Pharm 1140 Exam II

men's Health

......

Which medication is used to treat hypogonadism? 1 Megestrol 2 Alendronate 3 Esterified estrogens 4 Medroxyprogesterone

3. Esterified estrogens Esterified estrogens are a type of estrogen used in the treatment of hypogonadism. Megestrol is a synthetic progestin used to treat uterine bleeding. Alendronate is used to minimize bone loss in osteoporosis. Medroxyprogesterone is used to prevent pregnancy.

The primary health care provider prescribes diphenhydramine to a patient who has nausea and vomiting. What advice will the nurse give to the patient while administering this drug? 1 "You should not consume alcohol." 2 "You should not consume oral fluids." 3 "You should consume coffee frequently." 4 "You should not do relaxation techniques."

Correct 1 "You should not consume alcohol."

The nurse is reviewing the medication list for a patient and notes that finasteride (Propecia) 1 mg daily is on the list. This drug is for which of these problems? a. Benign prostatic hypertrophy (BPH) b. Erectile dysfunction c. Alopecia in male patients d. Alopecia in male and female patients.

c. Alopecia in male patients

The nurse is performing an assessment of a patient who is asking for a prescription for sildenafil (Viagra). Which finding would be a contraindication to its use? a. 65 years of age b. History of thyroid disease c. Medication list that includes nitrates d. Medication list that includes saw palmetto

c. Medication list that includes nitrates

. A patient is asking about the use of saw palmetto for prostate health. The nurse tells him that drugs that interact with saw palmetto include: a. acetaminophen (Tylenol). b. nitrates. c. nonsteroidal antiinflammatory drugs. d. antihypertensive drugs.

c. nonsteroidal antiinflammatory drugs.

The nurse is teaching a patient about the possible adverse effect of priapism, which may occur when taking erectile dysfunction drugs. The nurse emphasizes that, if this occurs, the most important action is to a. stay in bed until the erection ceases. b. apply an ice pack for 30 minutes. c. turn toward his left side and rest. d. seek medical attention immediately.

d. seek medical attention immediately.

Which patient statement indicates to the nurse full patient understanding of the discharge instructions regarding alendronate? 1 "I need to decrease my intake of dairy products to prevent hypercalcemia." 2 "I need to take this medication with food to prevent damage to my esophagus." 3 "This medication will help relieve the bone pain I have from my osteoporosis." Correct 4 "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 min

What vitamins are MOST likely to lead to toxic levels, hypervitaminosis, when administered in megadoses? (Select all that apply.)

k,d,a,

The nurse is providing care for a patient taking oxandrolone. Which test should the nurse evaluate to help prevent complications in the patient? 1 Glucose 2 Hematocrit 3 Hemoglobin 4 Liver function

liver function Oxandrolone causes the formation of blood-filled cavities, a condition known as peliosis of the liver; it is therefore necessary to give a liver function test. A glucose test is used to assess the blood glucose level in diabetic patients. Hematocrit and hemoglobin are evaluated for polycythemia.

What is an adverse effect associated with estrogen therapy? 1 Nausea 2 Dry skin 3 Weight loss 4 Higher-pitched voice

nausea The most common undesirable effect of estrogen use is nausea. Photosensitivity may also occur with estrogen therapy. One common dermatologic effect of note is chloasma, not dry skin. Weight loss and a higher-pitched voice are not caused by estrogen therapy.

The nurse is teaching students about progestin-only oral contraceptives. Which statement by a student suggests effective learning?

they may cause breakthrough bleeding

A patient has been taking finasteride (Proscar) for almost 1 year. The nurse knows that which is most important to evaluate at this time? a. Complete blood count b. PSA levels c. Blood pressure d. Fluid retention

b. PSA levels

. When the Testoderm form of testosterone is ordered to treat hypogonadism in a teenage boy, which instructions by the nurse are correct? (Select all that apply.) a. Place the patch on clean, dry skin on the back, upper arms, abdomen, or thighs. b. Place the patch on clean, dry scrotal skin that has been shaved. c. Place the patch on clean, dry scrotal skin, but do not shave the skin first. d. Place the patch on any clean, dry, nonhairy area of the body. e. Remove the old patch before applying a new patch.

b. Place the patch on clean, dry scrotal skin that has been shaved. e. Remove the old patch before applying a new patch.

The nurse is educating a client on vitamin supplementation. The client states, "I take a lot of vitamins every day to stay healthy." Based on knowledge and understanding of vitamin supplements, what is the nurse's best response?

"Can you tell me what vitamins you take and how many and how often?" The nurse needs further information on the amount and type of vitamins the patient is taking. A client may develop hypervitaminosis or toxic level of vitamins if more than the recommended daily allowance is taken with certain vitamins.

Which statement indicates that the patient understands the benefit of continuous administration of progestin with an estrogen regimen? 1 "Endometrial cancer risk can be reduced by adding progestin." 2 "The progestin in the regimen will help prevent breast cancer." 3 "The progestin in the regimen will help prevent ovarian cancer." 4 "Vaginal cancer is prevented by adding progestin to the regimen."

"Endometrial cancer risk can be reduced by adding progestin."

Which patient statement indicates to the nurse full patient understanding of the discharge instructions regarding alendronate? 1 "I need to decrease my intake of dairy products to prevent hypercalcemia." 2 "I need to take this medication with food to prevent damage to my esophagus." 3 "This medication will help relieve the bone pain I have from my osteoporosis." 4 "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. Decreasing dairy intake is not indicated. The medication does not directly relieve bone pain caused by osteoporosis.

Which clinical manifestations can be observed in a patient who is receiving teriparatide therapy? Select all that apply. 1 Vertigo 2 Joint pain 3 Chest pain

1 Vertigo 2 Joint pain 3 Chest pain

A female patient with strep throat is taking amoxicillin with clavulanate to treat the infection. Because the patient also takes an oral contraceptive (OC), how long should the nurse instruct the patient to use a different method of birth control? 1 For at least a month after starting the antibiotic 2 During the entire period the patient is taking the antibiotic 3 Until three throat cultures have been negative for the pathogen 4 For at least 6 weeks, starting at the end of the antibiotic regimen

1 month after starting the antibiotic Because antibiotics, especially penicillin and cephalosporins, can impair the action of OCs, the nurse should instruct the patient to use another method of birth control for at least 1 month after starting the antibiotic. The effect of OCs is reduced when antibiotic therapy is started. Hence, using birth control only at the end of the antibiotic regimen is not effective. If three throat cultures are negative for the pathogen, it indicates a need to stop the antibiotic therapy, not to resume the use of birth control.

Which assessment finding indicates that a patient is a suitable candidate for oxytocin therapy? 1. Vaginal bleeding at 38 weeks' gestation 2. Ineffective contractions in a full term pregnancy 3. Absence of cervical ripening at 42 weeks' gestation 4. Radiographic confirmation of cephalopelvic disproportion

2 Ineffective contractions in a full term pregnancy A patient whose pregnancy is full term but who has ineffective contractions is a suitable candidate for oxytocin therapy to augment the strength and increase the frequency of contractions. Vaginal bleeding in a patient near term is an obstetric emergency, and oxytocin is contraindicated, because it is likely to increase the bleeding, increase and strengthen the contractions, and cause fetal distress. Oxytocin is indicated for the induction of labor in a postterm patient, but the patient must have a soft cervix. In a patient with cephalopelvic disproportion, the fetus's head may be too large for the patient's pelvis; harm to both patient and fetus could occur if oxytocin were administered.

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? 1 The patient's cardiac output is 5.6 L/min. 2 The patient's blood pressure is 90/60 mm Hg. 3 The patient verbalizes the ability to maintain an erection. 4 The patient does not have dry mouth, nausea, or vomiting.

2 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 cardiac output of 5.6 L/min is a normal finding and indicates a positive response to the treatment. The ability to maintain an erection indicates the effectiveness of the treatment. Dry mouth, nausea, and vomiting are potential side effects of sildenafil. The absence of these symptoms indicates a positive outcome of the treatment.

What are the functions of testosterone? Select all that apply. 1 Fat metabolism 2 Bone development 3 Production of red blood cells 4 Excretion of sodium and potassium 5 Development of secondary sexual characteristics

2. Bone development 3. Production of red blood cells 5. Development of secondary sexual characteristics

The nurse is assessing a patient who is taking fluoxymesterone to treat reduced testosterone levels. The patient has gained weight 1 week after beginning the medication. What is the likely cause for weight gain in the patient? 1 Impaired liver function 2 Impaired thyroid activity 3 Increased fluid retention 4 Impaired lipid metabolism

3 Increased fluid retention

Why does the United States Drug Enforcement Administration classify anabolic steroids as Schedule III medications? 1 They cause endometriosis. 2 They cause erectile dysfunction. 3 They cause physical dependence. 4 They cause sedation and hypnosis.

3. They cause physical dependence.

The nurse encounters a male patient who is taking finasteride. Which condition should the nurse suspect in the patient? 1 Priapism 2 Bladder cancer 3 Testicular cancer 4 Benign prostatic hyperplasia (BPH)

4 Benign prostatic hyperplasia (BPH)

A male patient is taking sildenafil. What health problem should the nurse expect in the patient? 1 Gynecomastia 2 Decreased libido 3 Low sperm count 4 Erectile dysfunction

4 Erectile dysfunction Sildenafil is one of the primary agents used for the treatment of erectile dysfunction for patients. Finasteride is associated with gynecomastia and decreased libido. Testosterone is used for the treatment of oligospermia or fluctuating sperm count.

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 is on an anticonvulsant 4 the patient is on antibiotics

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.

anticholinergic

Dilates pupils Causes photophobia Used preoperatively for cataract removal Don't use in glaucoma Atropine is an example blocks parasympathetic nerve impulses; decreases oral and respiratory secretions (atropine, Artane)

The nurse prepares to administer daily medications to a female patient who takes furosemide (Lasix) for heart failure and uses brinzolamide (Azopt) ophthalmic drops for glaucoma. The nurse notes that the patient's serum potassium level is 3.0 mEq/L. What should the nurse do next? A. Assess the patient's cardiac rhythm B. Withhold the brinzolamide C. Withhold the furosemide D. Administer the medications

A. Assess the patient's cardiac rhythm Before administering or withholding the medications, the nurse should assess the patient for clinical indicators of hypokalemia, including the cardiac rhythm, because hypokalemia increases the risk of ventricular dysrhythmias. Once the assessment is complete, the nurse can determine if medication should be administered or withheld.

A patient with type 2 diabetes mellitus who takes metformin (Glucophage) daily has excessively high intraocular pressure (IOP). Which medication used in the treatment of increased IOP should the nurse avoid administering to this patient to prevent a serious adverse effect of therapy? A. Mannitol (Osmitrol) B. Betaxolol (Betoptic) C. Latanoprost (Xalatan) D. Brinzolamide (Azopt)

A. Mannitol (Osmitrol) The nurse avoids administering an osmotic diuretic such as mannitol to the patient taking metformin as a means of preventing metabolic acidosis because acidosis is an adverse effect of mannitol and metformin. Betaxolol is indicated in the treatment of chronic glaucoma. Lantanoprost is used in the treatment of open-angle glaucoma and ocular hypertension when other treatments have failed. Brinzolamide is a carbonic anhydrase inhibitor used in the treatment of open-angle and angle-closure glaucoma but not usually for the treatment of acute intraocular hypertension.

A patient requires dorzolamide (Trusopt) for glaucoma. What is the nurse's priority patient assessment before therapy is begun? A. Medication list B. Fine motor skills C. Eyelid condition D. Systemic illnesses

A. Medication list The nurse's priority is the compilation of a list of the patient's medications to help identify potential drug interactions and the potential for cross-sensitivity to sulfa drugs. The nurse will analyze the medication list for sulfa drugs and sulfonamides and diuretics because these medications have side-effect profiles similar to the hematologic, gastrointestinal, integumentary, and metabolic effects of carbonic anhydrase inhibitors. It is important to assess fine motor skills to determine whether the patient will be able to self-administer the dorzolamide. The condition of the eyelid is a reasonable nursing assessment before the start of any ophthalmic medication regimen. Listing of comorbid illnesses is an important means of identifying conditions that might affect therapy.

Which glaucoma ophthalmic drops reduce increased intraocular pressure without affecting pupil size? A. Timolol (Timoptic) B. Dipivefrin (Propine) C. Pilocarpine (Pilocar) D. Epinephryl (Epinal)

A. Timolol (Timoptic) Beta-adrenergic blockers such as timolol reduce increased intraocular pressure by slowing the formation of aqueous humor. Dipivefrin, pilocarpine, and epinephryl decrease intraocular pressure by means of mydriatic and miotic actions.

Which condition in a patient's history is a contraindication for the administration of estrogens? 1 Weight gain 2 Hypertension 3 Dysmenorrhea 4 Thrombophlebitis

Contraindications for estrogen administration include known drug allergy, any estrogen-dependent cancer, undiagnosed abnormal vaginal bleeding, pregnancy, and active thromboembolic disorder (e.g., stroke, thrombophlebitis) or a history of such a disorder. It is not contraindicated in patients with weight gain, hypertension, or dysmenorrhea.

A nurse is providing education to a group of athletes on the topic of anabolic steroids. What serious adverse effects would the nurse include in the discussion with the group of athletes? (Select all that apply.)

Correct Sterility Cardiovascular disease Liver cancer

Achlorydia

Absence of hydrochloric acid from the gastric juice.

Which group of college students does the nurse need to include in a teaching session on the risks of androgen abuse? 1 Students who are often tardy 2 Students who are on athletic teams 3 Students who do not socialize well in school 4 Students who perform extraordinarily in class

Correct 2. Students who are on athletic teams

A client receiving vitamin K MOST likely has which abnormal clinical finding?

Altered coagulation studies Vitamin K is an essential nutrient for the synthesis of clotting factors, which takes place in the liver. It is also the antidote for warfarin (Coumadin), an oral anticoagulant. The administration of vitamin K enhances the coagulation process, thus minimizing a patient's risk for excessive bleeding.

Which is an off-label use of oxandrolone? 1 Anemia 2 Alcoholic hepatitis 3 Hereditary angioedema 4 Metastatic breast cancer

An off-label use of oxandrolone is for the treatment of alcoholic hepatitis. The approved clinical uses of anabolic steroids, such as oxandrolone, are anemia, hereditary angioedema, and metastatic breast cancer.

The nurse is teaching patients with glaucoma to self-administer their medications. Which patient teaching should the nurse provide? A. Apply an ointment under the upper eyelid. B. Allow eyedrops to fall on the conjunctival sac. C. Allow all excess medication to be absorbed slowly. D. Wipe the eyes with a warm compress after administering eyedrops.

B. Allow eyedrops to fall on the conjunctival sac. The nurse instructs the patients to allow the medication to fall on the conjunctival sac and not directly on the eye. Ointment is applied under the lower eyelid. Excess medication may be dabbed away with a tissue, provided the patient is careful not to allow the tissue to remove medication from the eye. The nurse avoids instructing patients to wipe the eyes with a warm compress because the heat may affect the absorption of the medication.

A patient's intraocular pressure (IOP) is dangerously high. Which patient assessment data should the nurse use as baseline data before administering treatment for the IOP? A. Gastrointestinal (GI) function B. Breath sounds C. Renal function D. Peripheral edema

B. Breath sounds An osmotic diuretic such as mannitol is indicated in the treatment of acute intraocular hypertension. The nurse assesses the patient's breath sounds before administering mannitol for the acute reduction of IOP because osmotic diuretics are contraindicated in pulmonary edema. Assessments of GI function, renal function, and peripheral edema are reasonable nursing assessments before the administration of an osmotic diuretic but do not reveal contraindications to therapy

Which medication used as maintenance therapy in the treatment of glaucoma works by providing another exit route of aqueous humor besides the trabecular network? A. Isosorbide (Ismotic) B. Latanoprost (Xalatan) C. Dorzolamide (Trusopt) D. Levobetaxolol (Betagan)

B. Latanoprost (Xalatan) Lantanoprost is a prostaglandin agonist that relieves intraocular pressure (IOP) by increasing the outflow of aqueous humor between the uvea and the sclera in addition to the trabecular network. Isosorbide is an osmotic diuretic that reduces IOP by drawing water from the aqueous humor by means of osmotic pressure. Dorzolamide is a carbonic anhydrase inhibitor, and levobetaxolol is a beta-adrenergic blocker that reduces the formation of aqueous humor.

A patient who is 26 weeks pregnant and who has diabetes mellitus begins to experience preterm labor. Which treatment is the best initial therapy for the prevention of uterine contractions and complications in this patient's pregnancy? 1 Ritodrine 2 Terbutaline 3 Magnesium sulfate 4 Bed rest and hydration

Bed rest and hydration are especially good choices for this patient, because they do not carry the risk of increased blood sugar that terbutaline therapy does. Because pressure on the cervix or cervical incompetence can stimulate uterine contractions, bed rest may also be effective in relieving pressure on the cervix and inhibiting uterine activity. Ritodrine is generally reserved for when conservative measures and terbutaline have failed. Generally terbutaline, the drug of choice for preterm labor, is used after conservative measures have failed. Magnesium sulfate is used as an off-label therapy for preterm labor.

Which condition is an indication of saw palmetto use? 1 Dysuria 2 Back pain 3 Gastrointestinal upset 4 Benign prostatic hyperplasia

Benign prostatic hyperplasia Saw palmetto is an herbal supplement used to treat benign prostatic hyperplasia and alopecia. Dysuria, back pain, and gastrointestinal upset are the adverse effects associated with the use of saw palmetto.

What is an adverse effect of anabolic steroids? 1 Chest pain 2 Dermatitis 3 Tachycardia 4 Changes in libido

Changes in libido The use of anabolic steroids is associated with changes in libido. Patients receiving medications for erectile dysfunction may report chest pain. Dermatitis is associated with the topical use of peripheral vasodilators. Tachycardia is an adverse effect associated with the use of alpha1-adrenergic blockers.

Which medication is used for treating infertility? 1 Oxytocin Correct 2 Clomiphene 3 Indomethacin 4 Dinoprostone

Clomiphene Infertility is an absence of ovulation caused by an imbalance in reproductive hormones. stimulates the production of gonadotropin hormones, which in turn leads to ovulation. Oxytocin is used to induce labor when uterine contractions are weak. Indomethacin is used during preterm labor. Dinoprostone is used to evacuate the uterine contents during miscarriage and for cervical ripening.

The nurse is assessing a patient who is taking fluoxymesterone to treat reduced testosterone levels. The patient has gained weight 1 week after beginning the medication. What is the likely cause for weight gain in the patient? 1 Impaired liver function 2 Impaired thyroid activity Correct 3 Increased fluid retention 4 Impaired lipid metabolism

Correct 3 Increased fluid retention Fluoxymesterone is an androgenic drug that may cause fluid retention in some patients. Thus, in this patient, fluid retention would have been the most probable cause of weight gain. Impaired liver function is a complication associated with anabolic steroids and not fluoxymesterone. Impaired thyroid activity may cause weight gain; however, androgenic drugs do not affect the thyroid activity. Impaired lipid metabolism is also a complication associated with androgens that causes elevated cholesterol levels. However, weight gain from high cholesterol levels takes place over a long period of time.

What is the purpose of giving estrogen therapy in combination with progestins?

Correct 3 To prevent endometrial cancer

What is the purpose of giving estrogen therapy in combination with progestins? 1. To treat ovarian cancer 2. To treat breast cancer 3. To prevent endometrial cancer 4. Correct 3 To prevent endometrial cancer

Correct 3 -To prevent endometrial cancer To reduce the risk of endometrial hyperplasia or cancer, the concurrent use of a progestin for 10 to 14 days of the cycle is recommended for women with an intact uterus. Estrogens are administered to prevent complications from ovarian failure but not to treat ovarian cancer. Estrogen therapy raises recurrence risk if administered to patients with breast cancer. Vaginal cancer is treated with surgery or chemotherapy.

A patient who reports difficulty passing urine is prescribed finasteride by the primary health care provider. What condition should the nurse suspect to have caused difficulty in urination? 1 Renal calculi 2 Neurogenic bladder 3 Urinary tract infection 4 Benign prostatic hyperplasia

Correct 4 Benign prostatic hyperplasia Difficulty in passing urine is the characteristic symptom of benign prostate hyperplasia. Finasteride is a 5-alpha reductase inhibitor drug that is prescribed for benign prostate hyperplasia. This drug impairs prostatic growth. Renal calculi also cause difficulty in urination. However, finasteride is not helpful in dissolving calcium stones. Finasteride does not affect the central or the peripheral nervous system; thus, it would be ineffective in treating urinary problems associated with neurogenic bladder. Finasteride has no antibiotic properties; thus, it would not be useful in treating a urinary tract infection.

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? 1 Obtain a prescription for terbutaline. 2 Decrease the drug dose immediately. 3 Obtain a prescription for indomethacin. 4 Request a prescription to give calcium gluconate

Correct 4 Request a prescription to give calcium gluconateThe nurse administers calcium gluconate, as it reverses magnesium toxicity in the patient. Terbutaline is a beta-adrenergic drug used to prevent premature labor, but it has maternal and fetal safety risks. Decreasing the drug dose will not have the desired drug effect on the patient. Indomethacin is an effective drug for preterm labor, but the most important action here is to reverse magnesium toxicity.

Cyanocobalamin (vitamin B12) is indicated for the treatment of which condition?

Cyanocobalamin is used to treat deficiency states of vitamin B12. The most common manifestation of untreated cyanocobalamin deficiency is pernicious anemia.Altered coagulation studies Vitamin K is an essential nutrient for the synthesis of clotting factors, which takes place in the liver. It is also the antidote for warfarin (Coumadin), an oral anticoagulant. The administration of vitamin K enhances the coagulation process, thus minimizing a patient's risk for excessive bleeding.

A female patient who has glaucoma and has used dipivefrin (Propine) ophthalmic drops for 6 months tells the nurse that she is experiencing palpitations. Which action should the nurse implement? A. Checking for over-the-counter medication B. Telling the patient to visit her health care provider C. Asking the patient about excessive caffeine intake D. Assessing the patient for signs of cardiac stimulation

D. Assessing the patient for signs of cardiac stimulation With prolonged use or excessive dosing, a sympathomimetic agent such as dipivefrin can cause systemic effects, including extrasystoles, hypertension, and tachycardia; although this is uncommon, the nurse assesses the patient for clinical indicators of sympathetic stimulation.

A female patient who has glaucoma and has used dipivefrin (Propine) ophthalmic drops for 6 months tells the nurse that she is experiencing palpitations. Which action should the nurse implement? A. Checking for over-the-counter medication B. Telling the patient to visit her health care provider C. Asking the patient about excessive caffeine intake D. Assessing the patient for signs of cardiac stimulation

D. Assessing the patient for signs of cardiac stimulation With prolonged use or excessive dosing, a sympathomimetic agent such as dipivefrin can cause systemic effects, including extrasystoles, hypertension, and tachycardia; although this is uncommon, the nurse assesses the patient for clinical indicators of sympathetic stimulation.

The nurse wants to decrease the risk of secondary infections and complications associated with the use of antimicrobial eyedrops. What is the nurse's priority instruction during teaching of patients who are beginning to use the eyedrops? A. Tilt the head up and open the eye wide. B. Apply gentle pressure to the inner canthus. C. Retract the lower eyelid to instill the eyedrops. D. Avoid touching the medication container to the eye.

D. Avoid touching the medication container to the eye. The nurse stresses the importance of avoiding contact between the medication container and the infected tissue as a means of preventing both contamination of the medication and secondary infections. Tilting the head, applying gentle pressure, and retracting the lower eyelid are reasonable nursing instructions for a patient using eyedrops; however, these measures are unrelated to infection control.

When administering intravenous magnesium sulfate, the nurse will monitor for which signs and symptoms of hypermagnesemia?

Decrease in deep tendon reflexes Signs and symptoms of excess magnesium include tendon reflex loss, difficult bowel movements, central nervous system depression, respiratory distress, heart block, and hypothermia.

The nurse is assessing a patient who is prescribed estrogen replacement therapy. A history of which medical condition would be a contraindication to this therapy?

Deep vein thrombosis The most serious adverse effects of the estrogens are thromboembolic events. A previous history would put the patient at increased risk. Uterine bleeding is an indication for estrogen therapy. A history of weight loss or dysmenorrhea would not be a contraindication for estrogen replacement therapy.

Which medication is contraindicated in patients who have osteoporosis and a history of renal dysfunction? 1 Calcitonin 2 Tamoxifen 3 Ibandronate 4 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. Calcitonin is used to treat osteoporosis and is contraindicated in patients who are allergic to salmon, because it is derived from salmon. Tamoxifen is a selective estrogen receptor modulator (SERM) used to treat osteoporosis and is contraindicated in patients who have deep vein thrombosis or pulmonary embolism, because it increases the risk for thrombosis. Ibandronate is used in the treatment of osteoporosis and is contraindicated if the patient has hypocalcemia and esophageal dysfunction.

Which medication is contraindicated in patients who have osteoporosis and a history of renal dysfunction? 1 Calcitonin 2 Tamoxifen 3 Ibandronate 4 DenosumabSelective

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. Calcitonin is used to treat osteoporosis and is contraindicated in patients who are allergic to salmon, because it is derived from salmon. Tamoxifen is a selective estrogen receptor modulator (SERM) used to treat osteoporosis and is contraindicated in patients who have deep vein thrombosis or pulmonary embolism, because it increases the risk for thrombosis. Ibandronate is used in the treatment of osteoporosis and is contraindicated if the patient has hypocalcemia and esophageal dysfunction.

What possible common adverse effect would the nurse include in the discharge teaching for a patient prescribed finasteride (Proscar)?

Ejaculatory dysfunction Possible adverse effects of finasteride include ejaculatory dysfunction, loss of libido, loss of erection, hypersensitivity reactions, gynecomastia, and severe myopathy. It is also used to treat male pattern baldness and thus would cause hair growth, not hair loss.

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? 1 Hirsutism 2 Fluid retention 3 Roundness of face 4 Peliosis of the liver

Fluid retention is an adverse effect of androgen therapy that may be mistaken for weight gain in a patient. Hirsutism refers to excessive amounts of hair growth on the body. Roundness of the face is seen in patients taking corticosteroids. Peliosis of the liver refers to the formation of blood-filled cavities.

Which of the following hormones initiates the cycle of events in the female ovary? 1 Antidiuretic hormone 2 Luteinizing hormone (LH) 3 Adrenocorticotropic hormone 4 Follicle-stimulating hormone

Follicle stimulating hormone initiates mentstrual cycle

The nurse would question the administration of testosterone (Androderm) to a patient with which condition?

Hyperkalemia Testosterone can cause increased serum potassium levels.

The nurse would question a health care provider's prescription for vitamin D in a client with which condition?

Hyperparathyroidism Vitamin D is contraindicated with hypercalcemia, a clinical manifestation of hyperparathyroidism.

What is a pharmacodynamic effect of exogenous androgens? Increased protein synthesis Androgens retard the breakdown of amino acids, contributing to an increased synthesis of body proteins, which aids in the formation and maintenance of muscle tissue. Additionally, they stimulate the production of erythropoietin by the kidneys, resulting in enhanced erythropoiesis (red blood cell synthesis); increase the retention of nitrogen which is essential protein synthesis; and may suppress sperm production when given in large doses as a result of the feedback inhibition of pituitary follicle-stimulating hormone.

Increased protein synthesis Androgens retard the breakdown of amino acids, contributing to an increased synthesis of body proteins, which aids in the formation and maintenance of muscle tissue. Additionally, they stimulate the production of erythropoietin by the kidneys, resulting in enhanced erythropoiesis (red blood cell synthesis); increase the retention of nitrogen which is essential protein synthesis; and may suppress sperm production when given in large doses as a result of the feedback inhibition of pituitary follicle-stimulating hormone.

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 Menotropins may be used to promote spermatogenesis in infertile men. They are used primarily for the promotion of ovulation in anovulatory female patients. They increase fertility and stimulate sperm production. This may often lead to enhanced libido.

Which medication is used in management of preterm labor?

Indomethacin

Which medication is used in management of preterm labor? 1 Megestrol 2 Indomethacin 3 Methylergonovine 4 Medroxyprogesterone acetate

Indomethacin is a nonsteroidal antiinflammatory agent used in management of preterm labor. Megestrol is a progestational medication used to treat uterine bleeding. Methylergonovine is a uterine stimulant used to treat postpartum uterine hemorrhage. Medroxyprogesterone acetate is a progestational medication used to treat amenorrhea and uterine bleeding.

When teaching a patient regarding proper application of a testosterone (Testoderm) transdermal patch, the nurse will provide which information about this medication?

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? 1 Oral 2 Topical 3 Transdermal 4 Intramuscular

Intramuscular Testosterone cypionate is administered by intramuscular injection. Finasteride is administered orally. Testosterone gel is administered topically, and transdermal testosterone is administered via transdermal patch.

Which mineral is essential for energy metabolism but may also be used in higher doses to treat certain seizures and preeclampsia?

Magnesium Vitamin D .Magnesium is an essential mineral for body functioning but at higher doses is used to manage complications of pregnancy, including preeclampsia and eclampsia, to treat seizures related to hypomagnesium levels.

Which contraceptive device is most likely to prevent the transmission of sexually transmitted diseases? 1 Male condom 2 Spermicidal agent 3 Intrauterine device 4 Cervical diaphragm

Male condoms are most likely to prevent the transmission of a sexually transmitted disease, because they provide the most barrier protection. A spermicidal agent kills sperm. An intrauterine device is placed in the uterus. A cervical diaphragm is not as effective as condoms.

Which medication is suitable therapy for oral contraception in women who cannot take estrogen? 1 Estrone 2 Megestrol 3 Estropipate 4 Medroxyprogesterone

Medroxyprogesterone Because it prevents follicular maturation and ovulation, medroxyprogesterone is a suitable oral contraceptive for women who cannot take estrogen. Estrone and estropipate are synthetic estrogens. Megestrol is unsuitable because it is indicated in the palliative treatment of endometrial and breast cancers.

Which medication is used to treat amenorrhea? 1 Estradiol 2 Denosumab 3 Alendronate 4 Medroxyprogesterone acetate

Medroxyprogesterone acetate is a progestational medication used to treat amenorrhea. Estradiol is an estrogenic medication used to treat ovarian failure. Denosumab is used to treat osteoporosis. Alendronate is an oral bisphosphonate used in the treatment of osteoporosis.

The nurse is providing postpartum care for a female patient who is prescribed methylergonovine. Which aspect of the patient's medical history would be a contraindication for receiving this drug? Incorrect 1

Methylergonovine is used for postpartum uterine hemorrhage. It is contraindicated in patients with pelvic inflammatory disease. Hence, the nurse needs to inform the primary health care provider about this. Methylergonovine should be used cautiously in patients with hypertension, but it is not a contraindication. The medication is used to treat uterine atony. Nausea and vomiting is not a contraindication.

The nurse observes that a female patient is at risk for postpartum uterine hemorrhage. Which medication should the nurse discuss with the primary health care provider to initiate? 1 Estradiol 2 Megestrol 3 Alendronate 4 Methylergonovine

Methylergonovine is used to prevent postpartum uterine hemorrhage. Estradiol is used for relieving vasomotor symptoms of menopause, female castration, and ovarian failure. Megestrol is used in the treatment of recurrent, inoperable, or metastatic endometrial or breast cancer. Alendronate is an oral bisphosphonate used for preventing bone loss.

Which medication is used to induce labor?Oxytocin is a uterine stimulant that is used to induce uterine contractions for labor.

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.

During a counseling session for a group of teenage athletes, the use of androgenic steroids is discussed. The nurse will explain that which problem is a rare but devastating effect of androgenic steroid use? a. Peliosis of the liver b. Bradycardia c. Kidney failure d. Tachydysrhythmias

a. Peliosis of the liver

A pregnant patient has been prescribed oxytocin. What is the nurse's primary intervention for this patient? 1 Assess pulse oximetry continuously. 2 Administer acetaminophen as needed. 3 Monitor the patient's blood pressure frequently. 4 Suggest the patient take aluminum hydroxide with the medication.

Monitor the patient's blood pressure frequently. Hypertensive episodes can occur with oxytocin use, so the nurse should monitor the patient's blood pressure frequently. Pulse oximetry is not indicated. Acetaminophen is not given for pain. It is not necessary to give aluminum hydroxide.

While assessing a patient, the nurse finds that the patient is an athlete by profession and takes oxymetholone without a medical prescription. What reason does the nurse suspect for the patient taking oxymetholone? 1 Pain relief 2 Stress relief 3 Euphoric effect 4 Muscle hypertrophy

Muscle hypertrophy Oxymetholone is an anabolic steroid. It is usually taken by athletes and body builders to attain a muscular body, because this medication has muscle-building properties. Therefore, the nurse should suspect that the patient takes this medication for muscular hypertrophy. Oxymetholone does not have analgesic, anxiolytic, or sedative effects. Therefore, the patient will not take this medication for pain relief, stress relief, or euphoric effects.

Client teaching regarding the administration of vitamin C would include monitoring for which signs or symptoms that may indicate vitamin C toxicity?

Nausea and abdominal cramping Megadoses of vitamin C can produce nausea, vomiting, headache, and abdominal cramps and will acidify the urine, which can result in the formation of cystine, oxalate, and urate renal stones.

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? 1 Nitrates 2 Antibiotics 3 Alpha agonists 4 Anticoagulants

Nitrates Dizziness and fainting spells are signs associated with low blood pressure. Sildenafil decreases blood pressure by releasing nitric oxide. Nitrates also decrease the workload of the heart by reducing the blood pressure. Administration of both drugs may cause severe hypotension in the patient. Thus, the nurse should determine whether the patient is taking nitrate drugs. Alpha-agonist drugs will cause hypertension, whereas sildenafil will be helpful in reducing blood pressure in patients taking an alpha agonist. Antibiotic drugs and anticoagulants do not interact with sildenafil. Antibiotics such as erythromycin and clarithromycin increase the concentration of tamsulosin in the blood. Anticoagulants interact with androgens, thereby causing increased or decreased activity of oral anticoagulant drugs.

Which drug prescription does the nurse report to the primary health care provider if the patient is taking tadalafil? 1 Ibuprofen 2 Famotidine 3 Furosemide 4 Nitroglycerin

Nitroglycerin The major contraindication to the use of tadalafil is concurrent nitrate therapy, because this can result in severe hypotension. It includes the use of amyl nitrate, sublingual or topical nitroglycerin, and oral nitrate derivatives such as isosorbide mononitrates and dinitrates. Ibuprofen, famotidine, and furosemide are not contraindicated in patients taking tadalafil.

Patients prescribed sildenafil (Viagra) should be instructed regarding the potential life-threatening drug interaction with which medication?

Nitroglycerin (Nitrostat) Sildenafil and other drugs for erectile dysfunction should not be taken with nitroglycerin because it may lead to a significant hypotension that could be life threatening.

Ovulation commonly occurs at which day during the menstrual cycle? 1 Day 3 2 Day 7 3 Day 14 4 Day 21

Ovulation typically occurs at day 14 in the menstrual cycle, when the mature follicle ruptures and releases its ovum. It does not occur on day 3, 7, or 21.

The labor and delivery nurse is caring for a patient in preterm labor who is receiving indomethacin. The patient develops hypotension. What should be the nurse's initial action? 1 Place the patient on her left side. 2 Immediately discontinue IV fluids. 3 Administer phentolamine mesylate. 4 Instruct the patient to bear down and push.

Placement of the patient in the left lateral recumbent position minimizes hypotension, increases renal blood flow, and increases blood flow to the fetus. Phentolamine mesylate is an alpha-adrenergic blocker and antihypertensive and is not indicated in the treatment of hypotension. Bearing down and pushing when the patient is not ready to deliver could result in fetal compromise.

Which adverse reaction may occur as a result of raloxifene use during perimenopause? 1 Hot flashes 2 Loss of hair 3 Brown discoloration of face 4 Yellow undertone to the skin

Raloxifene is a selective estrogen receptor modulator (SERM) used in the treatment of osteoporosis. An adverse reaction associated with this medication, especially during perimenopause, is hot flashes. Although hair loss and chloasma may occur with other estrogen therapies, these are not adverse reactions associated with this specific medication. Progestin therapy can cause liver dysfunction and jaundice, which is a yellowing of the skin and the sclera of the eyes.

Which medication is most likely to decrease the effectiveness of norethindrone and ethinyl estradiol? 1 Rifampin 2 Furosemide 3 Calcium citrate 4 Acetaminophen

Rifampin decreases the estrogenic effects of oral contraceptives. Furosemide is used for the treatment of edema. Calcium citrate is a calcium supplement used for preventing osteoporosis. Acetaminophen is used to relieve pain and fever.

Which pharmacologic class is used to describe testosterone drugs? 1 Schedule I 2 Schedule II 3 Schedule III 4 Schedule IV

Schedule III Testosterone, a naturally occurring androgenic hormone produced primarily by the testes, regulates male sexual development. Most androgens are classified as Schedule III drugs in the United States. They have less abuse potential than Schedule II drugs and a moderate dependence liability. Schedule I and II drugs have a high potential for abuse. Schedule IV drugs have less abuse potential than Schedule III drugs.

Which medication treats erectile dysfunction? 1 Sildenafil 2 Minoxidil 3 Finasteride 4 Testosterone

Sildenafil treats erectile dysfunction. Minoxidil treats female and male androgenetic alopecia. Finasteride treats benign prostatic hyperplasia. Testosterone treats primary or secondary hypogonadism.

The clinical reports of a patient taking a bisphosphonate and calcium supplement indicate poor therapeutic levels of the bisphosphonate. Which changes in the medication administration will the nurse need to encourage the patient to implement? 1. "Discontinue the calcium supplement." 2. "Space the medications 1 to 2 hours apart." 3. "Replace the bisphosphonate with calcitonin." 4. "Obtain a prescription for increasing the bisphosphonate dose."

Space the medications 1 to 2 hours apart. Calcium supplements interfere with the absorption of bisphosphonates. Spacing the medications 1 to 2 hours apart helps prevent this interaction. The nurse does not replace the drug without consulting the primary health care provider. The nurse does not discontinue the calcium supplement, because it may affect the patient's health. Increasing the dose of bisphosphonate will not aid in absorption if it interacts with calcium

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.)

Tadalafil (Cialis) Vardenafil (Levitra) Phosphodiesterase inhibitors (PDIs) are used in the treatment of erectile dysfunction. Sildenafil (Viagra) was the first oral drug approved for the treatment of erectile dysfunction. Two drugs that are similar but have a longer duration of action are vardenafil (Levitra) and tadalafil (Cialis). Collectively, these drugs are referred to as erectile dysfunction drugs. Avanafil (Stendra) is the newest PDI approved for erectile dysfunction. A second type of drug used to treat erectile dysfunction is the prostaglandin alprostadil (Caverject). This drug must be given by injecting it directly into the erectile tissue of the penis or pushing a suppository form of the drug into the urethra.

Which drug is a Schedule III drug? 1 Goserelin 2 Minoxidil 3 Doxazosin 4 Testosterone

Testosterone The hormone testosterone is primarily produced in the testes.It is categorized as an androgen. Androgens are labeled as Schedule III drugs in the United States. Goserelin is a hormone analog, used to suppress the sex hormones. Minoxidil is specifically a peripheral vasodilator that is used for widening the blood vessels and for relieving hypertension. Doxazosin is an alpha blocker used to treat hypertension.

The nurse should inform a male patient about which potential type of cancer associated with testosterone therapy? 1 Kidney cancer 2 Prostate cancer 3 Bladder cancer 4 Intestine cancer

Testosterone plays a role in the development of prostate cancer, but the extent to which supplemental testosterone therapy increases cancer risk is unclear. Testosterone does not affect the kidneys, bladder, or intestines in a direct way.

The nurse is teaching students about applying a transdermal estradiol patch. Which statement made by a student suggests effective learning? 1 "Rotate the patch every 2 weeks." 2 "Rotate the patch at the same time each day." 3 "Apply the patch to the breast area for better absorption." 4 "Apply the patch to the lower abdomen for better absorption."

The estradiol transdermal patch should be applied as prescribed, which is usually one patch applied once or twice weekly to the lower abdomen and not to the breast or chest areas. The patch is not rotated unless prescribed by the primary health care provider and is changed once or twice each week, not daily or bi-weekly.

What should be the daily dose of finasteride for an adult patient who is being treated for androgenetic alopecia? 1 1 mg by mouth 2 5 mg by mouth 3 25 to 100 mg 1 hour before intercourse 4 50 to 400 mg by intramuscular injection

The expected adult daily dose for finasteride is 1 mg by mouth when prescribed for the treatment of androgenetic alopecia. A daily dose of 5 mg is prescribed for patients who are being treated for benign prostatic hyperplasia. This medication is not administered 1 hour before sexual intercourse or by intramuscular injection.

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? 1 Obtain a prescription for terbutaline. 2 Decrease the drug dose immediately. 3 Obtain a prescription for indomethacin. 4 Request a prescription to give calcium gluconate.

The nurse administers calcium gluconate, as it reverses magnesium toxicity in the patient. Terbutaline is a beta-adrenergic drug used to prevent premature labor, but it has maternal and fetal safety risks. Decreasing the drug dose will not have the desired drug effect on the patient. Indomethacin is an effective drug for preterm labor, but the most important action here is to reverse magnesium toxicity.

The nurse is providing education to a patient and the patient's caregiver, who is pregnant, on the medication dutasteride (Avodart) for treatment of benign prostatic hyperplasia (BPH). What important teaching would the nurse provide to the patient and the patient's caregiver about this medication?

The nurse is providing education to a patient and the patient's caregiver, who is pregnant, on the medication dutasteride (Avodart) for treatment of benign prostatic hyperplasia (BPH). What important teaching would the nurse provide to the patient and the patient's caregiver about this medication?

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.

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.

The nurse is about to administer dinoprostone to a patient. What condition is this medication used for? 1 Premature labor 2 Accelerated labor 3 Postpartum hemorrhage 4 Termination of pregnancy

The use of dinoprostone or other prostaglandin E2 drugs is indicated in specific situations requiring termination of pregnancy. It is not required during premature labor, accelerated labor, or postpartum hemorrhage.

What is the purpose of giving estrogen therapy in combination with progestins? 1 To treat ovarian cancer 2 To treat Which patient statement indicates to the nurse full patient understanding of the discharge instructions regarding alendronate? 1 "I need to decrease my intake of dairy products to prevent hypercalcemia." 2 "I need to take this medication with food to prevent damage to my esophagus." 3 "This medication will help relieve the bone pain I have from my osteoporosis." Correct 4 "I will take the medication on an empty stomach and not lie down for 30 minutes."breast cancer Correct 3 To prevent endometrial cancer Incorrect 4 To reduce the chances of vaginal cancer

To prevent endometrial cancer

Which clinical manifestations can be observed in a patient who is receiving teriparatide therapy? Select all that apply. 1. vertigo 2. joint pain 3. chest pain 4. hot flashes 5. loss of appetite

Vertigo Joint pain Chest pain

What vitamin can be synthesized by the skin when exposed to sunlight but can also be supplemented as needed?

Vitamin D The human body requires vitamins in specific minimum amounts on a daily basis, and these can be obtained from both plant and animal food sources. In some cases, the body synthesizes some of its own vitamin supply. Supplemental amounts of vitamin B complex and vitamin K are synthesized by normal bacterial flora in the gastrointestinal tract. Vitamin D can be synthesized by the skin when the skin is exposed to sunlight.

Which has the greatest potential to increase the risk of thromboembolism in a patient taking norethindrone and ethinyl estradiol? 1 Sedentary lifestyle 2 Smoking heavily every day 3 Consumption of saturated fats 4 Increased body mass index (BMI)

Women taking oral contraceptives are at increased risk of thromboembolic events if they smoke heavily or have a history of thromboembolism; this higher risk is partially caused by an increase in circulating levels of clotting factors. A sedentary lifestyle and increased BMI elevate the risk of several health problems and can contribute to the development of thromboemboli, but that risk is secondary to the risk resulting from concurrent smoking and use of oral contraceptives. Consumption of saturated fats is likely to increase the risk of a thromboembolic event in a patient who takes an oral contraceptive, but not as much as smoking.

A patient with which condition should not use oral contraceptives as a method of birth control? 1 Renal failure 2 Ovarian failure 3 Pulmonary embolism 4 Abnormal vaginal bleeding

pulmonary embolism A history of pulmonary embolism increases the patient's risk for developing thromboembolism, so this patient should not use oral contraceptives. Renal failure, ovarian failure, and abnormal vaginal bleeding are not contraindications for the use of oral contraceptives. Denosumab is contraindicated in patients who have renal failure. Fertility medications, such as clomiphene, are contraindicated in patients who have ovarian failure. Estrogen therapy is contraindicated in patients who have abnormal vaginal bleeding.

Which medication is contraindicated in a patient who has osteoporosis and a history of deep vein thrombosis? 1 Raloxifene 2 Denosumab 3 Risedronate 4 Alendronate

raloxifene estrogen receptor modulators (SERM) are used to treat osteoporosis. Raloxifene is a SERM medication. This medication is contraindicated for patients who have a history of deep vein thrombosis, because it increases the risk for blood clots. Denosumab is used to prevent bone resorption in patients who have osteoporosis and is contraindicated in patients who have a history of renal failure. Risedronate and alendronate are bisphosphonates used in treating osteoporosis and are contraindicated in patients who have hypocalcemia and esophageal dysfunction.