Chapter 46- Drugs for Disorders and Conditions of the Male Reproductive Systems

The nurse is teaching a client who h as a new prescription for testosterone gel. Which of the following instructions should the nurse give to this client? 1. "Avoid exposing women to the gel or to areas of skin where the gel has been applied." 2. "Report any weight gain over 5 lb (2 kg) in 1month ." 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."

Answer : 1. "Avoid exposing women to the gel or to areas of skin where the gel has been applied." Rationale: Women and children should avoid contact with the gel or areas of the skin where gel has been applied to avoid drug absorption. Options 2, 3, and 4 are incorrect. A weight gain of 5 lb (2 kg) in 1 week's time should be reported but a gain over 1 month may not be significant. The gel should be applied to the chest or upper torso, not to the scrotal or perineal areas. Showering or swimming should be avoided for several hours after gel application to allow for adequate absorption, but there is no need to wait a full 12 hours before these activities.

A client with a history of BPH 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 client to do? 1. Continue to take the drug to achieve full therapeutic effects. 2. Discuss the use of a low-dose diuretic with the health care provider. 3. Decrease the intake of coffee, tea, and alcohol. 4. Return to the health care provider for PSA laboratory studies and a prostate exam.

Answer : 4. Return to the health care provider for PSA laboratory studies and a prostate exam. Rationale: Finasteride promotes shrinking of enlarged prostates and helps restore urinary function with full therapeutic effects obtained within 6 to 12 months. Because this client reports a sudden increase in urinary symptoms after taking the drug for 9 months, he should be evaluated by the health care provider for prostate cancer screening. Options 1, 2, and 3 are incorrect. Continuing to take the dose, or a low-dose diuretic, with the onset of new symptoms would not be appropriate. Decreasing bladder irritants such as coffee, tea, and alcohol may help overall but do not explain the sudden increase in symptoms.

A client is given a prescription for finasteride (Proscar) for treatment of benign prostatic hyperplasia. Essential teaching for this client 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 crushed. 4. Blood donation should not occur while taking this drug. 5. Report any weight gain of over 5 lb (2 kg) in 1 week's time.

Answer: 1, 3, 4 1. Full therapeutic effects may take 3 to 6 months. 3. The drug should not be handled by pregnant women, especially if crushed. 4. Blood donation should not occur while taking this drug. Rationale: Enlarged prostatic tissue will decrease over a period of 3 to 6 months. The drug is teratogenic and should not be handled by pregnant women. Blood donation should not occur while taking finasteride because the blood may be given to a woman. Options 2 and 5 are incorrect. Finasteride in lower doses is given under the trade name "Propecia" for treatment of bald ness. There is a concern for edema and weight gain when alpha-blocking drugs are used to treat BPH but finasterid e (Proscar) is a 5-alpha reductase inhibitor, not an alpha-blocker, and edema and weight gain are not associated with its use.

The client with erectile dysfunction is being evaluated for the use of sildenafil (Viagra). Which of the following questions should the nurse ask before initiating therapy with sildenafil? 1. "Are you currently taking medication s 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 migraine headaches?"

Answer: 1. "Are you currently taking medication s for angina?" Rationale: Life-threatening hypotension is an adverse effect in clients who are taking sildenafil (Viagra) and organic nitrates. Options 2, 3, and 4 are incorrect. Diabetes, allergies to dairy, or migraines are not contraindications for sildenafil.

Which of the following nursing assessments would be appropriate for the client who is receiving testosterone? (Select all that apply.) 1. Monitor for a decrease in hematocrit (Hct). 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.

Answer: 2, 3 2. Assess for signs of fluid retention. 3. Assess for increased muscle mass and strength. A side effect of testosterone therapy is fluid retention . Testosterone is also used to increase muscle mass and strength. Options 1, 4, and 5 are incorrect. The hematocrit may increase with the use of testosterone, because it promotes the synthesis of erythropoietin. Muscle wasting should not occur and blood dyscrasias are not common with the use of testosterone.

The nurse is teaching a client 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 psychological conditions. 4. It will result in less intense sensation with prolonged use.

Answer: 3. It is not effective if sexual dysfunction is caused by psychological conditions. Rationale: Tadalafil (Cialis) and other similar drugs are not effective if the erectile dysfunction is psychological in nature. Options 1, 2, and 4 are incorrect. Tadalafil will not heighten sexual response in females. It does not cause decreased sensations over time and it enhances, rather than causes, an erection

Which of the following questions should the nurse ask before administering Viagra? a. "Are you currently taking medications for angina?" b. "Do you have a history of diabetes?" c. "Have you ever had an allergic reaction to dairy products?" d. "Have you ever been treated for migraine headaches?"

Answer: a. "Are you currently taking medications for angina?" Rationale: Life-threatening hypotension is an adverse effect in clients who are taking Viagra, as well as organic nitrates

Which of the following medications is used to treat male infertility? (Select all that apply.) a. HCG b. Menotropins c. Testolactone d. Cardura

Answer: a. HCG, b. Menotropins, c. Testolactone Rationale: Male infertility is difficult to treat pharmacologically; medications include HCG, menotropins, testolactone, and anti-estrogens.

Which of the following medications is used to treat oligospermia? a. Human chorionic gonadotropin (HCG) b. Menotropin (Pergonal) c. Clomiphene (Clomid) d. Anti-estrogens (tamoxifen)

Answer: a. Human chorionic gonadotropin (HCG) Rationale: Therapy for male infertility begins with the IM administration of human chorionic gonadotropin (HCG) for one year.

Which of the following disorders might predispose a client to male hypogonadism? a. Mumps b. Diabetes mellitus c. Hydrocele d. Adrenal insufficiency

Answer: a. Mumps Rationale: A complication of mumps is testicular failure. Testicular trauma or inflammation, and certain autoimmune disorders may also be causes.

Which of the following findings might be evident in a client who has undergone testosterone therapy? a. Virilization b. Electrolyte imbalances c. Hepatomegaly d. Precocious puberty

Answer: a. Virilization Rationale: The primary use of testosterone is to treat hypogonadism in males with delayed puberty.

Which of the following nursing interventions would be appropriate for the client receiving testosterone? a. Monitor for a decrease in hematocrit. b. Assess for signs of fluid retention. c. Check for blood dyscrasias. d. Assess for muscle wasting.

Answer: b. Assess for signs of fluid retention. Rationale: A side effect of testosterone therapy is fluid retention. Testosterone does not cause blood dyscrasias or muscles wasting.

Which of the following hormones regulates sperm production? a. Luteinizing hormone (LH) b. Follicle-stimulating hormone (FSH) c. Interstitial cell-stimulating hormone (ICSH) d. Testosterone

Answer: b. Follicle-stimulating hormone (FSH) Rationale: Although the follicle-stimulating hormone (FSH) applies to its target in the female ovary, this hormone regulates sperm production in males.

Which of the following statements best describes the action of doxazosin (Cardura)? a. It mobilizes excess fluid in the tissues. b. It relaxes smooth muscles in the prostate. c. It shrinks the size of the prostate. d. It increases renal secretion of sodium.

Answer: b. It relaxes smooth muscles in the prostate. Rationale: Doxazosin is an alpha 1-adrenergic blocker that relaxes smooth muscle in the prostate to ease urinary obstruction.

Which of the following medications could predispose the client to erectile dysfunction? a. Insulin b. Nonsteroidal anti-inflammatories c. Phenothiazides d. Oral hypoglycemics

Answer: c. Phenothiazides Rationale: In men, some medications such as phenothiazides cause impotence due to low testosterone secretion.

Which of the following findings is most likely to be found in a client using anabolic steroids? a. Hypogonadism b. Mental depression c. Permanent liver damage d. Increased cholesterol levels

Answer: d. Increased cholesterol levels Rationale: Use of anabolic steroids tends to raise cholesterol levels and lower sperm counts.