Pharm Made Easy 4.0- The Reproductive and Genitourinary Systems Test

A nurse is caring for a client who is taking combination oral contraceptive ethinyl estradiol and drospirenone and is about to begin taking rifampin to treat tuberculosis. Which of the following instructions should the nurse give the client due to a possible drug interaction? -"Increase the rifampin dose." -"Increase the oral contraceptive dose." -"Use additional birth control methods." -"Wait 2 hours between taking each drug."

"Use additional birth control methods." Rifampin can increase the metabolism of oral contraceptives, reducing the effectiveness. Clients who are taking oral contraceptives and rifampin should use additional contraceptive methods to prevent an unwanted pregnancy. Other drugs that can reduce the effects of oral contraceptives include some antifungal agents and anticonvulsants. "Increase the rifampin dose." Oral contraceptives do not reduce the effects of rifampin. They can, however, reduce the effects of warfarin and hypoglycemic drugs. "Increase the oral contraceptive dose." Taking additional oral contraceptives can increase the risk of serious adverse effects. "Wait 2 hours between taking each drug." Allowing 2 hr between taking the oral contraceptive and rifampin will not reduce the drug interaction.

A nurse is providing teaching to a client who is taking bethanechol for urinary retention. Which of the following instructions should the nurse include (select all that apply) A. Avoid driving and activities that require alertness B. Increase fluid intake C. take the drug with food D. Stay close to a bathroom after taking the drug E. Increase weight-bearing activities

A. Avoid driving and activities that require alertness B. Increase fluid intake D. Stay close to a bathroom after taking the drug Avoid driving and activities that require alertness is correct. Bethanechol, a muscarinic agonist, can cause dizziness and fainting. Clients who take the drug should use caution with activities that require alertness until they know how the drug will affect them. Increase fluid intake is correct. Bethanechol can cause diarrhea and increased salivary and gastric secretions. Clients who take the drug should maintain hydration by increasing their fluid intake. Take the drug with food is incorrect. Clients should take bethanechol on an empty stomach, 1 hr before or 2 hr after meals. Stay close to a bathroom after taking the drug is correct. Bethanechol can cause rapid relief of urinary retention or diarrhea, with fecal incontinence. Clients who take the drug should stay near a bathroom or have a bedpan or urinal ready. Increase weight-bearing activities is incorrect. Bethanechol is unlikely to cause bone loss. Leuprolide is a drug that can cause bone loss.

A nurse is caring for a male client who has hyperthyroidism and is not responding to treatment. The nurse should identify that hyperthyroidism is a contraindication for which of the following drugs? A. Sildenafil B. Bethanechol C. Tamsulosin D. Finasteride

B. Bethanechol Bethanechol, a cholinergic drug, can cause cardiac dysrhythmias in clients who have hyperthyroidism by triggering the release of norepinephrine. This reaction does not occur in clients who do not have hyperthyroidism. Sildenafil Clients who have hyperthyroidism can take sildenafil. It is contraindicated, however, for clients who also take nitroglycerin. Tamsulosin Clients who have hyperthyroidism can take tamsulosin. It is contraindicated, however, for clients who also take erectile dysfunction drugs. Finasteride Clients who have hyperthyroidism can take finasteride. It is contraindicated, however, for women and children.

A nurse is assessing a client who has a new prescription of oxybutynin to treat neurogenic bladder. Which of the following assessment findings should the nurse identify as an adverse effect of the drug? (Select all that apply) A. Diaphoresis B. Dilated pupils C. Dizziness D. Distended bladder E. Fever

B. Dilated pupils C. Dizziness D. Distended bladder E. Fever Dilated pupils is correct. Oxybutynin can cause mydriasis or dilated pupils, dry eyes, and blurred vision. Clients who take the drug should use lubricating eye drops to help reduce dryness. Dizziness is correct. Oxybutynin can cause dizziness and drowsiness. Clients who take the drug should use caution with activities that require alertness until they know how the drug will affect them. Distended bladder is correct. Oxybutynin can cause urinary retention and bladder distention. Fever is correct. Oxybutynin can cause heat exhaustion and fever. Clients who take the drug should use it with caution in hot weather.

A nurse is providing safety education to a client who is scheduled to begin treatment with tamsulosin for benign prostatic hypertrophy (BPH). Which of the following instructions should the nurse include in the teaching? A. Change positions slowly B. Crush the medication C. Take the medication on an empty stomach D. Report increased urinary output immediately

Change positions slowly. Alpha adrenergic blockers such as tamsulosin are also used to treat hypertension. These drugs can cause the blood pressure to drop, leading to orthostatic hypotension. Therefore, the nurse should instruct the client to change positions slowly to prevent harm. Crush the medication. Tamsulosin comes in a capsule form and should be swallowed whole, not crushed or chewed. Take the medication on an empty stomach. The client should take the drug at the same time each day, 30 min after the same meal. Report increased urinary output immediately. Tamsulosin should improve urinary flow for a client who has BPH. The client should experience an increase in the amount of urine they are able to void. The client should report indications of fluid retention, such as edema or weight gain.

A nurse is caring for a client who has benign prostatic hypertrophy and is taking tamsulosin. The nurse should question the use of the drug if the client also has which of the following? A. A seizure disorder for which he takes carbamazepine B. Erectile dysfuntion for which he take sildenafil C. Diabetes mellitus for which he takes glyburide D. Angle-closure glaucoma for which he take pilocarpine

Erectile dysfunction for which he takes sildenafil. Drugs that lower blood pressure, such as sildenafil, can exacerbate hypotension in combination with tamsulosin. Clients who take sildenafil should not take tamsulosin. A seizure disorder for which he takes carbamazepine- Clients who have a seizure disorder and take carbamazepine can also take tamsulosin. They should not, however, take erythromycin because it increases carbamazepine levels and puts them at risk for serious adverse effects. Diabetes mellitus for which he takes glyburide- Clients who have diabetes mellitus and take glyburide can also take tamsulosin. They should not, however, take cimetidine because taking the two together increases hypoglycemic effects. Angle-closure glaucoma for which he takes pilocarpine- Clients who have glaucoma and take pilocarpine can also take tamsulosin. They should not, however, take atropine preparations because pilocarpine and atropine have antagonizing effects.

A nurse is caring for a client who received human menopausal gonadotropin (hMG) Which of the following findings should the nurse expect ? -Prolactin secretion -Estrogen release -Follicular maturation -Oxytocin secretion

Follicular maturation. Before a client receives human chorionic gonadotropin (hCG) to stimulate ovulation, they must receive a drug that induces follicular maturation, such as hMG, which is a mixture of LH and FSH, clomiphene, or follitropin. Prolactin secretion Cabergoline inhibits prolactin secretion; hMG does not promote prolactin secretion. Estrogen release Clomiphene blocks estrogen receptors, causing the pituitary gland to secrete LH and FSH; hMG does not promote estrogen release. Clients receive hCG 1 day after the last dose of hMG or follitropin or 7 to 9 days after the last clomiphene dose. Oxytocin secretion Oxytocin promotes uterine contractions; hMG does not promote oxytocin secretion.

A nurse is caring for a client who is about to begin clomiphene therapy to treat infertility. The nurse should monitor the client for which of the following adverse effects? -Breast cancer -Deep-vein thrombosis -Ovarian hyperstimulation syndrome -Restless leg syndrome

Ovarian hyperstimulation syndrome. Pelvic pain can indicate ovarian hyperstimulation and can lead to ovarian cyst rupture. The nurse should monitor a client who is taking clomiphene for ovarian enlargement and advise them to seek medical attention immediately for sudden or severe pelvic pain. Breast cancer- Clomiphene is unlikely to cause breast cancer. Using a combination of estrogen and progestin for hormone replacement, however, can increase the risk for breast cancer. Clients who are taking hormone replacement drugs should perform self-breast examinations and have mammograms at the recommended intervals. Deep-vein thrombosis- Clomiphene is unlikely to cause deep-vein thrombosis. Combination oral contraceptives and estrogens can, however, cause this adverse effect. Restless leg syndrome- Clomiphene is unlikely to cause restless leg syndrome. It can, however, cause hot flashes, nausea, and headache.

A nurse is providing teaching to a clent about using leuprolide to treat endometriosis. Which of the following instructions should the nurse include? A. Perform weight-bearing activities B. Wear sunscreen or protective clothing C. Take the drug with food to increase absorption D. Avoid drinking grapefruit

Perform weight-bearing activities. Leuprolide suppresses estrogen and can cause bone loss. The nurse should instruct the client to perform weight-bearing activities and increase their intake of calcium and vitamin D. Wear sunscreen or protective clothing. Although all clients should protect their skin from sun exposure, leuprolide is unlikely to make a client any more vulnerable to damage from ultraviolet radiation. Some antipsychotics, such as chlorpromazine, can cause photosensitivity. Take the drug with food to increase absorption. Leuprolide is available via IM administration only, monthly or every 3 to 4 months. Avoid drinking grapefruit juice. Grapefruit juice interacts with many different drugs, including sildenafil, cyclosporine, midazolam, and lovastatin, but it is unlikely to affect the metabolism of leuprolide.

A nurse is caring for a client who is about to begin taking cabergoline to treat infertility. The nurse should explain to the client the need to monitor which of the following laboratory values? A. Potassium B. Glucose C. BUN and creatinine D. Prolactin Level

Prolactin level. Cabergoline inhibits the secretion of prolactin. The provider should monitor prolactin levels to determine the appropriate dosage. Potassium- Cabergoline should not alter serum potassium levels. Ethinyl estradiol and drospirenone is a reproductive-system drug combination that can cause hyperkalemia. Glucose- Cabergoline should not alter serum glucose. Terbutaline is a reproductive-system drug that can cause hyperglycemia. BUN and creatinine- Cabergoline should not alter serum BUN and creatinine or renal function. Celecoxib is a drug that can cause elevations in BUN and creatinine.

A nurse is caring for a client who is about to begin taking finasteride to treat benign prostatic hypertrophy. The nurse should explain to the client the need to monitor which of the following laboratory values? A. Prostate-specific antigen (PSA) B. BUN C. Creatine phosphokinase (CPK) D. ALT

Prostate-specific antigen (PSA). The nurse should monitor PSA levels at baseline and periodically thereafter. Increases in PSA can indicate prostate cancer. PSA levels should decrease with finasteride therapy. BUN- Finasteride should not alter serum BUN. Celecoxib is a drug that can cause elevations in BUN. Creatine phosphokinase (CPK)- Finasteride should not alter CPK levels. Pramipexole is a drug that can alter CPK levels. ALT- Finasteride should not alter ALT levels. Pioglitazone is a drug that can alter LDL levels.

A nurse is teaching a client about receiving leuprolide to treat endometriosis. The nurse should instruct the client to expect which of the following side effects? -Vaginal dryness -Hypertension -Blurred vision -Orthostatic hypotension

Vaginal dryness. Leuprolide can cause vaginal dryness. The nurse should suggest that the client use water-based vaginal lubricants to help minimize this effect. Hypertension- Leuprolide is unlikely to cause hypertension. Methylergonovine is a reproductive-system drug that can cause this effect. Blurred vision- Leuprolide is unlikely to cause blurred vision. Clomiphene is a reproductive-system drug that can cause this effect. Orthostatic hypotension- Leuprolide is unlikely to cause orthostatic hypotension. Cabergoline is a reproductive-system drug that can cause this effect.

A nurse is caring for a client who has a new prescription for transdermal conjugated estrogen and medroxyprogesterone to treat postmenopausal symptoms. the nurse should explain to the client that this drug combination includes which of the following therapeutic effects? Reduces the risk of ovarian cancer Relieves hot flashes Prevents osteoporosis Reduces the risk of breast cancer Reduces the risk of thromboembolism

reduces the risk of ovarian cancer relieves hot flashes prevents osteoporosis Reduces the risk of ovarian cancer is correct. Drug therapy with an estrogen and progesterone combination reduces the risk of ovarian cancer. However, the use of estrogen alone without progesterone can increase the risks of endometrial and ovarian cancer. Relieves hot flashes is correct. Drug therapy with an estrogen and progesterone combination or estrogen alone reduces hot flashes and the sweating and sleep disturbances they cause. Prevents osteoporosis is correct. Drug therapy with an estrogen and progesterone combination or estrogen alone increases bone density and prevents osteoporosis. Reduces the risk of breast cancer is incorrect. Drug therapy with an estrogen and progesterone combination increases the risk of breast cancer. Clients taking the drug combination should perform self-breast examinations and have mammograms at the recommended intervals. Reduces the risk of thromboembolism is incorrect. Drug therapy with an estrogen and progesterone combination or estrogen alone increases the risk of thromboembolism. Clients taking the drugs should report a swollen calf, erythema of the skin, shortness of breath, slurred speech, headache, or disorientation.

A nurse is teaching a client about conjugated estrogen and medroxyprogesterone. Which of the following instructions should the nurse include? A. Monitor for rectal bleeding B. Avoid drinking alcoholic beverages C. Have blood pressure checked regularly D. Sit up for 30min after taking the drug

​Have blood pressure checked regularly. ​Using conjugated estrogen and medroxyprogesterone, a combination of estrogen and progestin for hormone replacement, can cause hypertension. Clients taking the drug combination should have their blood pressure checked regularly and report headache or edema. Monitor for rectal bleeding. Conjugated estrogen and medroxyprogesterone can help reduce the risk for colorectal cancer. The combination of estrogen and progestin is unlikely to cause rectal bleeding. Avoid drinking alcoholic beverages. Conjugated estrogen and medroxyprogesterone, a combination of estrogen and progestin for hormone replacement, is unlikely to interact with alcohol. Clients should avoid taking St. John's wort while taking the drug combination because it reduces the effectiveness. Sit up for 30 min after taking the drug. It is not necessary to sit up or stand for 30 min after taking conjugated estrogen and medroxyprogesterone. Bisphosphonates, such as alendronate, can cause esophagitis, which can be avoided by sitting up or standing for 30 min after taking the drug.