Pharmacology II Prep U Chapter 41: Drugs Affecting the Male Reproductive System
A client is taking androgens and warfarin (Coumadin). What effect will these two medications have on the client's coagulation?
Coagulation will be decreased.
The nurse is educating a young adult client diagnosed with androgen deficiency about the prescribed testosterone transdermal system, apply two systems (dose of 5 mg) nightly. Which statement made by the client establishes the need for further clarification?
"One transdermal patch is applied to my back, upper arm, or abdomen to dry, clean skin, and the other to my groin."
Which would the nurse expect to administer as a depot injection?
Testosterone
Which is an example of an androgen that can be used to treat hypogonadism?
fluoxymesterone
A 52-year-old has made an appointment with his primary care provider and has reluctantly admitted that his primary health concern is erectile dysfunction (ED). He describes the problem as increasing in severity and consequent distress. Which of the nurse's assessment questions is most likely to address a common cause of ED?
"Are you taking any medications for high blood pressure?"
What question should the nurse ask when assessing for therapeutic effects of vardenafil?
"Have you found that you're better able to get and maintain erections?"
After teaching a client who is prescribed sildenafil about using the drug, the nurse determines that the teaching was successful when the client states:
"I need to take the pill about an hour before any sexual stimulation."
The nurse is educating an adult male client diagnosed with erectile dysfunction about the prescribed sildenafil. Which statement made by the client establishes the need for further clarification?
"If I eat a fatty meal I will need to take two pills instead of one, so the drug will take effect faster."
A male client has been diagnosed with impotence and is started on a regimen of androgens. Which statement by the client indicates that he has understood the teaching?
"If my skin appears yellow or my urine turns dark, I will contact my health care provider."
A male client has been prescribed testosterone for cryptorchidism. Which statement indicates that the client teaching was effective?
"My body hair will increase."
A nurse is caring for a 28-year-old patient who is taking exogenous testosterone for treatment of cryptorchidism. What statement by this patient would lead the nurse to believe that patient teaching has been ineffective?
"My sperm count should increase."
The nurse is aware that a client receiving which category of medication will not be prescribed vardenafil?
Antidysrhythmics
A 70-year-old man has enjoyed good overall health for all of his adult life, but he has been experiencing urinary frequency and dribbling that has culminated in a diagnosis of benign prostatic hypertrophy (BPH). As a result, the client has been prescribed finasteride. When teaching the client about the potential adverse effects of the drug, the nurse should ensure that he knows about the possibility of:
sexual dysfunction
A client with a recent history of benign prostatic hypertrophy (BPH) will soon begin treatment with finasteride. Before beginning this course of therapy, the nurse should caution the client to be aware of what potentially adverse effect?
sexual dysfunction
A nurse is instructing a client about vardenafil. The nurse would instruct the client to take the drug how many minutes before sexual stimulation?
60 minutes
What effect can administration of androgens have on fetal development?
A female fetus may experience masculinization.
A 24-year-old female athlete is using high doses of anabolic steroids to enhance her performance. She may be at risk for which condition?
Acne
A client has been prescribed a PDE5 inhibitor for penile erectile dysfunction. Medication education should strongly discourage the use of what drug classification while on this medication?
Alpha-blockers
A 17-year-old boy has been admitted to the emergency department after suffering a knee sprain during a football practice. The nurse notes that the client has exceptional muscle mass, and the boy quietly admits that this is mostly attributable to the use of steroids, which he obtains from a teammate. What should the nurse teach the boy about anabolic steroid abuse?
Anabolic steroids are universally dangerous but are especially harmful to adolescents.
Which would be most important to assess in a client receiving testosterone for a prolonged period of time?
Liver function studies
The nurse knows that finasteride is used to treat prostatic hypertrophy, and in smaller doses is used to treat what condition?
Male pattern baldness
Anabolic steroid use causes an increase in muscular work capacity, which is what makes these agents popular as performance-enhancing drugs. They are dangerous specifically to teens because they:
can damage the heart, liver, and kidneys.
Androgens may be prescribed to women to treat conditions related to the effects of the female sex hormones. Danazol is prescribed to prevent or treat fibrocystic breast disease and:
endometriosis
A patient with delayed puberty has been advised to take testosterone (Androderm) transdermal therapy. Which instruction should the nurse provide the patient to help promote an optimal response to this therapy?
Apply immediately after removing the cover.
The health care provider has prescribed testosterone for a 77-year-old client with a low testosterone level. The nurse will evaluate this client for what condition that may develop in this client in response to this medication?
Benign prostatic hypertrophy
An 80-year-old patient with chronic renal insufficiency is advised to undertake anabolic steroid therapy for the management of anemia associated with renal insufficiency. Which risk increases in elderly patients undergoing anabolic steroid therapy?
Cancer of the prostate
The nurse is reviewing the history of a client who is to receive testosterone. Which of the following would alert the nurse to the need for close monitoring of the client?
Cardiovascular disease
Mark, age 42, is prescribed sildenafil for the treatment of pulmonary hypertension. The nurse caring for Mark would explain that sildenafil works by what mechanism?
Causing vasodilation in the pulmonary vascular bed
A female patient receiving fluoxymesterone, an androgenic drug, for metastatic breast cancer is disturbed by the physical changes seen in her body. Which feature of virilization may be seen in the patient receiving this therapy?
Deepening of the voice
When fluoxymesterone is administered to a 14-year-old male, what is the expected result?
Development of sexual organs
A client is receiving androgen therapy. Which would cause the nurse the greatest concern?
Elevated liver enzyme levels
The nurse is instructing the parents of an 11-year-old male who has testosterone deficiency. Which symptom, if found in this child, would cause the discontinuation of this medication?
Enlarged penis
Which of the following would a nurse identify as a contraindication for the use of danazol?
Prostate cancer
The nurse would instruct a client who is using a transdermal system for testosterone administration to apply a new patch at which frequency?
Every day
Androgens are used as replacement therapy for hypergonadism.
False
Testosterone is injected directly into the corpus spongiosum.
False
A client has been receiving long-term testosterone therapy. The nurse would expect to monitor:
Liver function studies
The nurse is obtaining a history from a 23-year-old man. The nurse suspects that the client may be using DHEA if he displays which symptom?
Hirsutism
When teaching a group of high school students about using anabolic steroids, the nurse would include information that these drugs are classified as which class of controlled substances?
III
A 9 year old child has been prescribed testosterone. What information should the nurse provide the client's parents regarding the continuation of the therapy?
If signs of early puberty are identified the therapy should be stopped
In older adult men, anabolic steroids may be prescribed for a deficiency condition. If hypertensive, what might be the cause for an increase in blood pressure?
Increased fluid and sodium retention
A client with a history of benign prostatic hypertrophy (BPH) is seeking androgenic medication treatment for penile erectile dysfunction. What information should the nurse provide the client regarding this therapy?
It increases the risk for prostate cancer
A male taking anabolic steroids may experience which side effects?
Jaundice
A male client who uses a transdermal testosterone gel for treatment of his oligospermia applies the medication first thing in the morning and washes it off before bed. What client education is necessary?
Leave the gel on until the next application is due.
A nurse is reviewing the medication history of a client. The nurse understands that a PDE5 inhibitor would be inappropriate for a client taking:
Nitroglycerin
A client is receiving a medication that has androgenic effects. Which would the nurse expect to assess?
Oily skin
After teaching a group of students about anabolic steroids, the instructor determines that the teaching was successful when the students identify which agent as an example?
Oxandrolone
A teenage client who is using testosterone to treat a hormone deficiency calls the clinic to report acne-like skin eruptions on the face. How should the nurse counsel this client?
Practice frequent and thorough skin cleansing.
The nurse is scheduled to administer testosterone transdermal patch to a client admitted with primary hypogonadism. What is the priority teaching that would be provided regarding this medication?
Report to primary care provider any leg pain, redness, and swelling right away.
The nurse will provide a client, prescribed alprostadil, with information regarding which method of administration?
Self-injection
A group of students are reviewing the drugs available for treating penile erectile dysfunction. The students demonstrate understanding when they identify which drug as a PDE5 inhibitor?
Sildenafil
A woman is diagnosed with pulmonary hypertension. The nurse explains the drug prescribed and the patient states, "That's a drug that used to treat erectile dysfunction." Which drug would this most likely be?
Sildenafil
A client has been using sildenafil on an intermittent basis for several years. However, he has cited delays in the onset and peak of action as the occasional source of frustration. What PDE5 inhibitor may be of particular benefit to this client's needs?
avanafil
Sildenafil has been prescribed to a client in his 60s, and the nurse is providing health education about the safe and effective use of the drug. The nurse should teach the client to:
avoid taking the drug more than once in any 24-hour period.
A nurse is preparing a class on the various drugs used to treat erectile dysfunction. Which would the nurse include?
Tadalafil
Which agent is available for use as a daily dose?
Tadalafil
What is most important to tell the client who will be taking adrenergic blocking drugs for benign prostatic hypertrophy?
Take the medication at the same time each day.
A client diagnosed with benign prostatic hypertrophy (BPH) is prescribe tamsulosin. The client communicates with the nurse about a friend that was prescribed sildenafil for his BPH. Which is the nurse's best response regarding the difference in the use of the two drugs for BPH?
Tamsulosin relaxes muscles in the prostate and bladder and increases ability to urinate.
A nurse is working with a patient in the clinic who has erectile dysfunction. The patient has been prescribed sildenafil (Viagra). The patient wants to do everything he can to promote effectiveness of the drug. The nurse will instruct him to
avoid taking the drug with a high-fat meal.
An older adult client has developed an androgen deficiency, and treatment options are being considered. The client's nurse should be aware that the use of exogenous testosterone has the potential to exacerbate what problem?
benign prostatic hypertrophy (BPH)
A client is using a transdermal system for androgen administration. Which drug would the client most likely be using?
Testosterone
A female client expresses the desire to suppress her female sex characteristics to facilitate a transition to being male. Which androgen does the nurse anticipate the provider will prescribe?
Testosterone
What aspect of a client's current health status may contraindicate the use of a PDE5 inhibitor?
The client has a history of unstable angina pectoris.
A male adolescent is prescribed testosterone. In order to help the client deal with the added social stress that the medication may cause, the nurse should discuss which possible adverse effect?
The development of acne
A male client is prescribed sildenafil for the treatment of erectile dysfunction. What mechanism of action of sildenafil causes a sustained erection?
The drug inhibits phosphodiesterase (PDE) type 5, consequently decreasing the metabolism of cGMP.
On the advice of his brother, a 53-year-old man has made an appointment to request a prescription for sildenafil. The nurse who works at the clinic is reviewing the man's medical history and would recognize what health problem as being prohibitive to this treatment?
angina, treated with nitroglycerin
An older adult client's current medication regimen includes tamsulosin and sildenafil. The combination of these two medications should prompt what action by the nurse?
assessing the client regularly for signs of orthostatic hypotension
The nurse is closely following a client who began treatment with testosterone several months earlier. When assessing the client for potential adverse effects of treatment, the nurse should prioritize which assessment?
assessment of serum calcium levels
A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this client would contraindicate the use of tadalafil for his ED?
has unstable angina and uses a nitroglycerin patch
An older adult man has moved to a long-term care facility and the nurse is performing a medication reconciliation. The resident's current medication regimen includes alfuzosin. After considering the most likely indication for this drug, the nurse should include what potential problem in the resident's interdisciplinary plan of care?
impaired urinary elimination
After teaching a group of nursing students about testosterone, the nurse determines that additional teaching is needed when they identify that testosterone can be given by which route?
intravenous
A client has begun treatment for penile erectile dysfunction. What explanation should the nurse provide regarding the primary effect a prescribed phosphodiesterase type 5 inhibitor will have on this condition?
Blood flow to the penis will be improved
A young male patient, age 14, has been prescribed testosterone for delayed onset of puberty. Follow-up care includes a visit to the clinic at least every 6 months for ongoing assessment. It will be most important for the nurse to monitor:
Bone growth
An adult client is suspected of having an androgen deficiency and has spoken with his primary care provider about the possibility of treatment with testosterone. The use of testosterone would be most complicated by the presence of what preexisting health problem?
benign prostatic hypertrophy
Mr. Craig, age 55, is seen by his family physician today for follow-up care. He was hospitalized 2 months ago for a myocardial infarction. Mr. Craig is taking the following medications: atenolol, Zetia, and Zestril. In addition to requesting a refill of his medication for his cardiac condition, he also asks for something to help with his erectile dysfunction, which has increased in severity over the last year. What would be the most appropriate response to Mr. Craig with regard to sildenafil?
Prior to being prescribed sildenafil, you will need to have a stress test.
A middle-aged client with erectile dysfunction has sought care and is receiving health education from the nurses. The client has expressed a desire to understand the physiology of the sex hormone production and the sexual response. The nurse should describe the fact that testosterone is normally secreted in response to:
stimulation by luteinizing hormone.
A young man has received a diagnosis of androgen deficiency and has been prescribed testosterone. At clinic follow-up appointments, the nurse should prioritize which assessment?
weight and measurement of blood pressure
A nurse should advise a client beginning therapy with testosterone (Androderm) of which adverse effects? (Select all that apply.)
• Impotence • Fluid retention • Male pattern baldness
The nurse receives a call from a male client who takes finasteride (Proscar) for treatment of BPH, and tells the nurse that his wife may be pregnant. What does the nurse expect the health care provider to do?
Discontinue the medication.
A male client informs his physician that sildenafil therapy is not working for him. What is most likely to be the reason for this and needs to be carefully assessed for by the nurse?
Ingestion of high-fat meal along with the drug
A client is prescribed testosterone gel. Which would the nurse include in the teaching plan? Select all that apply.
• Allowing the application site to dry before getting dressed. • Applying the gel once daily in the morning. • Washing hands with soap and water after applying.
A nurse should advise a female client beginning therapy with methyltestosterone (Testred) for the treatment of inoperable advanced breast carcinoma of which of the following adverse reactions? Select all that apply:
• Amenorrhea • Acne • Facial hair growth
What potentially serious adverse effects do large doses of anabolic steroids produce? Select all that apply.
• Jaundice • Inability to stop taking the drug • Metabolic disorders
What should a nurse's pre-administration assessment for a client about the receive oxymetholone (Anadrol-50) include? (Select all that apply.)
• Weight • Fasting lipid panel • Hepatic function tests
A 72-year-old client has been diagnosed with benign prostatic hypertrophy (BPH) and will begin treatment with tamsulosin. The client admits that he is skeptical about the drug's ability to relieve his distressing symptoms. The nurse should respond in what way?
"Tamsulosin can relax your prostate and your bladder neck, making it easier to pass urine."
