Pharmacology Test 3: Renal and Reproductive

A nurse is planning discharge teaching for a female client who has a new prescription for trimethoprim-sulfamethoxazole. Which of the following information should the nurse include?

Take it on an empty stomach

ATA nurse is teaching a client who is postoperative following a kidney transplant and is taking cyclosporine. Which of the following instructions should the nurse include?

"Monitor for and report a sore throat to you provider"

The nurse counseling a couple who cannot conceive learns that female infertility problems have been ruled out. What will the nurse expect to tell this couple?

"Most male infertility is not linked to known endocrine disorders."

A nurse instills 1% silver nitrate topically into the eyes of a neonate on delivery to prevent conjunctivitis caused by what? (Select all that apply.)

Chlamydia Gonorrhea

Which infections may be acquired through nonsexual transmission? (Select all that apply.)

Chlamydia trachomatis Gardnerella vaginalis Herpes simplex Neisseria gonorrhea Treponema pallidum **:A, B, C, D, E All of these organisms can be acquired through nonsexual transmission, usually from a mother to an infant either prenatally or during delivery.

Which is the most common bacterial sexually transmitted disease (STD) in the United States, for which the Centers for Disease Control and Prevention (CDC) has recommended annual screening in certain populations?

Chlamydia trachomatis infection

The nurse knows that diuretics mostly affect which function of the kidneys?

Cleansing and maintenance of extracellular fluid volume

A patient is being treated for infertility. An examination reveals cervical mucus that is scant, thick, and sticky. The nurse suspects that the patient has been taking which medication?

Clomiphene [Clomid]

The nurse would expect the healthcare provider to prescribe which of these medications, along with hCG, to promote ovulation in selected infertile women?

Clomiphene [Clomid]

A patient with hypertension who has been taking captopril (Capoten) for several months is admitted to the hospital. The patient reports that food "tastes funny." What will the nurse do?

Compare the patient's admission weight to a previous weight.

A postpartum patient is receiving methylergonovine to prevent hemorrhage. The nurse assesses the patient and notes a heart rate of 76 beats per minute, a respiratory rate of 16 breaths per minute, and a blood pressure of 120/80 mm Hg. The patient's uterus is firm. The patient complains of mild to moderate cramping. Bleeding is minimal. What will the nurse do?

Continue to monitor and tell the patient to report increased cramping.

A patient is prescribed lisinopril [Prinvil] as part of the treatment plan for heart failure. Which finding indicates the patient is experiencing the therapeutic effect of this drug?

Crackles in the lungs are no longer heard

A clinic nurse is assessing an adolescent male patient who has been receiving androgen therapy for hypogonadism via a transdermal patch. The patient's last clinic visit was 4 weeks earlier. Which part of the interval history is of most concern to the nurse?

Five-pound weight gain

A patient who has acute cystitis is receiving treatment with trimethoprim/sulfamethoxazole. Which manifestation should indicate to a nurse that the patient's condition is worsening?

Flank pain

When evaluating the effects of leuprolide [Lupron] in a patient who has endometriosis, a nurse should monitor the laboratory results for which hormone or hormones?

Follicle-stimulating hormone (FSH) and luteinizing hormone (LH)

A patient who is infertile is taking clomiphene [Clomid]. A nurse should expect the patient to have which therapeutic response?

Follicular maturation

The nurse is working with a patient who has a UTI. Because patient adherence to a medication regimen is a concern, the nurse anticipates use of which medication?

Fosfomycin

pt w/ chronic renal failure, what diuretic can you give?

Furosemide

A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this patient will expect to administer which drug?

Furosemide [Lasix]

A patient admitted to the hospital is using metronidazole [Flagyl] 0.75% gel. The nurse understands that this agent is used to treat which condition?

Gardnerella vaginalis

An adolescent patient comes to the clinic complaining of a burning sensation upon urination and a pus-like discharge from the penis. The nurse is correct to suspect that the patient has which disorder?

Gonorrhea

The nurse notes that a patient's medication list includes ceftriaxone. The patient reports a history of sexually transmitted infection but cannot recall the name of the infection. The nurse is aware that ceftriaxone is the preferred medication for treating which sexually transmitted infe

Gonorrhea

A nurse is obtaining a history from a patient who will receive tadalafil [Cialis] for erectile dysfunction. The patient reports that he expects to have sexual activity three or four times a week. What should the nurse tell the patient?

He should talk to his provider about daily dosing of tadalafil.

A patient who has erectile dysfunction asks a nurse whether sildenafil [Viagra] would be a good medication for him to take. Which aspect of this patient's history would be of most concern?

Occasional use of nitroglycerin

With the exception of pyelonephritis, the nurse is aware that most urinary tract infections are treated by which method?

Oral antibiotics in the home setting

The nurse is aware that which treatments are used in nonpregnant women to treat bacterial vaginosis? (Select all that apply.)

Oral metronidazole Vaginal metronidazole

Which are contraindications for taking sildenafil [Viagra]? (SATA)

Patients who are taking nitroglycerin for angina pectoris Patients with nonarteritic ischemic optic neuropathy (NAION) in one eye Patients with BPH who are taking alpha1-adrenergic antagonists

A nurse monitors for which adverse cardiovascular effects in a male patient taking testosterone [Androderm]? (Select all that apply.)

Pedal edema and weight gain Decrease in high-density lipoprotein (HDL) levels

A patient who has syphilis is to start treatment. It is most important for the nurse to ask the patient about allergies to which antibiotic?

Penicillin G

Which measurements should a nurse obtain to evaluate the effects of androgen therapy on the epiphyses of a patient with hypogonadism?

Periodic hand and wrist x-rays

A female patient who swims competitively admits to using anabolic steroids to increase her muscle mass and improve her performance. What will the nurse tell this patient?

The risk of liver disease will increase.

The nurse is providing patient education about the application of transdermal estrogen spray. Which statement made by the patient best demonstrates understanding of the application of this medication? "I should apply this medication to my:

thighs and calves." Posterior thigh

You are about to give mannitol and the nurse see crystalloids in the solution, what do you do first?

Warm the solution to dissolve the crystals

A 14-year-old male patient has not begun puberty. His parents tell the nurse that their son does not want to go to school, because he gets teased. The nurse learns that the boy's father did not begin puberty until age 16 years. Laboratory tests on this child do not reveal true hypogonadism. What will the nurse tell these parents when they ask what can be done for their son?

"A limited course of androgen therapy may be prescribed, but it is not necessary."

A patient who has been taking an antihypertensive medication for several years is recovering from a myocardial infarction. The prescriber changes the patient's medication to an ACE inhibitor. The patient asks the nurse why a new drug is necessary. What is the nurse's response?

"ACE inhibitors can prevent or reverse pathologic changes in the heart's structure."

A nurse is explaining to a nursing student how clomiphene [Clomid] works to improve fertility. Which statement by the student indicates a need for further teaching?

"Clomiphene directly stimulates the ovary, causing follicular maturation and ovulation."

A nurse is teaching a postmenopausal patient taking estrogen/progestin therapy (EPT) about breast self-examination (BSE). Which of these instructions should the nurse give?

"Do your breast self-examination the first day of each month."

Which of these instructions should a nurse give a patient who is to start taking clomiphene [Clomid]?

"Have intercourse every other day for 5 to 10 days after the last dose of this medication."

A patient with endometriosis is being treated with the gonadotropin-releasing hormone (GnRH) agonist leuprolide [Lupron Depot]. A nurse is teaching the patient about the drug. Which statement by the patient indicates understanding of the teaching?

"I may have menopausal-like symptoms when taking this medication."

A patient with chronic congestive heart failure has repeated hospitalizations in spite of ongoing treatment with hydrochlorothiazide [HydroDIURIL] and digoxin. The prescriber has ordered spironolactone [Aldactone] to be added to this patient's drug regimen, and the nurse provides education about this medication. Which statement by the patient indicates understanding of the teaching?

"I need to stop taking potassium supplements."

A nurse is providing education to a patient who is beginning therapy with AndroGel testosterone gel. What statement made by the patient demonstrates a need for further teaching?

"I should apply the medication to my genitals for best results."

A nurse is teaching a male adult patient about the use of testosterone gel. Which statement by the patient indicates an understanding of the teaching?

"I should not let my child touch the gel to prevent behavioral problems."

A nurse provides teaching to a woman who is taking tranexamic acid [Lysteda] for menorrhagia. Which statement by the patient indicates a need for further teaching?

"I should take an oral contraceptive to prevent pregnancy while taking this drug."

A nurse provides teaching to a patient who has had a hysterectomy and is about to begin hormone therapy to manage menopausal symptoms. Which statement by the patient indicates understanding of the teaching?

"I should take the lowest effective dose for the shortest time needed."

A female patient who is not taking any other medications is prescribed aliskiren [Tekturna], a direct renin inhibitor (DRI). The nurse reviews medication information with the patient. Which statement by the patient indicates understanding of the teaching?

"I should take this medication 1 hour before sitting down to a meal."

Tadalafil [Cialis] was prescribed 4 weeks ago for a patient with erectile dysfunction. The patient also takes prazosin [Minipress] for hypertension. Which statement by the patient best demonstrates understanding of the use of tadalafil [Cialis]?

"I should take this medication no more than once a day."

A patient who is taking furosemide [Lasix] and digoxin will begin taking captopril [Capoten]. The nurse is providing information about the drug. Which statement by the patient indicates a need for further teaching?

"I should take this medication on a full stomach."

The nurse is providing teaching regarding Duavee (conjugated estrogens/bazedoxifene). Which statement by the patient indicates that the teaching was effective?

"I understand that the combination product should help protect me from the side effects of the estrogen."

The nurse is teaching a patient who has a new prescription for spironolactone [Aldactone]. Which statement by the patient indicates that the teaching was effective?

"I will call my doctor if I begin having menstrual irregularities."

A patient who has experienced preterm births with her previous two pregnancies will begin receiving hydroxyprogesterone caproate [Makena] to prevent preterm delivery with her current pregnancy. Which statement by the patient indicates a need for further teaching about this drug?

"I will eventually learn to administer the injections of this drug myself."

A patient at increased risk for thromboembolic disorders will begin taking a progestin-only oral contraceptive. Which statement by the patient indicates understanding of how this oral contraceptive works?

"I will need to use backup contraception if I miss a pill."

The nurse is evaluating the teaching done with a patient who has a new prescription for fosinopril [Monopril]. Which statement by the patient indicates a need for further teaching?

"I will use a salt substitute to lower my sodium intake."

A nurse is teaching a patient about the use of sildenafil [Viagra] for erectile dysfunction. Which statement by the patient indicates understanding of the teaching?

"If my erection lasts longer than 4 hours, I should contact my provider."

A nurse is teaching a group of parents about the role of testosterone in puberty for boys. To evaluate the group's understanding, the nurse asks, "What physiologic effects related to testosterone can you expect to see in your sons?" Which responses indicate an understanding of the role of testosterone in male puberty? (Select all that apply.)

"It promotes skeletal muscle growth." "It increases height and weight." "It causes acne."

Nitrofurantoin [Macrodantin] is prescribed for an adolescent female patient with acute cystitis. What should the nurse include in the teaching for this patient? (Select all that apply.)

"Make sure you tell your prescriber if you might be pregnant." "If you experience any tingling or numbness, stop taking the drug and call the clinic immediately." "Headaches and drowsiness can occur and are mild side effects." "Your urine may have a brown tinge while you are taking this drug."

A healthy male patient who does not have erectile dysfunction asks about medications to improve sexual stamina. What will the nurse tell this patient?

"Medications for ED have no effect on erections in healthy men."

A nurse provides teaching to a group of nursing students about the risks and benefits of hormone therapy (HT), including estrogen therapy (ET) and combination estrogen/progestin therapy (EPT). Which statement by a student indicates understanding of the teaching?

"Principle benefits of ET are suppression of menopausal symptoms and prevention of bone loss."

A patient taking sildenafil [Viagra] asks a nurse what action to take if priapism occurs. Which response should the nurse make?

"Seek emergency help, because permanent damage can occur."

A patient with polycystic ovary syndrome (PCOS) asks the nurse what she can do to improve her chances of getting pregnant. Which statement by the patient indicates a need for further teaching?

"Spironolactone, which reduces androgens and facial hair, is helpful if I'm trying to conceive."

A prescriber orders ramipril [Altace] for an obese patient with type 2 diabetes mellitus who has developed hypertension. The nurse provides teaching before dismissing the patient home. Which statement by the patient indicates understanding of the teaching?

"Taking this medication helps reduce my risk of stroke and heart attack."

A nurse provides teaching for a female patient with anemia who has had cancer chemotherapy and who will begin treatment with testosterone. Which statement by the patient indicates understanding of the teaching?

"Testosterone treats anemia by stimulating the synthesis of a renal hormone."

When teaching a patient who has genital herpes about treatment with valacyclovir [Valtrex], the nurse includes which statement?

"The intensity of infection episodes is reduced when the medication is taken daily."

A pregnant patient with fever, flank pain, and chills has a history of two previous bladder infections before getting pregnant. She is allergic to several antibiotics. She reports having taken methenamine successfully in the past. What will the nurse tell her?

"This agent is not effective against infections of the upper urinary tract."

Which application instruction is the priority for a nurse to provide to a patient starting to use AndroGel testosterone gel?

"Wash your hands after applying the gel to prevent transfer to others."

A patient with osteopenia asks a nurse about the benefits of hormone therapy in preventing osteoporosis. Which statement by the nurse is correct?

"When hormone therapy is discontinued, bone mass is quickly lost."

A nurse is teaching a group of adolescent students about sexually transmitted diseases. Which statement by a student indicates understanding of infections caused by C. trachomatis?

"Women with asymptomatic Chlamydia trachomatis infections can become sterile."

Which statement should a nurse include when providing teaching to a patient who is scheduled to start taking dutasteride [Avodart]?

"You cannot donate blood while on this medication or for 6 months after stopping it."

A male patient is being treated for benign prostatic hyperplasia (BPH) by another provider but cannot remember which drug he is taking. He comes to the clinic seeking treatment for erectile dysfunction and receives a prescription for sildenafil [Viagra]. What will the nurse teach this patient?

"You should not take sildenafil if you are taking silodosin [Rapaflo]."

A 30-year-old male patient reports having two to four urinary tract infections a year. What will the nurse expect to teach this patient?

"You will need to take a low dose of medication for 6 months to prevent infections."

A newborn infant has been given erythromycin ophthalmic ointment as a routine postpartum medication. The infant's mother learns that she has a C. trachomatis infection and asks the nurse if her baby will need to be treated. Which response by the nurse is correct?

"Your baby will need to be treated with oral erythromycin."

The parent of a 5-year-old child who has had four urinary tract infections in the past year asks the nurse why the provider doesn't just order an antibiotic for the child's current symptoms of low-grade fever, flank pain, and dysuria since these are similar symptoms as before. Which is the most important reason given by the nurse?

"Your child may need tests to assess for urinary tract abnormalities."

Which new symptom suggests hypomagnesemia when a patient is prescribed a thiazide or loop diuretic?

-muscle weakness and tremors -Tremors and dysrhythmias

A nurse assesses the urine output of a patient receiving oxytocin [Pitocin]. Which finding would require immediate follow-up by the nurse?

80 mL in the past 4 hours

A young, nonpregnant female patient with a history of a previous urinary tract infection is experiencing dysuria, urinary urgency and frequency, and suprapubic pain of 3 days' duration. She is afebrile. A urine culture is positive for more than 100,000/mL of urine. The nurse caring for this patient knows that which treatment is most effective?

A 3-day course of trimethoprim/sulfamethoxazole [Bactrim]

A nurse identifies therapeutic goals for androgen therapy for which patients? (Select all that apply.)

A male patient with hypogonadism A female patient with breast engorgement A female patient with acquired immunodeficiency syndrome (AIDS)

A patient is admitted to the hospital with a diagnosis of hypertension. The nurse understands that which medication works by preventing angiotensin II from binding with its receptor sites?

Candesartan [Atacand]

Which patient may be given progestin therapy during pregnancy?

A woman who is 8 weeks pregnant and diagnosed with corpus luteum deficiency syndrome

A nurse is reviewing a patient's medications before administration. Which drug-to-drug interactions will most concern the nurse in a patient with a history of heart failure and a potassium level of 5.5 mEq/L?

Captopril [Capoten] and spironolactone [Aldactone] Eplerenone (Inspra) and spironolactone (Aldactone)

A patient reports unfavorable mucus. The healthcare provider would be expected to prescribe which medication to restore cervical mucus to its proper volume and consistency?

Estrogen

A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will the nurse do?

Instruct the patient not to get up without assistance.

A patient has been experiencing side effects with a combination oral contraceptive, and her provider has ordered a different combination product. The nurse will instruct the patient to do what?

Change products at the beginning of her next cycle

An adolescent patient with mild cervicitis is diagnosed with gonorrhea. The nurse will expect the provider to order which drug(s)?

Ceftriaxone [Rocephin], 250 mg IM once, and azithromycin [Zithromax], 1 gm PO once Cefixime (Suprax), 400 mg PO once, and azithromycin (Zithromax), 1 gm PO once

Which patient with a urinary tract infection will require hospitalization and intravenous antibiotics?

An older adult man with a low-grade fever, flank pain, and an indwelling catheter

A nurse working in a family planning clinic is teaching a class on intrauterine devices (IUDs). Which patient should be advised against using an IUD for contraception?

An 18-year-old woman with multiple sexual partners

The nurse is aware that goserelin [Zoladex] has several uses, including which? (Select all that apply.)

Endometriosis Dysfunctional uterine bleeding Prostate cancer Breast cancer

Which are indications for early induction of labor? (Select all that apply.)

Abruptio placentae Gestational hypertension Premature rupture of the membranes

The nurse is aware that which medications are used to treat genital herpes? (Select all that apply.)

Acyclovir Valacyclovir Famciclovir

A patient complains of painful urination. A physical examination reveals vesicles on her labia, vagina, and the foreskin of her clitoris. The nurse will expect to teach this patient about which medication?

Acyclovir [Zovirax]

A patient is scheduled to start taking sildenafil [Viagra]. A nurse should recognize that the patient is at risk for developing an adverse cardiac event if the patient's history reveals which of these conditions?

Angina

The renin-angiotensin-aldosterone system plays an important role in maintaining blood pressure. Which compound in this system is most powerful at raising the blood pressure?

Angiotensin II

Which drugs are useful for preventing preterm labor? (Select all that apply.)

Antibiotics Hydroxyprogesterone

A nurse should report which finding of ovarian hyperstimulation in a woman receiving menotropins?

Ascites and weight gain

A patient receiving menotropins [Repronex] for infertility comes to the clinic for evaluation on the ninth day of treatment. Her serum estrogen level is 200 pg/mL per maturing follicle. An ultrasound reveals that follicles have enlarged to 22 mm. The patient complains of left lower abdominal pain. What will the nurse do?

Assess for abdominal fullness and distension and auscultate lung sounds.

A patient who has erectile dysfunction asks about medications to treat this disorder, but tells the nurse he doesn't want to have to plan sexual activity several hours in advance. Which medication will the nurse expect the provider to order for this patient?

Avanafil [Stendra]

The nurse is teaching a patient prescribed captopril [Capoten] for the treatment of hypertension. Which instructions should the nurse include? (Select all that apply.)

Avoid potassium salt substitutes. A persistent dry cough may occur. Report difficulty in breathing immediately.

During a routine screening, an asymptomatic, pregnant patient at 37 weeks' gestation learns that she has an infection caused by Chlamydia trachomatis. The nurse will expect the provider to order which drug?

Azithromycin

Which assessment should a nurse monitor more frequently in a patient who takes both an alpha blocker for BPH and metoprolol [Lopressor]?

Blood pressure

A patient in the emergency department reports taking sildenafil [Viagra] and nitroglycerin 1 hour before sexual activity. Which finding should the nurse immediately report to the physician?

Blood pressure (BP) of 70/50 mm Hg

A nurse should recognize that which therapies would be beneficial to a patient with BPH? (Select all that apply.)

Botulinum [Botox] Tolterodine [Detrol] Alfuzosin [Uroxatral]

Most cases (more than 80%) of uncomplicated, community-acquired urinary tract infection (UTI) are caused by which bacteria?

Escherichia coli

An adolescent female patient with multiple sexual partners asks a nurse about birth control methods. The patient tells the nurse she tried oral contraceptives once but often forgot to take her pills. The nurse will recommend discussing which contraception with the provider?

DMPA (Depo-Provera) and condoms

A patient is prescribed lisinopril [Prinivil] 40 mg by mouth once a day for hypertension. For which therapeutic effect will the nurse monitor?

Decrease in blood pressure

Which outcome would a nurse establish for a patient with trichomoniasis who is receiving metronidazole [Flagyl]?

Decrease in yellow-green, odorous vaginal discharge

The nurse plans to closely monitor for which clinical manifestation after administering furosemide [Lasix]?

Decreased blood pressure

According to studies of estrogen/progestin therapy (EPT), what are its known benefits? (Select all that apply.)

Decreased osteoporosis risk Glycemic control Improved wound healing

When evaluating the effects of ergonovine [Ergotrate], the nurse expects which assessment finding?

Decreased vaginal bleeding

A nurse develops a plan of care for a pregnant patient receiving nifedipine [Procardia]. Which outcome should be included?

Delivery is postponed for at least 24 hours.

Besides having diuretic effects for patients with congestive heart failure, thiazides are also used to treat what? (Select all that apply.)

Diabetes insipidus Hepatic failure Postmenopausal osteoporosis

The nurse should monitor for which adverse effect after administering hydrochlorothiazide [HydroDIURIL] and digoxin [Lanoxin] to a patient?

Digoxin toxicity

A patient who is taking a combination oral contraceptive begins taking carbamazepine. After several weeks, the patient tells the nurse she has begun experiencing spotting during her cycle. What will the nurse tell her to do?

Discuss an oral contraceptive with increased estrogen.

A patient is diagnosed with pelvic inflammatory disease (PID). Which treatment regimen is most appropriate for reducing the risk of sterility in this patient?

Doxycycline [Vibramycin], 100 mg IV twice daily, and cefoxitin, 2 gm IV every 6 hours in the hospital

A patient is taking nitrofurantoin [Macrodantin]. Which finding should a nurse recognize as an indication that the treatment is having an undesired effect?

Dyspnea with chills

A nurse teaches a health education class to male adolescents. Which of these topics should be a priority for the nurse to include?

Effects of performance-enhancing androgens

When assessing a patient who takes finasteride [Proscar], a nurse should monitor for which adverse effect?

Ejaculatory dysfunction

Progestins may be used to treat which conditions? (Select all that apply.)

Endometrial hyperplasia Dysfunctional uterine bleeding Amenorrhea

A nurse is educating a patient about sildenafil [Viagra]. The nurse should instruct the patient that which adverse effect would be a priority for the patient to report to his prescriber?

Hearing loss

A nurse who is assessing a patient with polycystic ovary syndrome (PCOS) would expect to observe which findings? (Select all that apply.)

High blood glucose levels Infertility Absence of menstrual cycles

The nurse caring for a patient taking furosemide [Lasix] is reviewing the patient's most recent laboratory results, which are: sodium, 136 mEq/L; potassium, 3.2 mEq/L; chloride, 100 mEq/L; blood urea nitrogen, 15 mg/dL. What is the nurse's best action?

Hold the Lasix and notify the physician.

A provider has ordered captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct?

Hold the dose and notify the provider.

A nurse reviewing a client's medication history notes an allergy to sulfonamides. This allergy is a contraindication for taking which of the following medications? (SATA)

Hydrochlorothiazide Glipizide Furosemide

A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE inhibitors will not occur with an ARB medication?

Hyperkalemia

The nurse is reviewing the home medication list with the patient. The nurse recognizes that hydrochlorothiazide is used primarily for which condition?

Hypertension

Which of these findings, if identified in a patient receiving ergonovine [Ergotrate], should a nurse report to a physician immediately?

Hypertension

A nurse is providing teaching to a client who will start alfuzosin for treatment of benign prostatic hyperplasia. The nurse should instruct the client that which of the following is an adverse effect of this medications?

Hypotension

A nurse assesses the history of a patient who has had multiple complicated UTIs for which risk factors? (Select all that apply.)

Indwelling catheter Prostate hypertrophy Urinary tract stones

A nurse knows that which condition is a potential long-term complication in a patient with pelvic inflammatory disease (PID)?

Infertility

A nurse is planning to administer ciprofloxacin IV to a client who has cystitis. Which of the following actions should the nurse take?

Infuse the medication over 60 min.

A patient asks about the effectiveness of various birth control methods. The nurse should inform her that the most effective methods are what? (Select all that apply.)

Intrauterine devices (IUDs) Intramuscular medroxyprogesterone acetate Etonogestrel subdermal implants Male or female sterilization

A nurse is caring for a client who has angina and ask about obtaining a prescription for sildenafil to treat erectile dysfunction. Which of the following medications is contraindicated with sildenafil?

Isosorbide

A patient begins taking an ACE inhibitor and complains of a dry cough. What does the nurse correctly tell the patient about this symptom?

It indicates that a serious side effect has occurred.

The nurse is caring for a patient prescribed aliskiren [Tekturna]. How does this medication lower blood pressure?

It inhibits the conversion of angiotensinogen into angiotensin I.

Which beneficial metabolic effects does estrogen have in nonreproductive tissues? (Select all that apply.)

It promotes and suppresses coagulation. It reduces low-density lipoproteins (LDLs). It suppresses bone resorption.

The nurse is caring for a patient with bipolar disorder treated with lithium [Eskalith]. The patient has a new prescription for captopril [Capoten] for hypertension. The combination of these two drugs makes which assessment particularly important?

Lithium level

A 14-year-old male patient who plays football is admitted to the hospital. The nurse notes that the patient has short stature for his age according to a standard growth chart. The patient is muscular, has a deep voice, and needs to shave. The nurse notifies the provider of these findings. Which test will the nurse expect the provider to order?

Liver function tests and serum cholesterol

Which outcomes should a nurse establish when planning care for a patient taking methenamine [Mandelamine]? (Select all that apply.)

Maintains a urine pH of 5.5 or lower. Uses an enteric-coated formulation. Avoids sulfonamide medications.

A female patient has come to the STD clinic and has been diagnosed with a Trichomonas vaginalis infection. What education should be provided to this patient?

Male partners should always be treated, even if they are asymptomatic.

Which of the following statements about mannitol [Osmitrol] are correct? (Select all that apply.)

Mannitol cannot be given orally. Mannitol can cause edema. Diuresis begins in 30 to 60 minutes after administration.

The nurse has just administered the initial dose of enalapril [Vasotec] to a newly admitted patient with hypertension. What is the priority nursing intervention over the next several hours?

Monitor blood pressure.

A patient is to begin taking nitrofurantoin [Macrodantin]. The nurse should teach the patient that which manifestation should be the priority to report to the healthcare provider?

Muscle weakness and tingling

A nurse is teaching a client who has a new prescription for nitrofurantoin. Which of the following information should the nurse include? (SATA)

Observe for bruising on the skin Take the medication with milk or meals Expect brown discoloration of urine

A nurse is teaching a female client who has a severe UTI about ciprofloxacin. Which of the following information about adverse reactions should the nurse include? (SATA)

Observe for pain and swelling of the Achilles tendon Watch for vaginal yeast infections Inspect the mouth for cottage cheese-like lesions

A 46-yr-old female patient returns to the clinic with recurrent dysuria after being treated with trimethoprim and sulfamethoxazole for 3 days. Which action will the nurse plan to take

Obtain a midstream urine specimen for culture and sensitivity testing.

Which nursing action is the priority for a patient in preterm labor who is receiving magnesium sulfate?

Obtaining deep tendon reflexes

A postmenopausal patient who has had a hysterectomy and who has a family history of coronary heart disease reports experiencing vaginal dryness and pain with intercourse but tells the nurse that she does not want to take hormones because she is afraid of adverse effects. The nurse will suggest that the woman ask her provider about:

Premarin vaginal.

During the follicular phase of the menstrual cycle, estrogen has which effects on the female reproductive organs?

Proliferation of the endometrium

Androgens are prescribed for a patient with anemia. The nurse is aware that the action of the androgen in this patient is what?

Promoting synthesis of erythropoietin

A patient is in preterm labor, and the prescriber orders magnesium sulfate for its neuroprotective effect on the fetus. The order calls for 4 gm given as an intravenous bolus over 20 minutes, followed by a maintenance infusion of 2 gm/hr. What will the nurse do?

Question the maintenance amount.

What is the primary difference between the selective estrogen receptor modulators tamoxifen and raloxifene?

Raloxifene does not increase the risk for uterine cancer.

A patient receives an injection of human chorionic gonadotropin after follicular maturation has been induced with another agent. The patient comes to the clinic 2 days later complaining of headache, irritability, and fatigue. What will the nurse do?

Reassure the patient that these are known adverse effects.

The nurse identifies which statements about frequent urinary tract reinfections as true? (Select all that apply.)

Reinfections are considered frequent if the individual has three or more a year. If reinfection is associated with sexual intercourse, the risk can be reduced by instructing the patient to void after intercourse. If a symptomatic episode occurs, the standard therapy for acute cystitis should be used.

Which action should a nurse take when a pregnant patient develops uterine contractions after receiving dinoprostone [Cervidil] into the vaginal system?

Remove the insert using the long tape.

A patient takes fluoxetine [Prozac] for premenstrual disorder (PMD). Which priority assessment allows the nurse to evaluate the effectiveness of this treatment?

Reports of mood improvement

A nurse working in a family planning clinic is preparing to administer a first dose of intramuscular DMPA [Depo-Provera] to a young adult patient. The woman tells the nurse she has just finished her period. What will the nurse do?

Schedule an appointment for her to receive the injection in 3 weeks.

A patient is admitted to the hospital with fever, headache, malaise, joint pain, and enlarged lymph nodes. Blood cultures are positive for Treponema pallidum. The nurse recognizes this as which type of syphilis?

Secondary

The nurse is caring for a patient with renal artery stenosis who has been prescribed benazepril [Lotensin]. Which laboratory result indicates an adverse effect of this drug?

Serum creatinine level of 2.3 mg/dL

A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider?

Serum potassium 5.2 mL in 4 hr

A patient has just purchased a 1-year supply of 28-day-cycle oral contraceptives. She tells the nurse she wishes she had planned things better, because she has calculated that her period will begin during her upcoming honeymoon. What will the nurse suggest?

She should discard the inert pills and start a new pack during the honeymoon.

Which finding does the nurse expect when assessing a male patient with secondary syphilis?

Skin lesions and flulike symptoms

A patient has 2+ pitting edema of the lower extremities bilaterally. Auscultation of the lungs reveals crackles bilaterally, and the serum potassium level is 6 mEq/L. Which diuretic agent ordered by the prescriber should the nurse question?

Spironolactone [Aldactone]

The nurse is caring for a patient with heart failure who needs a diuretic. Which agent is likely to be chosen, because it has been shown to greatly reduce mortality in patients with heart failure?

Spironolactone [Aldactone]

A patient who is near term gestation is receiving oxytocin [Pitocin]. Which response should the nurse expect if the medication is having the desired therapeutic effect?

Stimulation of uterine smooth muscle

The Women's Health Initiative (WHI) landmark trial data led to which recommendations about hormone replacement therapy? (Select all that apply.) on

There are benefits to using HRT short term to reduce vasomotor symptoms. Postmenopausal women should avoid smoking, exercise regularly, and control hypertension. Treatment with HRT for longer than 5 years increases the risk for pulmonary embolus and stroke.

A nurse explaining the mechanism of action of combination oral contraceptives to a group of clients. The nurse should tell the clients that which of the following actions occur with the use of combination oral contraceptives? (SATA)

Thickening the cervical mucus Altering the endometrial lining Inhibiting ovulation

A nurse is reviewing the health care record of a client who is asking about conjugated equine estrogens. The nurse should inform the client this medication is contraindicated in which of the following conditions?

Thrombophlebitis

HR 48, what med to hold and contact HCP?

Timolol

A patient who is taking nitrofurantoin calls the nurse to report several side effects. Which side effect of this drug causes the most concern and would require discontinuation of the medication?

Tingling of the fingers

Which therapeutic effect is the purpose of a progestin medication in menopausal hormone therapy (HT)?

To suppress endometrial proliferation

A 20-year-old female patient has suprapubic discomfort, pyuria, dysuria, and bacteriuria greater than 100,000/mL of urine. Which are the most likely diagnosis and treatment?

Uncomplicated lower urinary tract infection treatable with short-course therapy

An adolescent male patient is beginning androgen therapy for delayed puberty. His parents ask the nurse when this treatment may be stopped. The nurse will offer which response?

When testicular enlargement occurs

The nurse is aware that acute cystitis occurs most often in which patient population?

Women of child-bearing age

An infertile patient has received two 5-day courses of clomiphene [Clomid] to help her conceive. An ultrasound 1 week after the last dose reveals that follicular maturation has occurred without ovulation. The nurse expects the next step for this patient to be:

administration of human chorionic gonadotropin (hCG).

A patient with a history of benign prostatic hyperplasia is admitted to the unit. The patient is taking multiple medications, including terazosin [Hytrin]. During the evening rounds, the patient begins to complain of dizziness and nasal congestion. Upon assessment, the patient is somnolent and has a blood pressure of 101/42 mm Hg. The nurse is correct to suspect:

adverse effects.

Renal calculi w/ hyperuricemia, what drug to prevent reoccurrence?

allopurinol

An infertile couple begins treatment with menotropins. To enhance the therapeutic effects of the medication, the nurse will advise the patients to have intercourse:

before hCG injection and the following 2 to 3 days.

A patient has a positive urine culture 1 week after completion of a 3-day course of antibiotics. The nurse anticipates that the prescriber will:

begin a 2-week course of antibiotics.

A patient with a history of renal calculi has fever, flank pain, and bacteriuria. The nurse caring for this patient understands that it is important for the provider to:

begin antibiotic therapy after urine culture and sensitivity results are available.

A patient calls a family planning clinic and tells the nurse that her vaginal ring, which has been in place for 2 weeks, came out sometime during the night while she was sleeping. The nurse will instruct her to:

clean the ring with warm water, reinsert it, and use condoms for 7 days.

A patient who will begin combination estrogen/progestin therapy (EPT) for menopause asks the nurse why she cannot take an estrogen-only preparation. The patient has not had a hysterectomy, has a slightly increased risk of cardiovascular disease, and has mild osteopenia. The nurse will tell her that the progestin is necessary to:

decrease her risk of endometrial cancer.

A nurse is providing teaching to a female client who is taking testosterone to treat advanced breast cancer. The nurse should tell the client that which of the following are adverse effects of this medications? (SATA)

deepening voice weight gain facial hair

What action is a priority when a female nurse is handling dutasteride?

do not handle capsule with bare hands

A male patient tells the nurse he awakens once or twice each night to void and has difficulty starting his stream of urine. He describes these symptoms as "annoying." The patient's provider examines him and notes that the prostate is moderately enlarged. The patient is sexually active and tells the nurse that he does not want to take any medication that will interfere with sexual function. The nurse anticipates the provider will order:

doxazosin [Cardura].

Which adverse effect reflecting accumulation of bradykinin may a patient experience when taking an ace inhibitor?

dry cough eye swelling

Clomiphene therapeutic response

follicular maturation

A patient is admitted to the obstetric unit in preterm labor at 36 weeks' gestation. The prescriber orders a tocolytic agent. When teaching the patient about this medication, the nurse will tell her that tocolytics:

help delay delivery while glucocorticoids are given.

What would not stimulate renin RELEASE by the kidneys?

hypernatremia

Which medication taken at home by a patient with decreased renal function will be of most concern to the nurse?

ibuprofen (Motrin)

A pregnant patient is being induced with oxytocin, which has been infusing for 1 hour. The initial rate was 6 milliunits/min, and the rate now is 18 milliunits/min. The nurse notes regular contractions occurring every 3 minutes, each lasting 35 seconds. The nurse will:

increase the rate of infusion by 3 to 6 milliunits/min every 15 to 40 minutes.

A nurse is teaching a community education class on contraceptives. The nurse tells the class that if spermicides containing nonoxynol-9 are used, the patient should take special precautions, because these spermicides have been linked to:

increased transmission of the human immunodeficiency virus (HIV).

A pregnant female patient with bacteriuria, suprapubic pain, urinary urgency and frequency, and a low-grade fever is allergic to sulfa, ciprofloxacin, and amoxicillin. The nurse knows that the best alternative for treating this urinary tract infection is with:

methenamine [Hiprex].

Patient taking captopril, what to monitor for?

monitor for hypotension

Phenazopyridine (Pyridium) side effects

orange urine

A patient with infertility will begin taking menotropins [Repronex]. The nurse will evaluate this patient's history to determine whether the:

patient's ovaries are capable of responding to gonadotropins.

A patient presents to the emergency department with complaints of chills, severe flank pain, dysuria, and urinary frequency. The patient has a temperature of 102.9°F, a pulse of 92 beats per minute, respirations of 24 breaths per minute, and a blood pressure of 119/58 mm Hg. The nurse would be correct to suspect that the patient shows signs and symptoms of:

pyelonephritis.

A patient has been taking a progestin-only, or "minipill," OC for 3 months and reports spotting and irregular menstrual cycles. The nurse will:

reassure the patient that this is normal with this form of contraception.

A patient who was in a motor vehicle accident sustained a severe head injury and is brought into the emergency department. The provider orders intravenous mannitol [Osmitrol]. The nurse knows that this is given to:

reduce intracranial pressure.

A 68-year-old male patient receives a prescription for 25-mg tablets of sildenafil [Viagra] for erectile dysfunction. When he asks the nurse how to take the medication, the nurse will tell him to:

start with one tablet about 1 hour before anticipated sexual activity.

Trimethoprim and sulfamethoxazole (Bactrim) BID for 7 days is ordered for a patient who has a recurrent relapse of an Escherichia coli UTI. The nurse instructs the patient to

take the antibiotic for the full 7 days, even if symptoms improve in a few days.

Gonorrhea, why give 2 drugs?

to stop increasing drug resistance

A 50-year-old postmenopausal patient who has had a hysterectomy has moderate to severe vasomotor symptoms and is discussing estrogen therapy (ET) with the nurse. The patient is concerned about adverse effects of ET. The nurse will tell her that:

transdermal preparations have fewer side effects.

Anticholinergic side effects

urinary retention

A nurse is obtaining a history and reviewing the chart of an adult male patient who has been taking oral androgens. Which assessment would warrant notifying the provider?

Nausea, anorexia, and fatigue

An adult male patient will begin androgen therapy for testicular failure. Which statement by the patient indicates understanding of the treatment regimen?

"My libido may improve while I am taking this medication."

A nurse is teaching an adolescent female patient about 28-day monophasic combination oral contraceptives. The provider has instructed the patient to begin taking the pills on the first Sunday after the onset of her next period. What will the nurse tell the patient?

"Use another form of contraception for the next month."

A nurse is caring for a woman during the perinatal and postnatal period. To stop postpartum hemorrhage, how will the nurse administer oxytocin [Pitocin] to this patient?

20 units in 1000 mL of IV solution after delivery of the placenta

A patient has received two doses of dinoprostone [Prepidil] to initiate labor. It has been 6 hours since the last dose. The nurse assesses the patient and notes that the cervix is ripe and dilated to 4 cm, but contractions are diminishing in intensity and frequency. What will the nurse expect to do?

Administer oxytocin.

The nurse is discussing upper and lower UTIs. Which of these conditions can be treated at home? (Select all that apply.)

Acute cystitis Acute urethritis Recurrent UTI

A 12-year-old male patient diagnosed with hypogonadism will begin testosterone injections. What will the nurse include when teaching the family about this therapy?

Injections are given every 2 to 4 weeks for 3 to 4 years.

A pregnant patient is 1 week post-term and will receive intravenous oxytocin. Which will the nurse evaluate before starting the infusion? (Select all that apply.)

Cervical ripening Fetal monitoring Uterine activity

Before giving methenamine [Hiprex] to a patient, it is important for the nurse to review the patient's history for evidence of which problem?

Elevated blood urea nitrogen and creatinine

An older adult patient with congestive heart failure develops crackles in both lungs and pitting edema of all extremities. The physician orders hydrochlorothiazide [HydroDIURIL]. Before administering this medication, the nurse reviews the patient's chart. Which laboratory value causes the nurse the most concern?

Elevated creatinine clearance

A female patient who begins taking spironolactone [Aldactone] as an adjunct to furosemide [Lasix] complains that her voice is deepening. What will the nurse do?

Explain that this drug binds with receptors for steroid hormones, causing this effect.

A patient who is having her sixth child has gone beyond term, and her labor is being induced with oxytocin [Pitocin]. The patient is having increased frequency, duration, and intensity of contractions. The nurse will interrupt the oxytocin infusion if what occurs?

Individual contractions last 2 minutes.

A patient who has endometriosis has been unable to conceive. She asks the nurse about medications to treat the condition. What will the nurse tell the patient?

Pharmacologic agents used to treat endometriosis do not enhance fertility.

A patient who is taking digoxin is admitted to the hospital for treatment of congestive heart failure. The prescriber has ordered furosemide [Lasix]. The nurse notes an irregular heart rate of 86 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82 mm Hg. The nurse auscultates crackles in both lungs. Which laboratory value causes the nurse the most concern?

Potassium level of 3.5 mEq/L

A patient with hypertension is prescribed an angiotensin-converting enzyme (ACE) inhibitor. The nurse reviewing this patient's chart before administering the medication will be most concerned about which other disease process?

Renal artery stenosis

A nurse preparing to administer morning medications notes that a patient with a history of hypertension has been prescribed spironolactone [Aldactone]. The nurse assesses the patient and notes dyspnea, bilateral crackles, and pitting edema in both feet. Which intervention is appropriate?

Request an order for furosemide [Lasix]

A patient is taking gentamicin [Garamycin] and furosemide [Lasix]. The nurse should counsel this patient to report which symptom?

Ringing in the ears

A patient with hypertension is taking furosemide [Lasix] for congestive heart failure. The prescriber orders digoxin to help increase cardiac output. What other medication will the nurse expect to be ordered for this patient?

Spironolactone [Aldactone]

The nurse is providing patient education for a postmenopausal patient who is considering EPT. Which risks associated with EPT should the nurse discuss with the patient? (Select all that apply.)

Stroke Deep vein thrombosis Ovarian cancer

A patient in preterm labor is receiving intravenous magnesium sulfate at a rate of 1 gm/hr. The woman reports headache and dizziness. Her blood pressure is 90/60 mm Hg. What will the nurse do?

Tell the patient not to get up without assistance.

A patient is taking a combination oral contraceptive (OC) and tells the nurse that she is planning to undergo knee replacement surgery in 2 months. What will the nurse recommend for this patient?

The patient should discuss an alternate method of birth control prior to surgery.

A patient is taking a combination oral contraceptive (OC) and reports breast tenderness, edema, and occasional nausea. What will the nurse recommend?

The patient should request an OC containing less estrogen.

A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient?

The patient should stop taking the medication and contact her provider immediately.

A patient who is at risk for osteoporosis will begin taking the selective estrogen receptor modulator raloxifene [Evista]. Which statement will the nurse include when teaching this patient about the medication?

Vasomotor symptoms are a common side effect of this drug.

A patient calls the nurse to report that she forgot to take a combination OC pill during the third week of her cycle. She tells the nurse that she missed another pill earlier that week. The nurse will tell her to:

take a pill now, continue the pack, skip the placebo pills, and start a new pack on week 4.

A woman has been taking a progestin-only oral contraceptive and will begin using a vaginal ring. The nurse will teach the patient to insert the ring:

the day the last pill is taken and use backup contraception for 7 days.

A patient with cancer is taking rasburicase [Elitek] to treat hyperuricemia and develops neutropenia with fever and respiratory distress on the fourth day of treatment. The nurse caring for this patient will expect to:

continue giving the drug and monitor the patient's symptoms closely.

An older male patient comes to the clinic with complaints of chills, malaise, myalgia, localized pain, dysuria, nocturia, and urinary retention. The nurse would most likely suspect that the patient has:

prostatitis.

A nurse is discussing various ways to obtain a medical abortion with a patient. Which statement by the patient best demonstrates understanding of mifepristone (RU 486) [Mifeprex]? "This drug is most effective if I use it:

within 7 weeks of conception."