chapter 35

The nurse is reviewing the medication list of a patient who will be starting androgen therapy. Which drug classes, if taken with androgens, may have an interaction with them?" a Oral anticoagulants b Nitrates c Beta blockers d Proton pump inhibitors

ANS: A Androgens, when used with oral anticoagulants, can significantly increase or decrease anticoagulant activity. The other options are incorrect.

When a male patient is receiving androgen therapy, the nurse will monitor for signs of excessive androgens such as:" a fluid retention. b dehydration. c restlessness. d visual changes.

ANS: A Fluid retention is an undesirable effect of androgens. The other options are incorrect.

A 21-year-old male athlete admits to using androgenic steroids. The nurse tells him that which of these is a possible adverse effect of these drugs?" a Liver damage b Renal failure c Heart failure d Stevens-Johnson syndrome

ANS: A Peliosis of the liver, the formation of blood-filled cavities, is a potential effect of androgenic anabolic steroid therapy and may be life threatening. Other serious hepatic effects are hepatic neoplasms (liver cancer), cholestatic hepatitis, jaundice, and abnormal liver function. The other options are incorrect.

The nurse is instructing a male patient about application of transdermal testosterone gel (AndroGel). Which body location is preferred for this medication? (Select all that apply.)" a Back b Chest c Thigh d Scrotum e Abdomen f Upper arms

ANS: A, C, E, F AndroGel is applied to the skin of the back, abdomen, upper arms, or thighs. Testoderm patches are applied to the scrotal skin.

The nurse notes in a patient's medication history that the patient is taking the synthetic androgen danazol (Danocrine). Indications for danazol include which conditions? (Select all that apply.)" a Endometriosis b Decreased sexual libido c Postpartum breast engorgement d Fibrocystic breast disease in women e Hereditary angioedema f Metastatic breast cancer

ANS: A, D, E Danazol is used to treat hereditary angioedema and to treat women who have endometriosis or fibrocystic breast disease. The other options are incorrect.

A patient is receiving finasteride (Proscar) for treatment of benign prostatic hyperplasia. The nurse will tell him that a possible effect of this medication is:" a alopecia. b increased hair growth. c urinary retention. d increased prostate size.

ANS: B Finasteride is given to reduce prostate size in men with benign prostatic hyperplasia. It has been noted that men taking this medication experience increased hair growth. The other options are incorrect.

During the administration of finasteride (Proscar), the nurse must remember which important precaution?" a It must be taken on an empty stomach. b It must not be handled by pregnant women. c It is given by deep intramuscular injection to avoid tissue irritation. d The patient needs to be warned that alopecia is a common adverse effect.

ANS: B Finasteride must not be handled by pregnant women because of its teratogenic effects. It is taken orally and without regard to meals. The other options are incorrect.

A 73-year-old male patient is in the clinic for a yearly physical and is asking for a prescription for sildenafil (Viagra). He has listed on his health history that he is taking a nitrate for angina. The nurse is aware that which problem may occur if sildenafil is taken with a nitrate?" a Significant increase in pulse rate b Significant decrease in blood pressure c Increased risk of bleeding d Reduced effectiveness of the sildenafil

ANS: B In patients with pre-existing cardiovascular disease, especially those on nitrates, erectile dysfunction drugs such as sildenafil lower blood pressure substantially, potentially leading to more serious adverse events. The other options are incorrect.

A patient is to receive testosterone therapy via a transdermal patch. He asks the nurse, "Why am I getting a patch? Can't I just take a pill?" Which response by the nurse is correct?" a "The patch reduces the incidence of side effects." b "If you don't take the patch, you will have to have injections instead." c "The patch allows for better absorption of the medication." d "You will only have to change the patch weekly."

ANS: C The transdermal form allows for better absorption of testosterone because of its high first-pass effect. Oral forms are poorly absorbed, and the transdermal form is preferable to an injection and is preferred for hormonal replacement therapy. The patch is changed daily.

A 63-year-old male patient is scheduled for a physical examination, and he tells the nurse that he wants to start taking a vitamin formula that includes saw palmetto for prostate health. Which is the nurse's best response?" a "I've heard many good things about saw palmetto." b "It's not a good idea to start herbal therapy at your age." c "There are very few adverse effects with saw palmetto therapy." d "The doctor will need to draw some blood and do a digital rectal exam first."

ANS: D A prostatic-specific antigen test and digital rectal examination needs to be performed before initiation of treatment with saw palmetto for benign prostatic hyperplasia. Adverse effects may include gastrointestinal upset, headache, back pain, and dysuria.

The nurse notes in a female patient's history that she has an order for the androgen methyltestosterone (Android). Based on this finding, the nurse interprets that the patient has which disorder?" a Fibrocystic breast disease b Hereditary angioedema c Hypertension d Inoperable breast cancer

ANS: D Methyltestosterone can be used in cases of inoperable breast cancer in women. The other options are incorrect.