Chapter 51: (Mens Health)

After teaching a patient who is prescribed sildenafil about using the drug, the nurse determines that the teaching was successful when the patient states: "I need to take the pill about an hour before any sexual stimulation." "I should take the medication just before I start having sex." "I can take the pill in the morning before I engage in sex later in the day." "I should take the pill after dinner if I'm planning to have sex later that night."

"I need to take the pill about an hour before any sexual stimulation."

A nurse is caring for an adolescent with hypogonadism who has been prescribed fluoxymesterone (Androxy) for replacement. What adverse effect of this drug will the nurse alert the patient to that could cause self-esteem concerns? Acne Dizziness Insomnia Fatigue

Acne

A 69-year-old male is diagnosed with hypogonadism, and the physician orders testosterone. The patient is found to have hypertension on assessment by the nurse. What is this patient at increased risk for? Liver failure Aggravated cardiovascular disorders Kidney failure Impotence

Aggravated cardiovascular disorders

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? Decreasing arterial blood flow Causing vasodilation in the pulmonary vascular bed Decreasing the function of the right ventricle Increasing systemic vascular resistance

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? Increase in body weight Hypopigmentation of the skin Decrease in clitoris size Deepening of the voice

Deepening of the voice

A child in renal failure is taking dandrolone (Durabolin) 25 mg IM every 3 weeks and is seen in the clinic every other month. What adverse effects related to this drug therapy would the nurse be most concerned with monitoring for? Growth of facial hair Weight gain Epiphyseal closure Skin color

Epiphyseal closure

A patient presenting with an androgen deficiency state is prescribed an oral anabolic steroid. A higher dose of steroid is indicated due to its: High excretion rate in feces. Being metabolized more slowly by the kidneys. Antagonistic effects on male sex hormones. Extensive metabolism in the first pass through liver.

Extensive metabolism in the first pass through liver.

Androgens are used as replacement therapy for hypergonadism. True False

False

Testosterone is injected directly into the corpus spongiosum. True False

False

Mr. Tyler arrives for a follow-up visit. He began minoxidil 2 months ago for the treatment of his male pattern baldness. At today's visit, he expresses his concern because he has not noted any hair growth. What would be the best course of action for the nurse in this case? Assess whether the client suffers from a nonintact scalp. Assess whether the client suffers from frontal hair loss. Inform the patient that the therapy will require at least 4 months of twice-daily application. Advise the patient to consult a prescriber for an increased dose.

Inform the patient that the therapy will require at least 4 months of twice-daily application.

A female athlete is using high doses of anabolic steroids to enhance her performance. When a female use anabolic steroids at high doses, what result may she have? Immobility of joints Hypotension Obesity Masculinization

Masculinization

A woman who has been prescribed high doses of anabolic steroids should be instructed on which effects? Hypotension Obesity Immobility of joints Masculinization

Masculinization

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? Alprostadil Tadalafil Danazol Oxandrolone

Oxandrolone

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? Sildenafil will not work for you because of the type of erectile dysfunction that you have. It is not recommended that you have sexual intercourse for a year after having a heart attack. It is not recommended that you take sildenafil, because you are on atenolol. Prior to being prescribed sildenafil, you will need to have a stress test.

Prior to being prescribed sildenafil, you will need to have a stress test.

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? Vardenafil Sildenafil Tadalafil Alprostadil

Sildenafil

An adult female has been taking prescribed androgens. What result of taking androgens should be included in the patient teaching? Atrophy of breasts Rapid bone growth Loss of pubic hair Suppression of menstruation

Suppression of menstruation

Which would the nurse expect to administer as a depot injection? Danazol Testosterone Methyltestosterone Fluoxymesterone

Testosterone Testosterone is administered IM, transdermally, and in long-acting depository (depot injection) forms. Danazol is administered orally only. Methyltestosterone is administered orally. Fluoxymesterone is administered orally.

An older male patient will begin taking an androgen. The patient has difficulty swallowing tablets and pills. Because of the available drug route, a good choice for this patient would be: Danazol (Danocrine) Fluoxymesterone (Halotestin) Testosterone (Testoderm) Testolactone (Teslac)

Testosterone (Testoderm)

Anabolic steroids are analogs of testosterone with increased protein-building effects. False True

True

Phil is prescribed testosterone for erectile dysfunction secondary to androgen deficiency. During the assessment, the nurse notes that he also suffers from benign prostatic hypertrophy (BPH). What effect is the drug most likely to have in this case? Worsening of the BPH with possible urethral obstruction Decreased difficulty in voiding No progression of the BPH Improvement of the BPH

Worsening of the BPH with possible urethral obstruction

A nurse is teaching a class at the local high school on the abuse of anabolic steroids. One potential adverse reaction the nurse should cite is: hypotension. sedation. excessive testicular growth. liver tumors.

liver tumors.

A student asks the pharmacology instructor what effect the administration of androgens can have on a fetus if administered during pregnancy. What should the instructor respond? Female child may have masculinized features Sex of child will be female Increased growth of fetus Sex of child will be male

Female child may have masculinized features

Which is an example of an androgen that can be used to treat hypogonadism? Nandrolone Oxymetholone Dutasteride Fluoxymesterone

Fluoxymesterone

When fluoxymesterone is administered to a 14-year-old male for hypogonadism, what is the expected result? Growth of sexual organs Higher voice Euphoria Decreased muscle mass

Growth of sexual organs

A male patient has been diagnosed with impotence and is started on a regimen of androgens. Which statement by the patient indicates that he has understood the patient teaching? "If my skin appears yellow or my urine turns dark, I will contact my physician." "My blood count will drop, but if I have bruising, I will contact my physician." "I know headaches are common, so I won't get alarmed if it is severe." "If I experience increasing baldness, I will contact my physician immediately."

"If my skin appears yellow or my urine turns dark, I will contact my physician."

The nurse is caring for a patient with cryptorchidism who is 28 years old and taking testosterone to treat his problem. What statement by this patient would lead the nurse to believe that he has understood the teaching? "My sexual desire may decrease." "My skin may become clear and soft." "My body hair may increase." "My voice may become higher."

"My body hair may increase."

Testosterone therapy would be recommended for all these patients except for a: 25-year-old with low testosterone levels and loss of pubic hair. 52-year-old female with inoperable metastatic breast cancer. 35-year-old male with erectile dysfunction due to diabetes mellitus. 14-year-old who is diagnosed with hypogonadism.

35-year-old male with erectile dysfunction due to diabetes mellitus. Erectile dysfunction due to diabetes is caused by damage to the nerves that innervate the penis, not by low androgen levels.

A patient diagnosed with erectile dysfunction has been advised to take Viagra. For up to how many hours does the action of the drug persist? 8 hours 12 hours 24 hours 4 hours

4 hours

A patient will begin taking sildenafil (Viagra) for penile erectile dysfunction. The nurse will teach him what concerning use of this drug? He should use his nitroglycerin before intercourse to protect his heart. There is no need to worry about interactions with any other drugs. An erection will only occur in the presence of sexual stimulation of the penis. He will have an erection exactly one hour after taking the drug.

An erection will only occur in the presence of sexual stimulation of the penis.

A patient at the clinic reports amenorrhea and has participated in competitive bodybuilding for years. She tested positive for pregnancy. After obtaining a health history, you find healthy eating habits, regular exercise, herbal supplement use, and alcohol avoidance. What patient education should follow? Anabolic steroid use is contraindicated in pregnancy. Anabolic steroid use is indicated in pregnancy. Anabolic steroid use during pregnancy is an individual choice. Anabolic steroid use during pregnancy decreases the need for exercise during pregnancy.

Anabolic steroid use is contraindicated in pregnancy.

Matt, age 16, has been taking testosterone since age 7 for the treatment of hypogonadism. He is in the physician's office today for follow-up care. He asks about taking anabolic steroids instead of testosterone because he heard this will increase his growth. What is the primary difference between anabolic steroids and testosterone? Anabolic steroids produce both anabolic and androgenic effects. Anabolic steroids are given via the buccal route. Anabolic steroids have a greater anabolic effect. Anabolic steroids are synthetic.

Anabolic steroids have a greater anabolic effect.

Carter, age 13, is prescribed testosterone for delayed onset of puberty. What is a priority when monitoring the prepubescent? Sodium and potassium levels Hemoglobin levels Fluid intake and output Bone growth

Bone growth

A 9-year-old boy is taking testosterone injections for treatment of hypogonadism. What should be measured every 6 months on this child? Hand and wrist epiphyseal growth plates LFT Cholesterol level Vision

Hand and wrist epiphyseal growth plates

An 8-year-old boy is being administered testosterone injections for treatment of hypogonadism. What should be measured every 6 months? Electroencephalogram Electrocardiogram Visual acuity Hand and wrist epiphyseal growth plates

Hand and wrist epiphyseal growth plates

A man is taking an anabolic steroid. He has an undiagnosed prostate tumor. What effect will the anabolic steroid have on the prostate tumor? Increase vascularization Decrease the size Limit metastasis Increase the size

Increase the size

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 bioavailability of androgens Potassium retention Increased RBD production Increased fluid and sodium retention

Increased fluid and sodium retention

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? Potassium retention Increased fluid and sodium retention Increased RBD production Increased bioavailability of androgens

Increased fluid and sodium retention

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? Nonadherence to the prescribed dosage Prescribed dosage is less than normal Urethral blockage Ingestion of high-fat meal along with the drug

Ingestion of high-fat meal along with the drug

The androgen, testosterone, is available in several dosage forms. In which route is testosterone not able to be given? Intravenously Topically Orally Subcutaneously

Intravenously

A male patient 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 patient education is necessary? Use additional doses of the gel. Use the same amount of doses, just increase the amount of gel used. Only use the gel at times of procreation. Leave the gel on until the next application is due.

Leave the gel on until the next application is due.

Which would be most important to assess in a patient receiving testosterone for a prolonged period of time? Serum electrolyte levels Complete blood count Platelet count Liver function studies

Liver function studies

A nurse is caring for patients receiving androgen therapy. For which of the following conditions may androgen therapy be given as replacement therapy? Select all that apply. Delayed puberty Male pattern baldness Testosterone deficiency Benign prostatic hypertrophy Failure of development of the testes

Testosterone deficiency Delayed puberty Failure of development of the testes

A patient has been prescribed sildenafil citrate. What should the nurse teach the patient about this medication? A dose of more than 80 mg will result in a change of vision, making everything appear blue. Facial flushing or headache should be reported to the physician immediately. The drug should be taken 1 hour prior to intercourse. Sexual stimulation is not needed to obtain an erection.

The drug should be taken 1 hour prior to intercourse.