulation may be effective in decreasing the severity of dysmenorrhea (painful menstruation). Dysmenorrhea is thought to be caused by the release of prostaglandins in response to tissue destruction during the ischemic phase of the menstrual cycle. Use of oral contraceptives often improves facial acne
The nurse determines teaching regarding the levonorgestrel-releasing intrauterine delivery system has been effective when the client makes which statement? "These devices are 100% effective.' "I can keep this device in place for up to 5 years." "I will need to use a barrier method of birth control in addition to this device." "I will have the device removed every two years and replaced."
I can keep this device in place for up to 5 years
Which patient statement indicates to the nurse full patient understanding of the discharge instructions regarding alendronate? "I need to decrease my intake of dairy products to prevent hypercalcemia." "I need to take this medication with food to prevent damage to my esophagus." "This medication will help relieve the bone pain I have from my osteoporosis." "I will take the medication on an empty stomach and not lie down for 30 minutes."
I will take the medication on an empty stomach and not lie down for 30 minutes Alendronate can cause erosive esophagitis. To prevent this side effect, it is important to take the medication first thing in the morning on an empty stomach without any other medications and to maintain an upright position for 30 minutes. These actions facilitate rapid absorption and prevent reflux into the esophagus.
What is the purpose of administering menotropins to a male patient? 1 Decreases libido 2 Decreases fertility 3 Increases sperm production 4 Depresses sperm production
Increases sperm production
After dinoprostone is administered to a clinet, a nurse plans to monitor for which of the following? Fetal heart tones on a client who had difficulty conceiving Initiation of contractions for a client desiring an elective abortion Initiation of lactation for a client interested in breastfeeding. Early signs and symptoms of pregnancy.
Initiation of contractions for a client desiring an elective abortion.
When teaching a patient regarding proper application of a testosterone (Testoderm) transdermal patch, the nurse will provide which information about this medication? Remind to remove the patch every 72 hours. Explain to apply the patch on the back, abdomen, or upper arms. Instruct to place the patch on clean, dry, shaved scrotal skin. Advise to replace the patch every 36 hours.
Instruct to place the patch on clean, dry, shaved scrotal skin. Testoderm transdermal patches should be placed on clean, dry scrotal skin that has been shaved for optimal skin contact. A patch should be replaced every 24 hours.
Which method of administration is used for testosterone cypionate? Oral Topical Transdermal Intramuscular
Intramuscular
After a female client taking an estrogen-progestin combination reports by phone a sudden onset of blurred vision, the nurse at the outpatient clinic should ask what most appropriate question? Is there someone there with you? When was the last time you had your eyeglasses prescription changed? When is your next appoint with your ob/gyn? Do you have problems with migraine headaches?
Is there someone there with you? May indicate blood clot formation and the client may become suddenly unable to speak.
The nurse determines a client with endometriosis understands the purpose of the newly prescribed danazol when the client makes what statement? It suppresses pituitary output of the FSH. I'll need to take this medication for the rest of my life. I have to administer injections weekly. This medication will relieve hot flashes.
It suppresses pituitary output of FSH. Used for endometriosis to suppress the progress and pain.
Which laboratory test would the nurse expect the health care provider to prescribe to monitor a patient for adverse effects related to progestin medications? Complete blood count Serum creatinine level Liver function tests Cardiac enzymes
Liver function tests One of the most serious undesirable adverse effects of progestins is liver dysfunction, which would be assessed by monitoring liver enzymes.
A student nurse is caring for a male patient diagnosed with gonorrhea. The patient is receiving ceftriaxone and doxycycline. The nursing instructor asks the student why the patient is receiving two antibiotics. What is the student nurse's best response? "This combination of medications will eradicate the infection faster than a single antibiotic." "Many people infected with gonorrhea are infected with chlamydia as well." "The combination of these two antibiotics reduces the risk of reinfection." "There are many resistant strains of gonorrhea, so more than one antibiotic may be required for successful treatment."
Many people infected with gonorrhea are infected with Chlamydia as well.
Adverse effects of terbutaline are: (Select all that apply) Answers: Maternal tachycardia Diarrhea Hypokalemia Fetal Braycardia Palpitations Tremors Anxiety Hypotension
Maternal tachycardia Hypokalemia Palpitations Tremors Anxiety
Which medication is used to treat amenorrhea? 1 Estradiol 2 Denosumab 3 Alendronate 4 Medroxyprogesterone acetate
Medroxyprogesterone acetate
Which medication helps reduce postpartum uterine hemorrhage? 1 Megestrol 2 Raloxifene 3 Clomiphene 4 Methylergonovine
Methylergonovine Methylergonovine is a uterine stimulant used to treat postpartum hemorrhage.
The nurse's assessment of the client receiving an intravenous (IV) infusion of oxytocin notes that uterine contractions are 4 minutes apart and 60 seconds in duration. Which of the following nursing interventions is most important based on this assessment? Answers: Administer oxygen via face mask. Monitor the client for water intoxication. Position the client on her left side. Discontinue the infusion immediately
Monitor the client for water intoxication
A patient has been taking sildenafil for erectile dysfunction. The patient reports episodes of dizziness and fainting spells after using this drug. For which other drug should the nurse assess while taking the drug history of the patient? Nitrates Anticoagulants Antibiotics Alpha agonists
Nitrates
Which nursing action is the priority for a patient in preterm labor who is receiving magnesium sulfate? Answers: Documenting body temperature Obtaining deep tendon reflexes Measuring intake and output Monitoring the intensity of contractions
Obtaining deep tendon reflexes
Because a hypertensive client is experiencing post-partum hemorrhage, the nurse anticipates that the healthcare provider will most likely prescribe which drug to treat the hemorrhage? Ergonovine Methylergonovine Oxytocin Carboprost tromethamine
Oxytocin Oxytocin is used to control post-partum hemorrhage and promotion of postpartum uterine contraction.
The nurse finds that concentrated solutions of magnesium sulfate administered to prevent premature labor have caused toxicity in a patient. What is the best nursing intervention in this case? Answers: Obtain a prescription for terbutaline. Decrease the drug dose immediately. Obtain a prescription for indomethacin. Request a prescription to give calcium gluconate.
Request a prescription to give calcium gluconate
Which has the greatest potential to increase the risk of thromboembolism in a patient taking norethindrone and ethinyl estradiol? Sedentary lifestyle Smoking heavily every day Consumption of saturated fats Increased body mass index (BMI)
Smoking heavily every day
Which patient assessment finding does the nurse expect after the vaginal administration of dinoprostone? 1 Midline fundus 2 Decreased pain 3 Softened cervix 4 Strong contractions
Softened cervix Dinoprostone is indicated to ripen the cervix in preparation for labor induction. If labor induction is attempted without sufficient preparation of the cervix, cervical injury may occur.
A patient who is near term gestation is receiving oxytocin [Pitocin]. Which response should the nurse expect if the medication is having the desired therapeutic effect? Answers: Decreased force of uterine contraction Promotion of cervical ripening Stimulation of uterine smooth muscle Inhibition of milk ejection reflex
Stimulation of uterine smooth muscle
Because the client is being prepared for labor induction with oxytocin, the nurse instructs the LPN to report which client data? (SATA) Sudden rise in BP Changes in discomfort level immediately after drug is initiated. Gain of more than 5 lb in the last month. Sensation of nausea without vomiting. Changes in level of consciousness
Sudden rise in BP Change in LOC One common side effect of oxytocin is hypertensive episodes, so monitor BP and for a subarchnoid hermorrhage
The client taking an estrogen-progesterone combination oral contraceptive calls the clinic reporting that she has forgotten her pills for the last two days. what medication directions should the nurse provide? Take two pills today and two pills tomorrow, then one pill daily for the rest of the pack." "Take two pills today and then one pill every day until the pack is finished." "Notify your health care provider of the missed dosage." "Stop taking the pills and have your partner use condoms until the next menses, then restart a new pill pack."
Take two pills today and two pills tomorrow, then one pill daily for the rest of the pack."
To better help a client understand the action of clomiphene, the nurse should include which information in the teaching plan for a female client who will begin taking the drug? Teach normal process of conception. Explain uterine involution process Teach the client to keep a record of daily temperatures. Explain function of female hormones.
Teach normal process of conception. Clomiphene stimulates the production of LH and FSH, and therefore increases ovulation in women with anovulatory infertility.
The client is in preterm labor who has a history of asthma received 2.5 mg of terbutaline sulfate subQ. After the client expresses concern about the use of this drug, which reply by the nurse would be most appropriate? The HCP wanted to make sure you did not have asthma problems and early labor. I am sure the HCP has a very good reason for ordering this medication. What do you normally take to control your asthmatic attacks? Terbutaline sulfate causes the respiratory tract to relax as well as the uterine wall.
Terbutaline sulfate causes the respiratory tract to relax as well as the uterine wall.
The nurse is assessing a patient who is a professional weightlifter who has been banned from practicing weightlifting because of drug doping. The patient's reports reveal excessive concentration of nandrolone in the blood. What should the nurse interpret from these findings? Select all that apply. Answers: The patient is at a risk of developing anemia. The patient is at a risk of developing infertility. The patient is at a risk of having muscle atrophy. The patient is at a risk of cardiovascular disorder. The patient is at a risk of malabsorption syndrome. pt is at risk for increased cholesterol
The patient is at risk of developing infertility. The patient is at risk of cardiovascular disorder. The patient is at risk for increased cholesterol. Nandrolone is an anabolic steroid often abused by athletes for its muscle-building properties. These drugs are known to inhibit sperm production and increase cholesterol levels. Thus, sterility and cardiovascular disorders are the consequences associated with the improper use of anabolic steroids. Nandrolone promotes the anabolic processes in the body and also helps in erythropoiesis; thus it is medically prescribed for anemia.
The nurse is assessing a patient at a follow-up visit after starting treatment with sildenafil for erectile dysfunction. Which assessment finding would indicate that the treatment needs to be revised? Answers: The patient's cardiac output is 5.6 L/min. The patient's blood pressure is 90/60 mm Hg The patient verbalizes the ability to maintain an erection. The patient does not have dry mouth, nausea, or vomiting
The patient's blood pressure is 90/60 mm Hg Sildenafil is usually prescribed for the treatment of erectile dysfunction. The drug may cause severe hypotension. Therefore, if the patient has a blood pressure of 90/60 mm Hg, it means that the patient is unable to take sildenafil because of concern for further blood pressure lowering effects
A patient with menopausal symptoms is seeking hormone replacement therapy. During the assessment, the nurse finds that the patient has a history of endometrial cancer and is a smoker. Which is the most important information for this patient? Answers: "The therapy may cause thromboembolic events." "You may need to stop smoking during the therapy." "The treatment should be started as soon as possible." "The treatment is likely to cause endometrial cancer."
The therapy may cause thromboembolic events
A 26-year-old woman is considering Depo-Provera as the form of contraception that is best for her since she does not like to worry about taking a pill every day. To assist this woman with decision making concerning this method of contraception, the nurse would tell her that Depo-Provera: Is a combination of progesterone and estrogen. Is a small adhesive hormonal birth control patch that is applied weekly. Thickens and decreases cervical mucus, thereby inhibiting sperm penetration and ovulation. Has an effectiveness rate in preventing pregnancy of 100% when used correctly
Thickens and decreases cervical mucus, thereby inhibiting sperm penetration and ovulation. Depo-Provera is a progestin-only form of hormonal contraception. Depo-Provera is administered as an intramuscular injection. In addition to the changes in the cervical mucus, some but not all ovulatory cycles are suppressed, and formation of an endometrium capable of supporting implantation is inhibited. The effectiveness rate is 99% or greater over 5 years.
The nurse should conclude that a female client has understood medication instruction when she makes which statement about clomiphene? This medication will help me ovulate Ill take this medication orally for 1 month. This medication prepares the wall of the uterus for fertilization. My husband is going to ask if he can the the medication as well.
This medication will help me ovulate
After testosterone cypionate is prescribed for a 16 year old male client diagnosed with hypogonadism, the client asks, "Why do I need these hormones, anyway?" The nurse should provide which description of the relationship between hypogonadism and this drug? Testosterone is necessary to prevent your muscles from atrophying. This medication is a form of testosterone. Your doctor can best explain it to you. Testosterone prevents your body from becoming feminine-looking. This medication will increase your testosterone to a normal level.
This medication will increase your testosterone to a normal level. In cases of hypogonadism, too little testosterone is produced naturally.
A client beginning oral contraceptive therapy with desogestrel and ethinyl estradiol asks the nurse why two different drugs are needed in the pill. Which explanation by the nurse is best? This medication is a weak estrogen and progestin combination that requires additional estrogen to work. Together the hormones prevent the ovum from maturing and the sperm from penetrating through the cervical mucus. Estrogens alone would prevent pregnancy, but progestins are added so that spotting doesn't occur. Taking each hormone seperately would prevent most pregnancies but the combination taken together in one pill is more effective.
Together the hormones prevent the ovum from maturing and the sperm from penetrating through the cervical mucus. Progestins thicken cervical mucous to block sperm, estrogen prevents the LH surge that stimulates ova maturation.
The nurse is reviewing the health history of a client who is to begin therapy with a combined oral contraceptive drug. Which findings in the client's history should the nurse address with the client? (SATA) Use of St. John's wort for depression Smoking cessation over 10 years ago Frequent migraine headaches Follows a vegan diet Cholecystectomy 3 months ago
Use of St. John's wort for depression Frequent migraine headaches. St. john's wort and many antibiotics can decrease the estrogenic effects of oral contraceptives. Headaches are a side effect of oral contraceptives.
The nurse is educating a patient about medications used to treat erectile dysfunction. Which erectile dysfunction medications have the longest therapeutic effect when taken orally? (Select all that apply.) Avanafil (Stendra) Alprostadil (Caverject) Vardenafil (Levitra) Tadalafil (Cialis) Sildenafil (Viagra)
Vardenafil (Levitra) Tadalafil (Cialis)
Which clinical manifestations can be observed in a patient who is receiving teriparatide therapy? Select all that apply. Vertigo Joint pain Chest pain Hot flashes Loss of appetite
Vertigo Joint pain Chest pain
The nurse should conclude that which client is most likely to have testosterone transdermal prescribed for his condition? a 45 year old with status-post bilateral vasectomy a 17 year old with status-post right cryptorchidism repair a 23 year old with status post varicocele repair a 32 year old with status post bilateral orchidectomy.
a 32 year old with status post bilateral orchidectomy Orchidectomy is the removal of the testicle, which would require hormone replacement
The nurse should consult with the healthcare provider after noting that testosterone enanthate has been prescribed for which client? a 16 year old with moderate acne a 32 year old with an increased prostatic antigen level (PSA) a 66 year old with melanoma a 65 year old male with a high density lipoprotein (HDL) of 88 mg/dL
a 66 year old with melanoma Testosterone is contraindicated in a client suspected of having prostate cancer.