Pharm II Test 5 REPRODUCTIVE SYSTEM
A client asks the nurse for emergency contraception. Which question should the nurse ask the client? 1. "How long ago did you have unprotected sex?" 2. "Did you use a condom during intercourse?" 3. "What kind of birth control have you used in the past?" 4. "Where are you in your monthly cycle?"
1
The nurse is preparing to obtain a history from a client suspected of experiencing the early stage of menopause. Which statements made by the client support the condition? Select all that apply. 1. "I have experienced bouts of depression." 2. "I have a great deal of trouble sleeping." 3. "I have lost interest in having sex." 4. "I have been experiencing headaches." 5. "I have been leaking urine when I cough and sneeze."
1, 2, 4
A nurse is teaching a patient about the possible adverse effects of oral contraceptives. The nurse evaluates that the patient understands this teaching if which statements are made? Select all that apply. 1. "I may experience increased acne while on oral contraceptives." 2. "If I experience chest pain, I will call the clinic immediately." 3. "If I begin to lose more hair than is normal, my dose may need to be adjusted." 4. "Any blurry vision or loss of vision should be reported immediately." 5. "If I notice swelling in my feet, hands, or face, I will notify the clinic."
1, 2, 4, 5
Which information should the nurse include in the education about anabolic steroids for a group of high school athletes? Select all that apply. 1. The use of anabolic steroids can lead to infertility. 2. The entire body is affected by anabolic steroids, especially your liver. 3. The use of anabolic steroids is the most effective way to increase muscle mass. 4. The use of anabolic steroids should be monitored by your doctor. 5. The use of anabolic steroids can lead to very aggressive behavior.
1, 2, 5
Which information should the nurse provide a client that has stopped taking oral contraceptives so that she can become pregnant? SATA 1. "It may take several months for ovulation to return to normal." 2. "The incidence of miscarriage is slightly increased." 3. "It may take several months for your menstrual periods to become regular." 4. "The length of use can affect your fertility." 5. "If you are not pregnant within a year your healthcare provider will refer you to an infertility specialist."
1, 3
A patient is given a prescription for finasteride (Proscar) for treatment of benign prostatic hyperplasia. Essential teaching for this patient includes which of the following? (Select all that apply.) 1. Full therapeutic effects may take 3 to 6 months. 2. Hair loss or male-pattern baldness may be an adverse effect. 3. The drug should not be handled by pregnant women, especially if it is crushed. 4. Blood donation should not occur while taking this drug. 5. Report any weight gain of over 2 kg (5 lb) in 1 week.
1, 3, 4
Which history of clinical conditions should the nurse inquire about from a client with azoospermia? Select all that apply. 1. Sexually transmitted infections 2. Erectile dysfunction 3. Mumps 4. Tuberculosis 5. Atherosclerosis
1, 3, 4
1) Which should the nurse recognize as adverse effects from the use of sildenafil (Viagra)? Select all that apply. 1. Nasal congestion 2. Nausea 3. Blurry vision 4. Priapism 5. Photophobia
1, 3, 4, 5
A client receiving androgen therapy expresses concern about recent body changes as a result of the therapy. Which is the most therapeutic response by the nurse? 1. "Would you like to speak with your healthcare provider?" 2. "Can we talk about your concerns?" 3. "Are you aware that these changes are only temporary?" 4. "Can you tell me specifically what changes you are talking about?"
2
A patient is interested in taking levonorgestrel and estradiol (Seasonique) and asks how it is taken. Which explanation by the nurse is correct? 1. "Seasonique is taken year-round without a break and without a period." 2. "Seasonique is taken for 84 days and then followed by 7 days of a lower dose contained in the same package." 3. "Seasonique is a vaginal ring that is inserted monthly." 4. "Seasonique is taken for 2 months then off for 1 month using regular oral contraceptives."
2
The nurse has completed the education for a client prescribed clomiphene (Clomid). Which statement made by the client indicates an understanding of the information? 1. "This medication increases my estrogen levels so I can ovulate." 2. "This medication stimulates LH (luteinizing hormone)." 3. "This medication stimulates FSH (follicle-stimulating hormone)." 4. "This medication stimulates gonadotropin-releasing hormone."
2
The nurse has provided education for a client prescribed a transdermal patch for contraception. Which statement made by the client indicates an understanding of the teaching? 1. "I will change the patch every 4 weeks." 2. "I will change the patch every 7 days for the first 3 weeks." 3. "I will change the patch every 3 weeks and be patch free week 4." 4. "I will change the patch every 7 days for the 4 weeks."
2
A client taking oral contraceptives tells the nurse she is experiencing nausea and breast tenderness and is afraid she might be pregnant. Which information should the nurse provide the client? 1. Instruct the client to take an at-home pregnancy test. 2. Instruct the client to come to the clinic to evaluate their birth control prescription. 3. Reassure the client that these symptoms can be a side effect of oral contraceptives. 4. Ask the client if she is premenstrual.
3
A male client prescribed estrogen for prostate cancer asks the nurse why they are receiving a female hormone. Which response should the nurse provide? 1. "It shrinks your cancer by causing the cells to die at a faster rate." 2. "It eliminates the testosterone that encourages the growth of the cancer cells" 3. "It suppresses secretion of the androgens that make your cancer grow." 4. "It keeps the cancer cells from receiving nutrients."
3
A woman consults the nurse about Plan B (levonorgestrel) after unprotected intercourse that occurred 2 days earlier. Which instruction will the nurse give to this patient? 1. "You must wait 7 days before taking the pills for Plan B to be effective." 2. "Plan B is effective only within 24 hours of unprotected intercourse." 3. "You will take one pill of Plan B at first, followed by another pill 12 hours later." 4. "You will need to obtain a prescription for Plan B."
3
The educator has reviewed the action of the biphasic estrogen-progestin oral contraceptive with the nurse. Which statement made by the nurse indicates an understanding of the information? 1. "The amounts of both estrogen and progestin in each pill vary in 3 distinct phases during the treatment cycle." 2. "The oral contraceptive contains estradiol valerate, a synthetic estrogen, and dienogest, a progestin." 3. "The amount of estrogen in each pill remains constant, but the amount of progestin is increased toward the end of the treatment cycle to better nourish the uterine lining." 4. "The oral contraceptive delivers a constant dose of estrogen and progestin throughout the 21-day treatment cycle."
3
The nurse has provided education for a client prescribed the contraceptive Seasonale. Which statement made by the client indicates an understanding of the information? 1. "After I have taken 21 pills, I will not take pills for 7 days." 2. "I will remove the ring at the end of 3 weeks." 3. "After I have taken pills for 84 days, I will not take pills for 7 days." 4. "I will change the patch each week."
3
The nurse is preparing to assess a client suspected of having benign prostatic hyperplasia. Which common finding should the nurse anticipate? 1. Dysuria 2. Hematuria 3. Nocturia 4. Polyuria
3
A 43-year-old patient is receiving medroxyprogesterone (Depo-Provera) for treatment of dysfunctional uterine bleeding. Because of related adverse effects, which condition may indicate a potential adverse effect? 1. Breakthrough bleeding between periods 2. Insomnia or difficulty falling asleep 3. Eye, mouth, or vaginal dryness 4. Joint pain or pain on ambulation
4
A client calls the clinic and tells the nurse that she has missed taking several of her contraceptive pills during the current cycle. What is the best instruction for the nurse to give the client? 1. "Please come into the clinic immediately to have a pregnancy test done." 2. "You might consider another form of birth control if you keep missing your pills." 3. "If you have missed fewer than three of your pills, you do not need to worry." 4. "You should use an alternative form of birth control for the rest of this cycle."
4
A client receiving Depo-Provera as a method of birth control asks the nurse how long the prescription will be effective. Which response should the nurse provide the client? 1. 2 months 2. 6 months 3. 1 year 4. 3 months
4
A patient with a history of benign prostatic hyperplasia is complaining of feeling like he "cannot empty his bladder." He has been taking finasteride (Proscar) for the past 9 months. What should the nurse advise this patient to do? 1. Continue to take the drug to achieve full therapeutic effects. 2. Discuss the use of a low-dose diuretic with the healthcare provider. 3. Decrease the intake of coffee, tea, and alcohol. 4. Return to the healthcare provider for laboratory studies and a prostate exam.
4
The nurse completes an assessment of a patient in labor who is receiving an intravenous infusion of oxytocin. Which assessment indicates the need for prompt intervention? 1. There is no vaginal bleeding noted. 2. The patient is managing her pain through breathing techniques. 3. Fetal heart rate remains at baseline parameters. 4. Contractions are sustained for 2 minutes in duration.
4
Which describes the action of oxytocics? 1. Slow down uterine contractions 2. Increase the level of luteinizing hormones 3. Increase ovarian secretion 4. Stimulate uterine contractions
4
Which describes the goal of androgen therapy in men? 1. Increase the sperm count 2. Release follicle-stimulating hormone 3. Increase luteinizing hormone 4. Increase the libido
4
Which prescription is most appropriate for a client with benign prostatic hyperplasia (BPH) and hypertension? 1. Terazosin (Hytrin) 2. Sildenafil (Viagra) 3. Finasteride (Proscar) 4. Tamsulosin (Flomax)
1
Which should the nurse monitor the client for who is receiving hormone replacement therapy (HRT)? 1. Thrombophlebitis 2. Night sweats 3. Colorectal cancer 4. Fractures
1
Which statement made by a client indicates an understanding of the role of follicle-stimulating hormone (FSH) and the male reproductive system? 1. "Follicle-stimulating hormone (FSH) regulates sperm production." 2. "Follicle-stimulating hormone (FSH) regulates male androgen production." 3. "Follicle-stimulating hormone (FSH) regulates production of testosterone." 4. "Follicle-stimulating hormone (FSH) regulates male progesterone."
1
A patient has started taking clomiphene (Clomid, Serophene) after an infertility workup and asks the nurse why she is not having in-vitro fertilization. Which statement would be most helpful in explaining the use of clomiphene to the patient? 1. The patient's diagnostic workup suggested that infrequent ovulation may be the cause for her infertility, and clomiphene increases ovulation. 2. In-vitro fertilization is expensive and because clomiphene is less expensive, it is always tried first. 3. There is less risk of multiple births with clomiphene. 4. The patient's past history of oral contraceptive use has prevented her from ovulating. Clomiphene is given to stimulate ovulation again in these conditions.
1
The nurse has provided a postpartum client education about oxytocin (Pitocin). Which statement made by the client indicates an understanding of the information? 1. "Oxytocin will increase my uterine contractions." 2. "Oxytocin will promote fluid loss." 3. "Oxytocin will stimulate milk production." 4. "Oxytocin will increase the amount of milk I produce."
1
The nurse is preparing to provide education for a client prescribed an estrogen-progestin combination oral contraceptive. Which information should the nurse include in the teaching? 1. Inhibit ovulation 2. Inhibit the luteinizing hormone 3. Suppress the follicle-stimulating hormone 4. Suppress the growth of the follicle
1
The nurse is teaching a patient who has a new prescription for testosterone gel. Which instruction should the nurse give to this patient? 1. "Avoid exposing women to the gel or to areas of skin where the gel has been applied." 2. "Report any weight gain over 2 kg (5 lb) in 1 month." 3. "Avoid showering or swimming for at least 12 hours after applying the gel." 4. "Apply the gel to the scrotal and perineal areas daily."
1
The nurse reviewing the records of a client notes that he does not have a history of benign prostatic hyperplasia but is receiving finasteride (Proscar). Which assessment question should the nurse ask the client? 1. "Do you have male pattern baldness?" 2. "Do you have erectile dysfunction?" 3. "Do you have a stomach ulcer?" 4. "Do you have high blood pressure?"
1
The patient with erectile dysfunction is being evaluated for the use of sildenafil (Viagra). Which question should the nurse ask before initiating therapy with sildenafil? 1. "Are you currently taking medications for angina?" 2. "Do you have a history of diabetes?" 3. "Have you ever had an allergic reaction to dairy products?" 4. "Have you ever been treated for migraines?"
1
When caring for a laboring client, which assessment finding indicates the oxytocin (Pitocin) infusion should be discontinued? 1. Uterine contractions that are continuous and sustained. 2. The vaginal exam reveals that the client is entering transition. 3. The client reports that the uterine contractions are strong in intensity. 4. Uterine contractions occur every 2 to 3 minutes and last 40 to 60 seconds.
1
Which information should the nurse include in the education for a client prescribed finasteride (Proscar)? 1. "Pregnant women should not touch this medication." 2. "This drug has only very minor side effects." 3. "Side effects of the prescription occur within 1 week of starting treatment." 4. "Swallow medication whole with a full glass of water."
1
Which information should the nurse include in the education for a client prescribed flibanserin (Addyi) for the treatment of sexual desire disorder? 1. "Do not drink alcohol while taking the medication." 2. "You may experience insomnia while taking this prescription." 3. "Abstain from dairy products while taking this medication." 4. "This medication increases desire by increasing endogenous estrogen production."
1
Which prescription information should the nurse provide the client prescribed Premarin? Select all that apply. 1. "You may notice a decrease in your libido while on this prescription." 2. "You may experience depression while taking the prescription." 3. "Do not become pregnant while on this prescription." 4. "If you add the herbal black cohosh to this therapy, the results will be better." 5. "This prescription will help prevent cardiovascular disease."
1, 2, 3
A male patient has been started on a 5-alpha reductase inhibitor for the treatment of benign prostatic hyperplasia (BPH). Which information should the nurse provide? Select all that apply. 1. "Use a condom during intercourse." 2. "Keep this medication in a secure place away from children." 3. "Do not give blood while you are taking this medication." 4. "Do not do heavy exercise while taking this medication." 5. "Reduce your sodium intake while taking this drug."
1, 2, 3
Which information should the nurse include in the teaching for a client prescribed a progestin only oral contraceptive? Select all that apply. 1. "Progestin oral contraceptives have a higher failure rate." 2. "Progestin oral contraceptives inhibit plantation of a fertilized egg." 3. "Works primarily by producing a thick viscous mucus that discourages the sperms entrance to the uterus." 4. "You have an increased risk of a thromboembolism." 5. "You may notice your menstrual cycle will be more regular."
1, 2, 3
The nurse has completed the education for a client being treated for benign prostatic hypertrophy (BPH). Which statements by the client indicate an understanding of the disease? Select all that apply. 1. "These medications are not a cure." 2. "Taking an antihistamine might make my problem worse." 3. "Avoiding caffeine intake may reduce my symptoms." 4. "Surgery is the best treatment for this condition." 5. "I should avoid drinking fluids in the late evening."
1, 2, 3, 5
Which physical assessment findings support a diagnosis of hypogonadism in an 18-year-old male? Select all that apply. 1. Facial hair is minimal, soft, and light in color 2. Absent pubic hair 3. Decreased subcutaneous fat 4. Small testicles 5. Pale skin
1, 2, 4
Which system disorders are associated with erectile dysfunction (ED)? Select all that apply. 1. Cardiovascular 2. Integumentary 3. Endocrine 4. Nervous 5. Renal
1, 3, 4, 5
A client calls the family planning clinic and states, "I had unprotected sex, and now I am afraid I will get pregnant." Which information about Plan B should the nurse provide to the client? Select all that apply. 1. "You can purchase Plan B without a prescription." 2. "You cannot purchase Plan B until you have been examined at the family planning clinic." 3. "You may take two separate doses of Plan B." 4. "If you are already pregnant, Plan B will end the pregnancy." 5. "Plan B will prevent ovulation and implantation."
1, 3, 5
Which patients would have a higher risk for adverse effects from estradiol and norethindrone (Ortho-Novum)? (Select all that apply.) 1. An 18-year-old with a history of depression 2. A 16-year-old with chronic acne 3. A 33-year-old with obesity per her body mass index (BMI) 4. A 24-year-old who smokes one pack of cigarettes per day 5. A 41-year-old who has delivered two healthy children
1, 4
Which information should the nurse include in the teaching for a client prescribed testosterone? Select all that apply. 1. "Place the patch on a place that does not have hair." 2. "Avoid placing the patch on active areas like the thigh or arm." 3. "The patch should be changed every 7 days." 4. "Observe for a rash at the patch site." 5. "Keep these patches away from children."
1, 4, 5
The nurse has provided education for a client with benign prostatic hyperplasia (BPH). Which statement made by the patient indicates an understanding of the condition? 1. "The urethra is enlarged." 2. "The glands around the urethra are enlarged." 3. "The obstruction is around the glans penis." 4. "The ureteral openings are swollen."
2
The nurse reviewing the records of a female client notes a prescription for high doses of androgen. For which condition should the nurse understand the client is being treated? 1. Cervical cancer 2. Breast cancer 3. Uterine cancer 4. Ovarian cancer
2
Which finding indicates that endocrine pharmacotherapy has been successful in treating a male client? 1. Patient reports reduced difficulty in achieving and maintaining an erection. 2. Patient's sperm count is 22 million/mL. 3. Patient's ejaculate volume is 2 mL. 4. Patient reports pleasure with intercourse.
2
Which information should the nurse include in the teaching for a client prescribed doxazosin (Cardura)? 1. Take your first dose as soon as you get your prescription. 2. Do not drive for 12-24 hours after starting this medication. 3. You may experience sweating and a headache while taking this medication. 4. Increase fluids with this medication.
2
Which is responsible for the secretion of progestins? 1. Anterior pituitary 2. Corpus luteum 3. Ovarian follicles 4. Hypothalamus
2
Which is the mechanism of action for finasteride (Proscar)? 1. Relaxes smooth muscle in the penis 2. Promotes the shrinkage of an enlarged prostate gland 3. Increases the testosterone level 4. Stimulates RNA synthesis
2
Which response should the nurse provide a client that asks why infertility drugs are not being developed for men? 1. "It's difficult because the medications have many side effects that men do not like." 2. "It's difficult because about 25% of infertile men also have erectile dysfunction." 3. "It's difficult because only about 5% of infertile men have an endocrine problem." 4. "It's difficult because many men do not want to even admit they have a problem."
3
Which should the nurse include in the education for a client prescribed testosterone buccally? 1. Inflammation may occur in the mucosal tissue. 2. Fluctuations of libido and energy may occur. 3. Produces a continuous supply of testosterone in the blood. 4. The dosage can last for 2 weeks.
3
Which should the nurse include in the plan of care for a client receiving Ortho-Novum experiencing vaginal bleeding? 1. Ask the client if she has been having sexual intercourse recently. 2. Tell the client to go to the emergency department for medical treatment. 3. Ask the client if she is bleeding between cycles or if this is her regular period. 4. Tell the client not to worry if the bleeding resembles her monthly flow.
3
Which of the following nursing assessments would be appropriate for the patient who is receiving testosterone? (Select all that apply.) 1. Monitor for a decrease in hematocrit. 2. Assess for signs of fluid retention. 3. Assess for increased muscle mass and strength. 4. Check for blood dyscrasias. 5. Assess for muscle wasting.
2, 3
The nurse teaches a class for clients in their first trimester of pregnancy. The nurse evaluates that learning has occurred when the clients make which statements? Select all that apply. 1. "Ovulation occurs on approximately Day 21 of the ovarian cycle." 2. "Ovulation is caused by a surge of luteinizing hormone." 3. "Ovulation is caused by a surge of human chorionic gonadotropin." 4. "Follicle-stimulating hormone causes ovarian follicles to develop." 5. "The pituitary gland secretes gonadotropin-releasing hormone."
2, 4
The nurse is teaching a patient about the use of tadalafil (Cialis). What will the nurse teach him about the effects of tadalafil? 1. It should always result in a penile erection within 10 minutes. 2. It may heighten female sexual response. 3. It is not effective if sexual dysfunction is caused by psychologic conditions. 4. It will result in less intense sensation with prolonged use.
3
Which client behavior should the nurse be most concerned about for the client prescribed an estrogen/progestin oral contraceptive? 1. Multiple sexual partners 2. Pharmacological treatment for bipolar disorder 3. Smoking one-half pack of cigarettes per day 4. Drinking two glasses of wine a day
3
Which finding is an adverse effect of 5-alpha reductase inhibitors? 1. Headache 2. Acne 3. Sexual dysfunction 4. Chest pain
3
Which information should the nurse include in the education for a client prescribed sildenafil (Viagra)? 1. Grapefruit juice can decrease the effects of sildenafil (Viagra). 2. You can take sildenafil (Viagra) anywhere from 1 to 6 hours before sex. 3. Be sure to take only one pill in a 24-hour period. 4. Sildenafil (Viagra) should be taken with food.
3
Which information should the nurse include in the teaching for a client prescribed an alpha1-adrenergic blocker for the treatment of benign prostatic hyperplasia? 1. Take the first dose of the medication in the morning with breakfast. 2. Monitor your blood pressure on a weekly basis and report any B/P over 140/90 mmHg. 3. Call your healthcare provider if you are unable to take the prescription for 2 days. 4. Hold the prescription if you are experiencing dizziness.
3
Which is progestin primarily prescribed to treat? 1. Breast cancer 2. Amenorrhea 3. Dysfunctional uterine bleeding 4. Menopause
3
Which is responsible for the secretion of androgen? 1. Follicle-stimulating hormone 2. Gonadotropin-releasing hormone 3. Testes 4. Pituitary gland
3
Which is responsible for the secretion of estrogen? 1. Corpus luteum 2. Anterior pituitary 3. Ovarian follicles 4. Endometrium
3
Which question should the nurse ask the client that is requesting a refill of prescribed tadalafil (Cialis)? 1. "Do you have diabetes mellitus?" 2. "Do you have any sexually transmitted diseases?" 3. "Do you use nitroglycerine?" 4. "Do you take blood pressure medication?"
3
Which statement made by an older female client prescribed medroxyprogesterone (Provera) should the nurse be most concerned about? 1. "I have gained a bit of weight." 2. "I have had periods of feeling very sad." 3. "I have experienced moments of confusion." 4. "I have been experiencing bouts of nausea."
3
Which describes the primary function of luteinizing hormone (LH) in men? 1. Regulate sperm production 2. Regulate secondary sex characteristics 3. Regulate growth of male sex organs 4. Regulate testosterone
4
Which does the nurse anticipate to be prescribed for the treatment of a client's erectile dysfunction (ED)? 1. Leuprolide (Lupron) 2. Finasteride (Proscar) 3. Tamsulosin (Flomax) 4. Sildenafil (Viagra)
4
Which initial step occurs in the process of the formation of the corpus luteum? 1. A surge of luteinizing hormone (LH) occurs. 2. Ovarian follicles mature. 3. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are secreted. 4. Gonadotropin-releasing hormone (GnRH) is secreted.
4
Which comments made by a high school athlete should the nurse interpret as indicating an understanding of the risks of using anabolic steroids? Select all that apply. 1. "The only legal way I can take these drugs is if I inject them myself." 2. "Once I stop taking these drugs, my body will return to normal." 3. "As long as my coach says these drugs are okay, they won't hurt me." 4. "I might become mentally dependent on these drugs." 5. "I should not take ibuprofen while taking these other drugs."
4, 5
Which education should the nurse include in the teaching for a client prescribed a NuvaRing? Select all that apply. 1. "This ring should be inserted into your uterus." 2. "Once inserted, this ring will provide contraception for 6 months." 3. "You should expect to replace the ring every 3 weeks." 4. "Contraceptive protection is provided for 3 weeks." 5. "The ring uses estrogen and progestin to provide contraception."
4, 5
