Ch 34 & 35 Adaptive Quizzing

What should be the daily dose of finasteride for an adult patient who is being treated for androgenetic alopecia? 1. 1 mg by mouth 2. 5 mg by mouth 3. 25 to 100 mg 1 hour before intercourse 4. 50 to 400 mg by intramuscular injection

1. 1 mg by mouth The expected adult daily dose for finasteride is 1 mg by mouth when prescribed for the treatment of androgenetic alopecia. A daily dose of 5 mg is prescribed for patients who are being treated for benign prostatic hyperplasia. This medication is not administered 1 hour before sexual intercourse or by intramuscular injection.

A patient is sterile because of low testosterone levels. Which other complication should the nurse suspect in this patient? 1. Anemia 2. Fatty liver 3. Hyperacidity 4. Hypoglycemia

1. Anemia Testosterone is a hormone that plays an important role in erythropoiesis. It helps in the formation of red blood cells. Reduced levels of testosterone cause reduced production of red blood cells, which in turn causes anemia from reduced hemoglobin. Unlike alcohol consumption, low levels of testosterone do not cause fatty liver. Testosterone does not affect the function of the proton pump in the stomach, and hence, it does not cause hyperacidity. Testosterone does not affect the function of the pancreas. Therefore, it does not cause hypoglycemia.

The nurse at the fertility clinic is instructing a patient about the adverse effects of clomiphene. Which effects should the nurse instruct the patient to report to the health care provider? Select all that apply. 1. Anxiety 2. Hirsutism 3. Dizziness 4. Bradycardia 5. Blurred vision 6. Increased diuresis

1. Anxiety 3. Dizziness 5. Blurred vision Adverse effects of clomiphene, an ovarian stimulant, include anxiety, dizziness, blurred vision, tachycardia, deep vein thrombosis, nausea, constipation, urticaria, and others. Hirsutism, bradycardia, and increased diuresis are not known adverse effects associated with clomiphene.

A 67-year-old man is prescribed testosterone. Which sites may be used for the reservoir patch? Select all that apply. 1. Back 2. Thighs 3. Shoulder 4. Abdomen

1. Back 2. Thighs 4. Abdomen Testosterone has to be applied to clean, dry, and shaved areas for optimal skin contact. Places like the back, thighs, and abdomen are the best areas for administering the patch. Bony areas, such as the shoulder, should be avoided; they restrain the absorption process of the testosterone.

While reviewing the medical records of a patient, the nurse learns that the patient has taken finasteride in the past. The patient does not have a history of difficulty with urination. What is the probable reason for administering finasteride to this patient? 1. Baldness 2. Infertility 3. Hypertension 4. Benign prostate hyperplasia (BPH)

1. Baldness Finasteride is a 5-alpha reductase inhibitor drug that is also known to stimulate the hair follicles and stimulate hair growth. Thus, it is recommended for treating male-pattern baldness. Sperm production is not affected by finasteride. Thus, finasteride is not recommended for treating infertility in males. Finasteride does not affect blood pressure levels, unlike the alpha blockers used to treat BPH, which can cause hypotension. Because the patient had not reported any difficulty in urination in the past, it is unlikely that the patient ever had BPH.

Which medication is most likely to promote follicular maturation in an infertile female patient? 1. Clomiphene 2. Progesterone 3. Ethinyl estradiol 4. Choriogonadotropin alfa

1. Clomiphene Clomiphene facilitates follicular maturation by promoting the release of follicle-stimulating hormone and luteinizing hormone from the pituitary gland. Progesterone is more likely to be used to maintain a pregnancy. Ethinyl estradiol is a steroidal estrogen used in hormone replacement. Choriogonadotropin alfa causes ovulation from mature follicles.

What monitoring parameter should be evaluated for drug effectiveness for a patient in labor who is receiving oxytocin? Select all that apply. 1. Fetal heart rate 2. Asking no questions about fetal movement 3. Continuing the agent if uterine hyperactivity occurs 4. The patient's blood pressure and pulse during administration of the oxytocic agent

1. Fetal heart rate 4. The patient's blood pressure and pulse during administration of the oxytocic agent Before administering uterine stimulants (e.g., oxytocin or prostaglandins), the nurse should determine the fetal heart rate and contraction-related fetal heart rates and document findings. The nurse should also assess and document the patient's blood pressure, pulse, and respiration. Continuing the agent if uterine hyperactivity occurs is not safe. Asking no questions about fetal movement will not reveal anything useful for assessment.

What primary roles does testosterone play in the male body? Select all that apply. 1. Helps in production of red blood cells 2. Helps development of facial hair in men 3. Triggers better metabolic bodily functions 4. Helps develop the male sex characteristics 5. Triggers erectile dysfunction (ED), leading to delayed ejaculation

1. Helps in production of red blood cells 2. Helps development of facial hair in men 4. Helps develop the male sex characteristics Testosterone plays a crucial role in the human body as an androgen hormone. It is important for the development of the prostate, seminal vesicles, and other male reproductive organs. It is responsible for laryngeal enlargement and thickening of the vocal chords, and helps in the development of male facial hair. Catabolism is responsible for breaking down bodily tissues. The erythropoietic effect triggers the development of the red blood cells, whereas testosterone focuses more on the growth of the hormone.

A patient is receiving intravenous methylergonovine after a vaginal delivery. Which postpartum assessment is the nurse's priority to prevent complications of therapy? 1. Hypertension 2. Hypoglycemia 3. Decreased lochia 4. Uterine contractions

1. Hypertension The therapeutic goal is contraction of the fundus to stop postpartum bleeding. Hypertension is likely to increase the severity of postpartum bleeding, so the prevention of hypertension is the nurse's priority for a postpartum patient receiving an ergot alkaloid, because ergot alkaloids can increase blood pressure. Hypoglycemia is not an adverse effect of methylergonovine. Decreased lochia rubra is the therapeutic goal. Uterine contractions are expected during methylergonovine therapy, because this is the mechanism of action behind the cessation of postpartum uterine bleeding.

Which of the following hormones promotes the formation of progesterone in women? 1. Luteinizing hormone 2. Antidiuretic hormone 3. Follicle-stimulating hormone 4. Adrenocorticotropic hormone

1. Luteinizing hormone Luteinizing hormone promotes the secretory activity of the corpus luteum and the formation of progesterone. Antidiuretic hormone hinders the release of urine. In women, follicle-stimulating hormone initiates the cycle of events in the ovary. Adrenocorticotropic hormone is not directly involved in reproduction.

Which contraceptive device is most likely to prevent the transmission of sexually transmitted diseases? 1. Male condom 2. Spermicidal agent 3. Intrauterine device 4. Cervical diaphragm

1. Male condom Male condoms are most likely to prevent the transmission of a sexually transmitted disease, because they provide the most barrier protection. A spermicidal agent kills sperm. An intrauterine device is placed in the uterus. A cervical diaphragm is not as effective as condoms.

The obstetrics nurse reviews a postpartum patient's history. The patient is prescribed methylergonovine for control of postpartum hemorrhage. Which are essential nursing interventions for a patient receiving this medication? Select all that apply. 1. Monitor the patient for blurred vision. 2. Administer it before placenta delivery. 3. Monitor blood pressure during administration. 4. Assess for liver disease or pelvic inflammatory disease. 5. Question the prescription if the patient has liver disease.

1. Monitor the patient for blurred vision. 3. Monitor blood pressure during administration. 4. Assess for liver disease or pelvic inflammatory disease. 5. Question the prescription if the patient has liver disease. Blurred vision is an adverse effect, and the patient should report this symptom to the nurse and health care provider. Blood pressure should be assessed throughout administration of methylergonovine, because hypertension is a common adverse effect. If this drug is given to hypertensive women, it may precipitate seizures or a stroke. Pelvic inflammatory disease and liver disease are contraindications to the use of methylergonovine. Methylergonovine is administered after delivery of the placenta.

During a postpartum assessment, the nurse notes a boggy uterus and increased uterine bleeding. Which drug should the nurse anticipate will be prescribed? 1. Oxytocin 2. Terbutaline 3. Clomiphene 4. Prostaglandin E

1. Oxytocin Oxytocin is a uterine stimulant that causes uterine contractions, which will decrease the bleeding. Terbutaline was formerly the drug of choice for preterm labor; in 2011, the FDA stated that terbutaline should not be used to prevent preterm labor or for prolonged treatment because of maternal and fetal safety risks. Clomiphene is an ovulation stimulant and is not used for uterine bleeding. Prostaglandin E is used for termination of pregnancy.

The labor and delivery nurse is caring for a patient in preterm labor who is receiving indomethacin. The patient develops hypotension. What should be the nurse's initial action? 1. Place the patient on her left side. 2. Immediately discontinue IV fluids. 3. Administer phentolamine mesylate. 4. Instruct the patient to bear down and push.

1. Place the patient on her left side. Placement of the patient in the left lateral recumbent position minimizes hypotension, increases renal blood flow, and increases blood flow to the fetus. Phentolamine mesylate is an alpha-adrenergic blocker and antihypertensive and is not indicated in the treatment of hypotension. Bearing down and pushing when the patient is not ready to deliver could result in fetal compromise.

The nurse is caring for a patient who has erectile dysfunction who has been prescribed alprostadil. How will the nurse administer the medication to the patient? 1. Placing the medication in the patient's urethra 2. Placing the medication under the patient's tongue 3. Asking the patient to take the medication with milk 4. Asking the patient to chew the medication thoroughly

1. Placing the medication in the patient's urethra Alprostadil is a prostaglandin analog that is used for the treatment of erectile dysfunction. It increases the blood flow into the penis by causing vasodilation. This medication is available as an intravenous injection and intraurethral suppository. Therefore, the nurse can either insert the suppository by pushing it through the urethra, or the nurse may inject the medication into the erectile tissue of the penis. The medication is not available as sublingual tablets or chewable tablets. Therefore, the nurse should neither place the tablet under the patient's tongue nor ask the patient to chew the tablet thoroughly. The medication cannot be taken with milk, because this causes adverse effects.

The nurse is explaining the effects of estrogen therapy to a patient. Which effect mentioned by the patient indicates a need for additional teaching? 1. Prevention of breast cancer 2. Treatment of prostate cancer 3. Decrease in vasomotor symptoms 4. Improvement of atrophic vaginitis

1. Prevention of breast cancer Estrogen therapy increases the chances of breast cancer in women. Estrogen therapy leads to improvement of atrophic vaginitis, female hypogonadism, insufficient primary ovarian function, abnormal uterine bleeding, and severe vasomotor symptoms in women. It is also used to treat prostate cancer.

Which medication is contraindicated in a patient who has osteoporosis and a history of deep vein thrombosis? 1. Raloxifene 2. Denosumab 3. Risedronate 4. Alendronate

1. Raloxifene Selective estrogen receptor modulators (SERM) are used to treat osteoporosis. Raloxifene is a SERM medication. This medication is contraindicated for patients who have a history of deep vein thrombosis, because it increases the risk for blood clots. Denosumab is used to prevent bone resorption in patients who have osteoporosis and is contraindicated in patients who have a history of renal failure. Risedronate and alendronate are bisphosphonates used in treating osteoporosis and are contraindicated in patients who have hypocalcemia and esophageal dysfunction.

Which drug will be prescribed for a patient who presents with erectile dysfunction? 1. Finasteride 2. Alprostadil 3. Testosterone 4. Fluoxymesterone

2. Alprostadil Alprostadil is used in the treatment of erectile dysfunction. The intracavernous injection is also used as a single injection in the diagnosis of erectile dysfunction. Finasteride is used to treat benign prostatic hyperplasia. Fluoxymesterone and testosterone are used to treat male hypogonadism.

Which is a contraindication to the use of nandrolone? 1. Metastatic breast cancer 2. Androgen-sensitive tumor 3. Male hormone replacement 4. To reverse muscle debilitation

2. Androgen-sensitive tumor Nandrolone is a synthetic androgen (an anabolic steroid) that is contraindicated, because it would promote growth of the tumor. Metastatic breast cancer is an indication of nandrolone use. Synthetic androgens are used in male hormone replacement and to reverse muscle debilitation.

What are the functions of testosterone? Select all that apply. 1. Fat metabolism 2. Bone development 3. Production of red blood cells 4. Excretion of sodium and potassium 5. Development of secondary sexual characteristics

2. Bone development 3. Production of red blood cells 5. Development of secondary sexual characteristics Testosterone is a male reproductive hormone and is responsible for bone and tissue development, production of red blood cells, and development of secondary sexual characteristics. Testosterone does not play a role in fat metabolism or in the excretion of sodium and potassium ions; instead, it helps in the distribution of fat and retention of sodium and potassium ions.

The nurse will administer testosterone to a patient. Which route will provide the best absorption? 1. Oral 2. Buccal 3. Injection 4. Transdermal

2. Buccal Testosterone tablets, which are administered in the buccal cavity, can be easily dissolved and absorbed by the liver. Compared to the buccal process, oral administration has a very poor rate of absorption; the dose is metabolized and destroyed. Injections are another preferable way to administer the hormone, second to buccal application as an ideal option. The transdermal route, or skin patches, is useful when it comes to administration of the hormone, but they are not as useful as buccal administration.

Which medication is used for treating infertility? 1. Oxytocin 2. Clomiphene 3. Indomethacin 4. Dinoprostone

2. Clomiphene Infertility is an absence of ovulation caused by an imbalance in reproductive hormones. Clomiphene stimulates the production of gonadotropin hormones, which in turn leads to ovulation. Oxytocin is used to induce labor when uterine contractions are weak. Indomethacin is used during preterm labor. Dinoprostone is used to evacuate the uterine contents during miscarriage and for cervical ripening.

Which hormonal change directly causes the breakdown of the endometrium and resultant menstrual bleeding? 1. Increased levels of estrogens 2. Decreased level of progesterone 3. Increased luteinizing hormone (LH) 4. Decreased level of folicle-stimulating hormone (FSH)

2. Decreased level of progesterone The breakdown of the endometrium and the resultant menstrual bleeding are caused by the fall of the progesterone level at the end of the menstrual cycle. The decline in estrogens plays a role, but the decrease in progesterone is responsible for bleeding. The increase in estrogens after menstruation is responsible for the restoration of the endometrium. LH and FSH are not directly related to menstrual bleeding.

The nurse is providing care for a patient receiving androgen therapy for weight gain. Which adverse effect of the medication can be mistaken as weight gain? 1. Hirsutism 2. Fluid retention 3. Roundness of face 4. Peliosis of the liver

2. Fluid retention Fluid retention is an adverse effect of androgen therapy that may be mistaken for weight gain in a patient. Hirsutism refers to excessive amounts of hair growth on the body. Roundness of the face is seen in patients taking corticosteroids. Peliosis of the liver refers to the formation of blood-filled cavities.

Which medication is used in management of preterm labor? 1. Megestrol 2. Indomethacin 3. Methylergonovine 4. Medroxyprogesterone acetate

2. Indomethacin Indomethacin is a nonsteroidal antiinflammatory agent used in management of preterm labor. Megestrol is a progestational medication used to treat uterine bleeding. Methylergonovine is a uterine stimulant used to treat postpartum uterine hemorrhage. Medroxyprogesterone acetate is a progestational medication used to treat amenorrhea and uterine bleeding.

A patient has been diagnosed with benign prostatic hyperplasia (BPH). Why will the primary health care provider prescribe finasteride? 1. It helps relax urine retention. 2. It helps stop a growing prostate. 3. It helps treat erectile dysfunction. 4. It helps increase penile blood flow.

2. It helps stop a growing prostate. Finasteride focuses on the degeneration of the prostate epithelial tissue, which further helps reduce mechanical obstruction in the urethra. Finasteride inhibits 5-alpha reductase, responsible for converting testosterone to 5-dihydrotestosterone. Finasteride has no effect on urine retention. Sildenafil helps treat erectile dysfunction and increases penile blood flow.

Which medication is used to treat baldness in both men and women? 1. Sildenafil 2. Minoxidil 3. Finasteride 4. Methyltestosterone

2. Minoxidil Minoxidil treats baldness in both men and women. Sildenafil treats erectile dysfunction in men. Finasteride treats baldness in men. Methyltestosterone treats postpubertal cryptorchidism.

The nurse is planning to administer vardenafil to a patient with a past history of a myocardial infarction (MI). What intervention should the nurse perform first? 1. Assess the patient's blood pressure. 2. Perform a thorough history, including medication. 3. Instruct the patient to take all cardiac medications first. 4. Call the health care provider to change the prescription.

2. Perform a thorough history, including medication. Vardenafil is safe for patients with a past history of MI; however, it is contraindicated with nitrate use. The nurse's primary responsibility is to assess medications the patient is receiving before administration.

The nurse should inform a male patient about which potential type of cancer associated with testosterone therapy? 1. Kidney cancer 2. Prostate cancer 3. Bladder cancer 4. Intestine cancer

2. Prostate cancer Testosterone plays a role in the development of prostate cancer, but the extent to which supplemental testosterone therapy increases cancer risk is unclear. Testosterone does not affect the kidneys, bladder, or intestines in a direct way.

The nurse is assessing a patient who is a professional weightlifter who has been banned from practicing weightlifting because of drug doping. The patient's reports reveal excessive concentration of nandrolone in the blood. What should the nurse interpret from these findings? Select all that apply. 1. The patient is at a risk of developing anemia. 2. The patient is at a risk of developing infertility. 3. The patient is at a risk of having muscle atrophy. 4. The patient is at a risk of cardiovascular disorder. 5. The patient is at a risk of malabsorption syndrome.

2. The patient is at a risk of developing infertility. 4. The patient is at a risk of cardiovascular disorder. Nandrolone is an anabolic steroid often abused by athletes for its muscle-building properties. These drugs are known to inhibit sperm production and increase cholesterol levels. Thus, sterility and cardiovascular disorders are the consequences associated with the improper use of anabolic steroids. Nandrolone promotes the anabolic processes in the body and also helps in erythropoiesis; thus it is medically prescribed for anemia. Anabolic steroids do not cause muscle atrophy; they build muscle. Anabolic steroids promote weight gain. Malabsorption syndrome is not associated with the excess use of nandrolone.

The nurse is teaching a group of students about the use of megestrol. Which statement by a student suggests the need for additional teaching? 1. "It is used for breast cancer." 2. "It is used for endometrial cancer." 3. "It is used for the prevention of pregnancy." 4. "It is used for cachexia of acquired immunodeficiency syndrome (AIDS)."

3. "It is used for the prevention of pregnancy." Megestrol is not used for prevention of pregnancy. It is a synthetic progestin that is structurally very similar to progesterone. Although megestrol shares the actions of the progestins, it is primarily used in the palliative management of recurrent, inoperable, or metastatic endometrial or breast cancer. Because it can cause appetite stimulation and weight gain, it is also used in the management of anorexia, cachexia, or unexplained substantial weight loss in patients with AIDS and in patients with cancer.

How does an increased progesterone level promote pregnancy? 1. By thinning the cervical mucosa 2. By thickening the vaginal mucosa 3. By suppressing uterine contractions 4. By stimulating the development of breast tissue

3. By suppressing uterine contractions The progesterone level increases during pregnancy and helps sustain a pregnancy by suppressing uterine contractions. Estrogen thins the cervical mucosa, thickens the vaginal mucosa, and stimulates the development of breast tissue.

Ovulation commonly occurs at which day during the menstrual cycle? 1. Day 3 2. Day 7 3. Day 14 4. Day 21

3. Day 14 Ovulation typically occurs at day 14 in the menstrual cycle, when the mature follicle ruptures and releases its ovum. It does not occur on day 3, 7, or 21.

Which drug requires wearing gloves during administration? 1. Minoxidil 2. Stanozolol 3. Dutasteride 4. Tamsulosin

3. Dutasteride Dutasteride is a teratogenic medication that requires specific handling precautions. Stanozolol is an androgen that does not necessitate any kind of precautionary measures. Tamsulosin is an alpha1-adrenergic blocker and is safe for handling. Minoxidil is a peripheral vasodilator and does not need this kind of precaution.

Which medication is used to treat hypogonadism? 1. Megestrol 2. Alendronate 3. Esterified estrogens 4. Medroxyprogesterone

3. Esterified estrogens Esterified estrogens are a type of estrogen used in the treatment of hypogonadism. Megestrol is a synthetic progestin used to treat uterine bleeding. Alendronate is used to minimize bone loss in osteoporosis. Medroxyprogesterone is used to prevent pregnancy.

Which hormone is responsible for initiating activity in the ovary? 1. Luteotropic hormone 2. Luteinizing hormone (LH) 3. Follicle-stimulating hormone (FSH) 4. Interstitial cell-stimulating hormone

3. Follicle-stimulating hormone (FSH) FSH is responsible for initiating ovarian activity in women. FSH stimulates the ovaries to produce estrogen (primarily estradiol). Prolactin (PRL), also known as luteotropic hormone or luteotropin, is a protein that allows women to produce milk. Later in the cycle, the combined surges in the levels of estrogen, FSH, and LH stimulate ovulation. In males, LH is also called interstitial cell-stimulating hormone and stimulates Leydig cell production of testosterone.

What is the purpose of administering menotropins to a male patient? 1. Decreases libido 2. Decreases fertility 3. Increases sperm production 4. Depresses sperm production

3. Increases sperm production Menotropins may be used to promote spermatogenesis in infertile men. They are used primarily for the promotion of ovulation in anovulatory female patients. They increase fertility and stimulate sperm production. This may often lead to enhanced libido.

A pregnant patient has been prescribed oxytocin. What is the nurse's primary intervention for this patient? 1. Assess pulse oximetry continuously. 2. Administer acetaminophen as needed. 3. Monitor the patient's blood pressure frequently. 4. Suggest the patient take aluminum hydroxide with the medication.

3. Monitor the patient's blood pressure frequently Hypertensive episodes can occur with oxytocin use, so the nurse should monitor the patient's blood pressure frequently. Pulse oximetry is not indicated. Acetaminophen is not given for pain. It is not necessary to give aluminum hydroxide.

A female patient using contraceptives complains of headaches. Which contraceptive is the patient most likely using? 1. Medroxyprogesterone 2. Cervical cap with spermicidal jelly 3. Norethindrone and ethinyl estradiol 4. Male condom with spermicidal jelly

3. Norethindrone and ethinyl estradiol The patient has headaches, which are common side effects of estrogens. Progestin, the cervical cap, and male condom are reasonable alternatives for the prevention of pregnancy in this patient, because they are not associated with headache.

What condition is usually treated by administering menotropins? 1. Menopause 2. Endometriosis 3. Ovulatory dysfunction 4. Central precocious puberty

3. Ovulatory dysfunction Menotropins is the drug name for a standardized mixture of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) that is derived from the urine of postmenopausal women. The FSH component stimulates the development of ovarian follicles, which leads to ovulation. The LH component stimulates the development of the corpus luteum, which supplies female sex hormones (estrogens and progesterone) during the first trimester of pregnancy. Hormone replacement therapy is used to treat symptoms associated with menopause-related estrogen deficiency. Progestins are used in treating endometriosis. Menotropins are not used to treat central precocious puberty.

Which phase of the menstrual cycle involves the release of an unfertilized ovum? 1. Phase 1 2. Phase 2 3. Phase 3 4. Phase 4

3. Phase 3 The menstrual cycle has four phases. The unfertilized ovum is released from the ovum during phase 3, which is the ovulation phase. Phase 1 is referred to as the menstruation phase. The phase initiates the cycle and lasts 5 to 7 days. Phase 2 is known as the follicular phase. During this phase, the mature ovum develops from the ovarian follicle. Phase 4 is the luteal phase. During this phase, the corpus luteum is formed from the ruptured ovarian follicle. Topics

Which patient assessment finding does the nurse expect after the vaginal administration of dinoprostone? 1. Midline fundus 2. Decreased pain 3. Softened cervix 4. Strong contractions

3. Softened cervix Dinoprostone is indicated to ripen the cervix in preparation for labor induction. If labor induction is attempted without sufficient preparation of the cervix, cervical injury may occur. A midline fundus is expected during the postpartum period. Dinoprostone does not have analgesic properties and should not stimulate uterine contractions.

Which effect of finasteride should the nurse expect? 1. Increase in libido 2. Weight gain of 1 to 2 pounds per week 3. Stronger urinary stream without hesitancy 4. Restoration of full head of hair in 1 month

3. Stronger urinary stream without hesitancy Finasteride is given to treat symptoms of benign prostatic hyperplasia and should result in decreased nocturia, a stronger urinary stream that starts without hesitation, and an absence of urinary dribbling. Decreased libido is an adverse effect of the drug. Oxandrolone is used for weight gain. If finasteride is prescribed for male pattern baldness, it will take at least 3 months to see an effect, and any improvement will last only as long as the medication is taken.

The nurse is assessing a female patient who has osteoporosis. The nurse finds that the patient is prescribed a bisphosphonate instead of calcitonin. What is the possible reason for this prescription? 1. The patient has breast cancer. 2. The patient smokes frequently. 3. The patient is allergic to salmon. 4. The patient experiences joint pain.

3. The patient is allergic to salmon. Calcitonin is derived from salmon; hence the drug is not prescribed for patients who are allergic to salmon. Breast cancer is not a reason to prescribe a bisphosphonate. Smoking is harmful only if the patient is taking estrogen therapy, because it leads to thrombosis. Joint pain is a potential adverse effect of a bisphosphonate.

A patient with hypogonadism gives a return demonstration of application of a testosterone dermal patch. Which patient action when applying the patch indicates the need for additional teaching? 1. The patient applies the patch on the scrotum. 2. The patient applies the patch on shaved skin. 3. The patient replaces the patch every other day. 4. The patient applies the patch on clean, dry skin.

3. The patient replaces the patch every other day. The testosterone patch is usually prescribed to treat hypogonadism. The patch shows its maximum effect when it is used as prescribed. The patch is replaced every day, rather than on alternate days, for maximum benefit. Therefore, the nurse should instruct the patient to replace the patch every day. The patch is applied only on the scrotal skin for optimal action. The patch should be applied on shaved scrotal skin to facilitate maximum skin contact. The scrotal skin should be clean and dry for easy application.

What is the purpose of giving estrogen therapy in combination with progestins? 1. To treat ovarian cancer 2. To treat breast cancer 3. To prevent endometrial cancer 4. To reduce the chances of vaginal cancer

3. To prevent endometrial cancer To reduce the risk of endometrial hyperplasia or cancer, the concurrent use of a progestin for 10 to 14 days of the cycle is recommended for women with an intact uterus. Estrogens are administered to prevent complications from ovarian failure but not to treat ovarian cancer. Estrogen therapy raises recurrence risk if administered to patients with breast cancer. Vaginal cancer is treated with surgery or chemotherapy.

What information should the nurse include when teaching about cancer risks in postmenopausal women? 1. Estrogen monotherapy increases the risk of breast cancer. 2. Monotherapy with a progestin increases breast cancer risk. 3. Unopposed estrogen increases the risk of endometrial cancer. 4. Estradiol with progestin increases the risk of endometrial cancer.

3. Unopposed estrogen increases the risk of endometrial cancer. The prolonged use of estrogen alone is associated with an increased risk of endometrial cancer. Estrogens used alone are not associated with increased risk of breast cancer. Estrogen in combination with progestin is associated with an increased risk of breast cancer. When estrogen is combined with progestin, the risk of endometrial cancer diminishes.

The clinical reports of a patient taking fertility drugs indicate an increase in prolactin concentrations, which leads to impaired fertility. What should the nurse plan to assess in the patient? 1. Whether the patient is smoking frequently 2. Whether the patient has abnormal uterine bleeding 3. Whether the patient is taking medications for depression 4. Whether the patient is not complying with the fertility drugs

3. Whether the patient is taking medications for depression Tricyclic antidepressant medications, usually taken for depression, interact with the fertility drugs and increase prolactin concentrations. Smoking is harmful in patients who take estrogen therapy, because it may lead to thrombosis. Smoking does not increase prolactin concentrations. Fertility drugs are contraindicated in patients with abnormal uterine bleeding. Abnormal uterine bleeding does not increase prolactin concentrations. Noncompliance with fertility drugs will not increase prolactin concentrations, nor will it aid in conception.

The nurse is teaching students about applying a transdermal estradiol patch. Which statement made by a student suggests effective learning? 1. "Rotate the patch every 2 weeks." 2. "Rotate the patch at the same time each day." 3. "Apply the patch to the breast area for better absorption." 4. "Apply the patch to the lower abdomen for better absorption."

4. "Apply the patch to the lower abdomen for better absorption." The estradiol transdermal patch should be applied as prescribed, which is usually one patch applied once or twice weekly to the lower abdomen and not to the breast or chest areas. The patch is not rotated unless prescribed by the primary health care provider and is changed once or twice each week, not daily or bi-weekly.

A nurse is teaching a patient how to self-administer sildenafil. Which patient statement indicates effective learning? 1. "I should apply it to my abdomen." 2. "I should apply it onto the scrotal skin." 3. "I should push the suppository into my urethra." 4. "I should take the tablet 1 hour before intercourse."

4. "I should take the tablet 1 hour before intercourse." Sildenafil is available in tablet form and should be taken 1 hour before intercourse. Gels, ointments, creams, and transdermal patches are applied topically. Sildenafil is not a topical or suppository medication; therefore, it cannot be applied to the abdomen or scrotal skin or pushed into the urethra.

Which instruction should a nurse provide to a patient who is taking alendronate? 1. "Take the medication with aspirin." 2. "Take the medication with antacids." 3. "Take the medication with calcium supplements." 4. "Take the medication on an empty stomach with an 8-oz glass of water."

4. "Take the medication on an empty stomach with an 8-oz glass of water." Alendronate is a bisphosphonate medication used to treat osteoporosis. This medication causes esophageal burns and can lead to gastrointestinal upset. To prevent the esophageal burns, the nurse should instruct the patient to take the medication with an 8-oz of glass of water on an empty stomach. The nurse should not instruct the patient to take the medication along with antacids, because antacids can decrease the absorption of alendronate. Aspirin can cause gastric irritation if it is ingested along with alendronate. Calcium supplements can decrease the absorption of bisphosphonates; therefore, the nurse should suggest that the patient take calcium supplements 1 hour after receiving alendronate.

Which statement by the nursing student regarding endogenous testosterone indicates effective learning? 1. "It promotes male catabolic metabolism." 2. "It helps eliminate nitrogen from the body." 3. "This drug is used to treat alcoholic hepatitis." 4. "The seminiferous tubules produce testosterone."

4. "The seminiferous tubules produce testosterone." Testosterone is produced in the testicles, in the interstitial cells of the seminiferous tubules. Testosterone promotes anabolic metabolism and helps retain nitrogen in the body. Oxandrolone is used to treat alcoholic hepatitis.

The nurse is teaching a patient about finasteride therapy. How long will the drug take to achieve its full effect? 1. 1 to 2 weeks 2. 2 to 4 weeks 3. 1 to 3 months 4. 3 to 6 months

4. 3 to 6 months Finasteride is available in tablet form and must be taken orally. It is administered for the treatment of androgenetic alopecia in men (at a dose of 1 mg) or benign prostatic hyperplasia (BPH; at a dose of 5 mg). The results take from 3 to 6 months to achieve complete effect.

Which type of oral contraceptive (OC) delivers hormones for more than 30 days? 1. Biphasic 2. Triphasic 3. Monophasic 4. Extended-cycle

4. Extended-cycle Extended-cycle oral contraceptives deliver hormones for 84 to 365 consecutive days, shortening or eliminating the hormone-free period. Biphasic OCs, which deliver estrogen in a fixed amount for 21 or 28 days, contain a low dose of progestin for the first 10 days and a higher dose of progestin for the remainder of the cycle. Triphasic OCs deliver three different estrogen-progestin combinations over the course of the cycle. Monophasic OCs deliver an unchanging combination of estrogen and progestin.

A patient has been administered finasteride, a drug specifically prescribed for treatment of an enlarged prostate gland. For which side effects should the nurse monitor the patient? Select all that apply. 1. Impotence 2. Bradycardia 3. Libido enhancement 4. Increase of hair growth 5. Reduction of prostate size

4. Increase of hair growth 5. Reduction of prostate size Finasteride causes excessive hair growth because of prostatic dihydrotestosterone (DHT) concentrations in the patient's body. It mainly helps to reduce the size of the prostate. Finasteride does not cause impotence or bradycardia in adult males; however, it might decrease the libido, rather than increase it.

Which action of finasteride helps in the treatment of benign prostatic hypertrophy? 1. It relieves male urine retention. 2. It relaxes the prostatic sphincter. 3. It increases the penile blood flow. 4. It inhibits the growth of the prostate.

4. It inhibits the growth of the prostate. Finasteride promotes the regression of prostate epithelial tissues, resulting in decreased mechanical obstruction of the urethra through the inhibition of 5-alpha reductase. Finasteride has no effect on urinary stasis or penile perfusion. The prostatic sphincter does not exist.

Which medication is suitable therapy for oral contraception in women who cannot take estrogen? 1. Estrone 2. Megestrol 3. Estropipate 4. Medroxyprogesterone

4. Medroxyprogesterone Because it prevents follicular maturation and ovulation, medroxyprogesterone is a suitable oral contraceptive for women who cannot take estrogen. Estrone and estropipate are synthetic estrogens. Megestrol is unsuitable because it is indicated in the palliative treatment of endometrial and breast cancers.

Which medication helps reduce postpartum uterine hemorrhage? 1. Megestrol 2. Raloxifene 3. Clomiphene 4. Methylergonovine

4. Methylergonovine Methylergonovine is a uterine stimulant used to treat postpartum hemorrhage. Megestrol is a progestational medication used to treat uterine bleeding. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent the occurrence of postmenopausal osteoporosis. Clomiphene is used to treat infertility.

While assessing a patient, the nurse finds that the patient is an athlete by profession and takes oxymetholone without a medical prescription. What reason does the nurse suspect for the patient taking oxymetholone? 1. Pain relief 2. Stress relief 3. Euphoric effect 4. Muscle hypertrophy

4. Muscle hypertrophy Oxymetholone is an anabolic steroid. It is usually taken by athletes and body builders to attain a muscular body, because this medication has muscle-building properties. Therefore, the nurse should suspect that the patient takes this medication for muscular hypertrophy. Oxymetholone does not have analgesic, anxiolytic, or sedative effects. Therefore, the patient will not take this medication for pain relief, stress relief, or euphoric effects.

A - Cryptorchidism - Methyltestosterone B - Hypogonadism - Testosterone C - Erectile dysfunction - Sildenafil D - Benign prostatic hyperplasia - Minoxidil A nurse is reviewing the prescriptions for a group of patients assigned to receive nursing care on a medical-surgical unit. Which patient's medication prescription should the nurse question? 1. Patient A 2. Patient B 3. Patient C 4. Patient D

4. Patient D Patient 4 is diagnosed with benign prostatic hyperplasia and should be treated with finasteride, not minoxidil; therefore, the nurse should question the medication prescription for this patient. Methyltestosterone is used in the treatment of postpubertal cryptorchidism. Primary or secondary hypogonadism is treated with testosterone. Patients who have erectile dysfunction are administered sildenafil as a treatment strategy.

The nurse is providing postpartum care for a female patient who is prescribed methylergonovine. Which aspect of the patient's medical history would be a contraindication for receiving this drug? 1. Hypertension 2. Uterine atony 3. Nausea and vomiting 4. Pelvic inflammatory disease

4. Pelvic inflammatory disease Methylergonovine is used for postpartum uterine hemorrhage. It is contraindicated in patients with pelvic inflammatory disease. Hence, the nurse needs to inform the primary health care provider about this. Methylergonovine should be used cautiously in patients with hypertension, but it is not a contraindication. The medication is used to treat uterine atony. Nausea and vomiting is not a contraindication.

Minoxidil is prescribed to a patient to treat hair loss. Which nursing intervention will help curtail the adverse effects of the therapy? 1. Drink excess water. 2. Rest to eliminate headaches. 3. Stop eating sodium-rich foods. 4. Report any occurrence of erythema.

4. Report any occurrence of erythema. Minoxidil is considered a potential peripheral vasodilator, but it causes extreme dermatologic reactions like erythema, dermatitis, eczema, and pruritus. Drinking excess water is the best option for patients suffering from hypotension. Rest will not help cure the headaches; they are caused by the anabolic steroids. Avoiding sodium-rich food is a remedial option for patients suffering from hypertension.

A patient who is taking terazosin for benign prostatic hyperplasia (BPH) reports symptoms of hypotension. Which drug should the nurse expect to be prescribed to the patient as an alternative to terazosin? 1. Sildenafil 2. Doxazosin 3. Finasteride 4. Tamsulosin

4. Tamsulosin Tamsulosin has a higher specificity to alpha1-receptors and is thus known to have fewer hypotensive effects in comparison to terazosin. Thus, the patient should ideally be prescribed this drug in place of terazosin. Sildenafil is a drug prescribed for erectile dysfunction; it is not used to treat the symptoms associated with BPH. Doxazosin is another alpha1-receptor antagonist drug, but it may cause hypotensive effects. Finasteride takes a longer time to treat BPH when compared with terazosin and falls within a different category of medications for BPH, so it should not be used as an alternative to terazosin.

A male patient is diagnosed with mild prostate enlargement. What should the nurse expect to administer to control the enlargement? 1. Minoxidil 2. Stanozolol 3. Finasteride 4. Tamsulosin

4. Tamsulosin Tamsulosin is an alpha1-adrenergic blocker, which helps reduce prostate enlargement. Minoxidil is a peripheral vasodilator, used to treat topical baldness. Stanozolol is an androgen. Finasteride is used primarily for benign prostatic hypertrophy (BPH) and generally takes longer to take effect.

The nurse is caring for a patient who has prostate cancer who has been prescribed finasteride. After continuing the medication for a few months, the patient's prostate-specific antigen (PSA) value is less than 2.5 ng/mL. What should the nurse infer from this? 1. The patient is nonadherent to the medication. 2. The patient may have hypersensitivity reaction. 3. The patient may have increased risk of liver failure. 4. The patient is responding effectively to the treatment.

4. The patient is responding effectively to the treatment. Patients with prostate cancer have high levels of PSA. To determine the effectiveness of the treatment, the nurse should monitor the PSA levels of the patient. Values less than 2.5 to 3 ng/mL are considered to be normal and indicate that the patient is effectively responding to the medication. If the patient was not taking the medication as prescribed, the PSA value would be higher than 3 ng/mL. In addition, the patient would have difficulty in urination because of worsening of symptoms. PSA levels do not indicate that the patient has hypersensitivity. The presence of a localized infection or allergy indicates that the patient is hypersensitive to the medication. Alteration in the levels of the liver enzymes and bile is indicative of liver failure. Therefore, the PSA values do not help the nurse to infer that the patient has an increased risk of liver failure.

Which condition in a patient's history is a contraindication for the administration of estrogens? 1. Weight gain 2. Hypertension 3. Dysmenorrhea 4. Thrombophlebitis

4. Thrombophlebitis Contraindications for estrogen administration include known drug allergy, any estrogen-dependent cancer, undiagnosed abnormal vaginal bleeding, pregnancy, and active thromboembolic disorder (e.g., stroke, thrombophlebitis) or a history of such a disorder. It is not contraindicated in patients with weight gain, hypertension, or dysmenorrhea.

What are the clinical uses of sildenafil? Select all that apply. 1. Treatment of hypoglycemia 2. Treatment of liver disorders 3. Treatment of hypothyroidism 4. Treatment of erectile dysfunction 5. Treatment of pulmonary hypertension

4. Treatment of erectile dysfunction 5. Treatment of pulmonary hypertension Sildenafil is a phosphodiesterase inhibitor, and it causes vasodilation, thereby enhancing the blood flow. Therefore, it is commonly used for the treatment of erectile dysfunction and pulmonary hypertension. Sildenafil does not alter insulin levels, liver functioning, or thyroid hormone levels. Therefore, sildenafil is not prescribed for the treatment of hypoglycemia, liver disorders, or hypothyroidism.

A patient who is pregnant tells the nurse, "My husband is losing his hair, and I apply finasteride cream on his scalp daily." Which test should the nurse discuss with the patient's health care provider? 1. Lipid profile 2. Liver function test 3. Exercise tolerance test 4. Ultrasonography of the fetus

4. Ultrasonography of the fetus Exposure to finasteride is contraindicated in women of childbearing age, because this drug has teratogenic effects. The patient has been applying finasteride to her husband; this indicates that the drug would have been topically absorbed into the skin of the patient. Thus, the nurse should suggest an ultrasound scan of the fetus to check for fetal abnormalities. Unlike anabolic steroids, finasteride does not affect the lipid levels. Therefore, the nurse need not refer the patient for a lipid profile. Unlike anabolic steroids, finasteride does not affect liver function; therefore, the nurse need not refer the patient for a liver function test. Finasteride does not affect cardiac function. Moreover, an exercise tolerance test is contraindicated in pregnant women.

Which medication treats erectile dysfunction? 1. Sildenafil 2. Minoxidil 3. Finasteride 4. Testosterone

1. Sildenafil Sildenafil treats erectile dysfunction. Minoxidil treats female and male androgenetic alopecia. Finasteride treats benign prostatic hyperplasia. Testosterone treats primary or secondary hypogonadism.

Which is an off-label use of oxandrolone? 1. Anemia 2. Alcoholic hepatitis 3. Hereditary angioedema 4. Metastatic breast cancer

2. Alcoholic hepatitis An off-label use of oxandrolone is for the treatment of alcoholic hepatitis. The approved clinical uses of anabolic steroids, such as oxandrolone, are anemia, hereditary angioedema, and metastatic breast cancer.

What is an adverse effect associated with estrogen therapy? 1. Nausea 2. Dry skin 3. Weight loss 4. Higher-pitched voice

1. Nausea The most common undesirable effect of estrogen use is nausea. Photosensitivity may also occur with estrogen therapy. One common dermatologic effect of note is chloasma, not dry skin. Weight loss and a higher-pitched voice are not caused by estrogen therapy.

Which conditions are contraindications for treatment with testosterone? Select all that apply. 1. Pregnancy 2. Oligospermia 3. Renal disease 4. Hypogonadism 5. Hepatic disease

1. Pregnancy 3. Renal disease 5. Hepatic disease Testosterone is contraindicated for patients who are pregnant and for those who are diagnosed with renal and hepatic disease. Testosterone is used to treat oligospermia and hypogonadism.

Which clinical manifestations can be observed in a patient who is receiving teriparatide therapy? Select all that apply. 1. Vertigo 2. Joint pain 3. Chest pain 4. Hot flashes 5. Loss of appetite

1. Vertigo 2. Joint pain 3. Chest pain Teriparatide is used to treat osteoporosis. Adverse reactions of this medication include vertigo (dizziness), joint pain (arthralgia), and chest pain. Hot flashes occur as an adverse effect of raloxifene therapy. Reduced appetite is an adverse effect of calcitonin therapy.

Which medication is used to induce labor? 1. Oxytocin 2. Terbutaline 3. Methylergonovine 4. Magnesium sulfate

1. Oxytocin Oxytocin is a uterine stimulant that is used to induce uterine contractions for labor. Terbutaline is a medication used to arrest preterm labor. Methylergonovine is used to treat postpartum hemorrhage. Magnesium sulfate is used to treat gestational hypertension.

The nurse is about to administer dinoprostone to a patient. What condition is this medication used for? 1. Premature labor 2. Accelerated labor 3. Postpartum hemorrhage 4. Termination of pregnancy

4. Termination of pregnancy The use of dinoprostone or other prostaglandin E2 drugs is indicated in specific situations requiring termination of pregnancy. It is not required during premature labor, accelerated labor, or postpartum hemorrhage.

Which medication is an alpha1-adrenergic blocker? 1. Alfuzosin 2. Goserelin 3. Nilutamide 4. Nandrolone

1. Alfuzosin Alfuzosin is an alpha 1-adrenergic blocker. Goserelin is a gonadotropin-hormone-releasing analogue. Nilutamide is an antiandrogen. Nandrolone is an anabolic steroid.

A patient with menopausal symptoms is seeking hormone replacement therapy. During the assessment, the nurse finds that the patient has a history of endometrial cancer and is a smoker. Which is the most important information for this patient? 1. "The therapy may cause thromboembolic events." 2. "You may need to stop smoking during the therapy." 3. "The treatment should be started as soon as possible." 4. "The treatment is likely to cause endometrial cancer."

1. "The therapy may cause thromboembolic events." Progesterone therapy may result in thromboembolic events, which should be the first information shared with the patient. In patients with a history of endometrial cancer, estrogen therapy may increase the possibility of recurrence of cancer. The nurse may advise the patient to stop smoking if she starts the therapy. The treatment is not started as soon as possible, but may be prevented.

Which statement indicates that the patient understands the benefit of continuous administration of progestin with an estrogen regimen? 1. "Endometrial cancer risk can be reduced by adding progestin." 2. "The progestin in the regimen will help prevent breast cancer." 3. "The progestin in the regimen will help prevent ovarian cancer." 4. "Vaginal cancer is prevented by adding progestin to the regimen."

1. "Endometrial cancer risk can be reduced by adding progestin." Estrogen, given alone, has been associated with an increased risk of endometrial hyperplasia, which can lead to endometrial cancer. Progestin reduces the incidence of endometrial hyperplasia.

A female patient is taking estrogen with progesterone. To facilitate monitoring of the risks associated with this therapy, what instruction should the nurse include in patient teaching? 1. "Have a yearly mammogram." 2. "Have tests for serum cholesterol." 3. "Perform weight-bearing exercise." 4. "Report missed menstrual periods."

1. "Have a yearly mammogram." Estrogen in combination with progesterone increases the risk of breast cancer, so the nurse should instruct the patient to have a yearly mammogram. Although patients taking estrogen with progestin are at increased risk of thromboembolic events, the effect on serum lipids is unclear. The risk of osteoporosis decreases for women who take estrogen therapy; hence, it is not necessary to perform weight-bearing exercise. Pregnancy is generally not a concern when women take this combination as hormone replacement therapy, and missed periods are common.

A female patient with strep throat is taking amoxicillin with clavulanate to treat the infection. Because the patient also takes an oral contraceptive (OC), how long should the nurse instruct the patient to use a different method of birth control? 1. For at least a month after starting the antibiotic 2. During the entire period the patient is taking the antibiotic 3. Until three throat cultures have been negative for the pathogen 4. For at least 6 weeks, starting at the end of the antibiotic regimen

1. For at least a month after starting the antibiotic Because antibiotics, especially penicillin and cephalosporins, can impair the action of OCs, the nurse should instruct the patient to use another method of birth control for at least 1 month after starting the antibiotic. The effect of OCs is reduced when antibiotic therapy is started. Hence, using birth control only at the end of the antibiotic regimen is not effective. If three throat cultures are negative for the pathogen, it indicates a need to stop the antibiotic therapy, not to resume the use of birth control.

Which medication is most likely to decrease the effectiveness of norethindrone and ethinyl estradiol? 1. Rifampin 2. Furosemide 3. Calcium citrate 4. Acetaminophen

1. Rifampin Rifampin decreases the estrogenic effects of oral contraceptives. Furosemide is used for the treatment of edema. Calcium citrate is a calcium supplement used for preventing osteoporosis. Acetaminophen is used to relieve pain and fever.

The clinical reports of a patient taking a bisphosphonate and calcium supplement indicate poor therapeutic levels of the bisphosphonate. Which changes in the medication administration will the nurse need to encourage the patient to implement? 1. "Discontinue the calcium supplement." 2. "Space the medications 1 to 2 hours apart." 3. "Replace the bisphosphonate with calcitonin." 4. "Obtain a prescription for increasing the bisphosphonate dose."

2. "Space the medications 1 to 2 hours apart." Calcium supplements interfere with the absorption of bisphosphonates. Spacing the medications 1 to 2 hours apart helps prevent this interaction. The nurse does not replace the drug without consulting the primary health care provider. The nurse does not discontinue the calcium supplement, because it may affect the patient's health. Increasing the dose of bisphosphonate will not aid in absorption if it interacts with calcium supplements.

A patient who has been taking sildenafil has developed angina. The health care provider has prescribed isosorbide mononitrate. What is the nurse's primary intervention? 1. Take the patient's blood pressure. 2. Advise the patient not to take the sildenafil. 3. Instruct the patient to take the medications on opposite days. 4. Tell the patient to take the isosorbide mononitrate before the sildenafil.

2. Advise the patient not to take the sildenafil. When taken in conjunction with nitrates, sildenafil can cause severe hypotension that is unresponsive to treatment. The patient should never take these medications together. The remaining responses are not the priority intervention.

Drugs from which drug class can cause both syncope and dyspnea as adverse reactions? 1. Androgens 2. Alpha1-adrenergic blockers 3. 5-alpha reductase inhibitors 4. Topical peripheral vasodilators

2. Alpha1-adrenergic blockers Alpha1-adrenergic blockers are associated with the adverse effects of producing syncope and dyspnea. Changes in libido, anxiety, and depression occur in patients prescribed androgens. 5-alpha reductase inhibitors cause the adverse effects of hypotension, drowsiness, and dizziness. Topical peripheral vasodilators are associated with precipitating dermatologic reactions, such as erythema, pruritus, and eczema.

Which condition is an indication for a primary health care provider to prescribe danazol for a female patient? 1. Facial hair 2. Endometriosis 3. High testosterone levels 4. Cardiovascular disorder

2. Endometriosis Danazol is a synthetic androgen. It is prescribed to women for the treatment of endometriosis, because it causes atrophy of the endometrium and therefore helps alleviate its symptoms. Danazol increases the testosterone levels and may cause growth of facial hair. Therefore, it is not given for the treatment of facial hair. Women treated with the drug may develop infertility from the medication, because it also increases the production of testosterone. Danazol causes cardiovascular disorders. Therefore, danazol should not be prescribed if the patient has facial hair, high testosterone levels, or cardiovascular disorders.

The nurse is caring for a patient receiving androgen therapy. For which conditions is androgen therapy indicated? Select all that apply. 1. Priapism 2. Endometriosis 3. Prostate cancer 4. Hypergonadism 5. Refractory anemias

2. Endometriosis 5. Refractory anemias Androgen therapy is indicated for the treatment of endometriosis, refractory anemias, advanced breast cancer in women, hypogonadism, angioneurotic edema, and tissue wasting associated with severe or chronic illness. It is not indicated for priapism, prostate cancer, or hypergonadism. In fact, hypergonadism and prostate cancer may be worsened with androgen administration.

Which assessment finding indicates that a patient is a suitable candidate for oxytocin therapy? 1. Vaginal bleeding at 38 weeks' gestation 2. Ineffective contractions in a full term pregnancy 3. Absence of cervical ripening at 42 weeks' gestation 4. Radiographic confirmation of cephalopelvic disproportion

2. Ineffective contractions in a full term pregnancy A patient whose pregnancy is full term but who has ineffective contractions is a suitable candidate for oxytocin therapy to augment the strength and increase the frequency of contractions. Vaginal bleeding in a patient near term is an obstetric emergency, and oxytocin is contraindicated, because it is likely to increase the bleeding, increase and strengthen the contractions, and cause fetal distress. Oxytocin is indicated for the induction of labor in a postterm patient, but the patient must have a soft cervix. In a patient with cephalopelvic disproportion, the fetus's head may be too large for the patient's pelvis; harm to both patient and fetus could occur if oxytocin were administered.

A pregnant patient is receiving magnesium sulfate to inhibit uterine contractions. The patient develops depressed reflexes and confusion. What is the nurse's priority action? 1. Administer epinephrine. 2. Administer protamine sulfate. 3. Administer calcium gluconate. 4. Administer intravenous atropine.

3. Administer calcium gluconate. Calcium gluconate is the antidote if magnesium toxicity (maternal neurologic, respiratory, or cardiac depression) is evidenced. Epinephrine will not reverse magnesium toxicity; it is used for the treatment of anaphylactic reactions. Protamine sulfate will not reverse magnesium toxicity; it is the antidote for heparin overdose. Atropine will not reverse magnesium toxicity; it is used for insecticide intoxication or slow heart rates.

The nurse is assessing a patient who is taking fluoxymesterone to treat reduced testosterone levels. The patient has gained weight 1 week after beginning the medication. What is the likely cause for weight gain in the patient? 1. Impaired liver function 2. Impaired thyroid activity 3. Increased fluid retention 4. Impaired lipid metabolism

3. Increased fluid retention Fluoxymesterone is an androgenic drug that may cause fluid retention in some patients. Thus, in this patient, fluid retention would have been the most probable cause of weight gain. Impaired liver function is a complication associated with anabolic steroids and not fluoxymesterone. Impaired thyroid activity may cause weight gain; however, androgenic drugs do not affect the thyroid activity. Impaired lipid metabolism is also a complication associated with androgens that causes elevated cholesterol levels. However, weight gain from high cholesterol levels takes place over a long period of time.

If fertilization of an ovum does not occur during a menstrual cycle, which of the following structures responds to the increased levels of estrogen and progesterone? 1. Ovary 2. Hypothalamus 3. Pituitary gland 4. Corpus luteum

3. Pituitary gland If fertilization does not occur, the pituitary responds to the increased levels of estrogen and progesterone by shutting off the release of follicle-stimulating hormone and luteinizing hormone. The ovaries, hypothalamus, and corpus luteum are not directly involved.

A patient with which condition should not use oral contraceptives as a method of birth control? 1. Renal failure 2. Ovarian failure 3. Pulmonary embolism 4. Abnormal vaginal bleeding

3. Pulmonary embolism A history of pulmonary embolism increases the patient's risk for developing thromboembolism, so this patient should not use oral contraceptives. Renal failure, ovarian failure, and abnormal vaginal bleeding are not contraindications for the use of oral contraceptives. Denosumab is contraindicated in patients who have renal failure. Fertility medications, such as clomiphene, are contraindicated in patients who have ovarian failure. Estrogen therapy is contraindicated in patients who have abnormal vaginal bleeding.

Which pharmacologic class is used to describe testosterone drugs? 1. Schedule I 2. Schedule II 3. Schedule III 4. Schedule IV

3. Schedule III Testosterone, a naturally occurring androgenic hormone produced primarily by the testes, regulates male sexual development. Most androgens are classified as Schedule III drugs in the United States. They have less abuse potential than Schedule II drugs and a moderate dependence liability. Schedule I and II drugs have a high potential for abuse. Schedule IV drugs have less abuse potential than Schedule III drugs.

Why does the United States Drug Enforcement Administration classify anabolic steroids as Schedule III medications? 1. They cause endometriosis. 2. They cause erectile dysfunction. 3. They cause physical dependence. 4. They cause sedation and hypnosis.

3. They cause physical dependence. Anabolic steroids increase muscle growth; because of this, they are often abused and may cause physical and psychological dependence in the patient. Therefore, anabolic steroids are classified as Schedule III medications by the United States Drug Enforcement Administration. Steroids enhance testosterone levels and therefore they do not cause endometriosis or erectile dysfunction. Anabolic steroids do not have central nervous system depressant effects. Hence, they do not cause sedation and hypnosis.

The nurse is teaching students about progestin-only oral contraceptives. Which statement by a student suggests effective learning? 1. "They are taken every week." 2. "They produce anovulatory cycles." 3. "They are taken after lunch and dinner." 4. "They may cause breakthrough bleeding."

4. "They may cause breakthrough bleeding."The use o f progestin-only formulations (often referred to as the "minipill") may cause breakthrough bleeding. They are taken daily. They have a higher incidence of ovulatory cycles. It is important for the patient to take this oral contraceptive at the same time every day to maintain effective hormone serum levels.

Which patient is not a candidate for oxandrolone therapy? 1. A patient with severe burns 2. A patient with catabolism after surgery 3. A patient with acquired immunodeficiency syndrome 4. A high-school athlete who has difficulty gaining weight

4. A high-school athlete who has difficulty gaining weight Oxandrolone is indicated for weight gain in severe conditions with involuntary weight loss. Anabolic steroids are not approved to help athletes gain weight; there is no need to administer oxandrolone to this patient. Weight gain is important in patients with severe burns, to prevent further complications in patients with catabolism after surgery, and in patients with acquired immunodeficiency syndrome.

A patient who is 26 weeks pregnant and who has diabetes mellitus begins to experience preterm labor. Which treatment is the best initial therapy for the prevention of uterine contractions and complications in this patient's pregnancy? 1. Ritodrine 2. Terbutaline 3. Magnesium sulfate 4. Bed rest and hydration

4. Bed rest and hydration Bed rest and hydration are especially good choices for this patient, because they do not carry the risk of increased blood sugar that terbutaline therapy does. Because pressure on the cervix or cervical incompetence can stimulate uterine contractions, bed rest may also be effective in relieving pressure on the cervix and inhibiting uterine activity. Ritodrine is generally reserved for when conservative measures and terbutaline have failed. Generally terbutaline, the drug of choice for preterm labor, is used after conservative measures have failed. Magnesium sulfate is used as an off-label therapy for preterm labor.

The nurse notes that a patient is prescribed dutasteride. Which condition should the nurse suspect in the patient? 1. Impotence 2. Hypogonadism 3. Testicular cancer 4. Benign prostatic hyperplasia (BPH)

4. Benign prostatic hyperplasia (BPH) Dutasteride is an alternative for finasteride, indicated for the treatment of benign prostatic hyperplasia (BPH). The medicine is available in 0.5 mg capsules. Dutasteride has no effect on impotence or testicular cancer. Testosterone is used for the treatment of hypogonadism.

The nurse encounters a male patient who is taking finasteride. Which condition should the nurse suspect in the patient? 1. Priapism 2. Bladder cancer 3. Testicular cancer 4. Benign prostatic hyperplasia (BPH)

4. Benign prostatic hyperplasia (BPH) Finasteride is specifically administered for the treatment of BPH, which leads to enlargement of the prostate. Finasteride is also administered for the treatment of hair loss, occurring in men between the ages of 30 and 80. Finasteride helps lower the dihydrotestosterone (DHT) level. The medication is not directly related to priapism, bladder cancer, or testicular cancer.

The nurse is assessing a patient who is prescribed estrogen replacement therapy. A history of which medical condition would be a contraindication to this therapy? 1. Weight loss 2. Dysmenorrhea 3. Uterine bleeding 4. Deep vein thrombosis

4. Deep vein thrombosis The most serious adverse effects of the estrogens are thromboembolic events. A previous history would put the patient at increased risk. Uterine bleeding is an indication for estrogen therapy. A history of weight loss or dysmenorrhea would not be a contraindication for estrogen replacement therapy.

Which medication is contraindicated in patients who have osteoporosis and a history of renal dysfunction? 1. Calcitonin 2. Tamoxifen 3. Ibandronate 4. Denosumab

4. Denosumab Denosumab prevents bone resorption in patients who have osteoporosis; however, it is contraindicated for patients who have a history of renal dysfunction, because it increases the risk for renal failure. Calcitonin is used to treat osteoporosis and is contraindicated in patients who are allergic to salmon, because it is derived from salmon. Tamoxifen is a selective estrogen receptor modulator (SERM) used to treat osteoporosis and is contraindicated in patients who have deep vein thrombosis or pulmonary embolism, because it increases the risk for thrombosis. Ibandronate is used in the treatment of osteoporosis and is contraindicated if the patient has hypocalcemia and esophageal dysfunction.

Which is a benefit of synthetic androgens? 1. Prolonged erection 2. Increased hair growth 3. Relief from fluid retention 4. Enhancement of the male libido

4. Enhancement of the male libido Synthetic androgen, administered through androgen-replacement therapy, helps treat testicular failure in a male patient. It helps improve the performance of the male libido. Prolonged erection and fluid retention are adverse effects of androgens. Finasteride causes increased hair growth.

Which medication is used to treat amenorrhea? 1. Estradiol 2. Denosumab 3. Alendronate 4. Medroxyprogesterone acetate

4. Medroxyprogesterone acetate Medroxyprogesterone acetate is a progestational medication used to treat amenorrhea. Estradiol is an estrogenic medication used to treat ovarian failure. Denosumab is used to treat osteoporosis. Alendronate is an oral bisphosphonate used in the treatment of osteoporosis.

The nurse observes that a female patient is at risk for postpartum uterine hemorrhage. Which medication should the nurse discuss with the primary health care provider to initiate? 1. Estradiol 2. Megestrol 3. Alendronate 4. Methylergonovine

4. Methylergonovine Methylergonovine is used to prevent postpartum uterine hemorrhage. Estradiol is used for relieving vasomotor symptoms of menopause, female castration, and ovarian failure. Megestrol is used in the treatment of recurrent, inoperable, or metastatic endometrial or breast cancer. Alendronate is an oral bisphosphonate used for preventing bone loss.

Which drug prescription does the nurse report to the primary health care provider if the patient is taking tadalafil? 1. Ibuprofen 2. Famotidine 3. Furosemide 4. Nitroglycerin

4. Nitroglycerin The major contraindication to the use of tadalafil is concurrent nitrate therapy, because this can result in severe hypotension. It includes the use of amyl nitrate, sublingual or topical nitroglycerin, and oral nitrate derivatives such as isosorbide mononitrates and dinitrates. Ibuprofen, famotidine, and furosemide are not contraindicated in patients taking tadalafil.

The nurse is asked to administer medications to several patients. Which patient is prescribed a proper dose, indication, and route of administration of the medication? 1. Sildenafil, 50 mg injected into the penile shaft 2. Finasteride, 5 mg/day by mouth, for baldness 3. Transdermal testosterone, 4 mg/day applied to the back 4. Testosterone cypionate, 300 mg intramuscularly each month

4. Testosterone cypionate, 300 mg intramuscularly each month The dosage range for testosterone cypionate is an intramuscular injection of 50 to 400 mg every second or fourth week. Sildenafil is taken as a dose of 25 to 100 mg by mouth, 1 hour before intercourse; finasteride is administered in a dos of 1 mg/day for male pattern baldness and 5 mg/day for benign prostatic hyperplasia; and transdermal testosterone is administered as 4 to 6 mg/day; it must be applied to the scrotum.

The nurse administers diluted oxytocin solution to a female patient for labor induction and continuously monitors the maternal blood pressure and pulse rate, as well as the fetal heart rate. The nurse stops the oxytocin infusion when the contractions are more frequent than every 2 minutes. What is the purpose of this action? 1. The fetal heart rate is stable. 2. The patient is ready for delivery. 3. The patient's blood pressure is stable. 4. The contractions can be fatal to the patient.

4. The contractions can be fatal to the patient. Contractions every 2 minutes indicates hyperstimulation in the patient, which may result in uterine rupture. Therefore, the nurse needs to stop the drug infusion immediately. Hyperstimulation also causes changes in other parameters, such as blood pressure and fetal heart rate, which may prove fatal to the patient. Hyperstimulation increases the patient's blood pressure level and also the fetal heart rate. The patient is not ready for delivery; rather, the patient is facing a serious complication. The nurse can administer intravenous fluids, administer oxygen, and place the patient in a side-lying position to reduce hyperstimulation.

A patient tests positive for pregnancy even though she has been taking oral contraceptives. What is a possible cause of this unintended pregnancy? 1. The patient has diabetes. 2. The patient has hypertension. 3. The patient takes anticonvulsants. 4. The patient is on antibiotic therapy.

4. The patient is on antibiotic therapy. Antibiotics reduce the effectiveness of oral contraceptives; hence, the nurse needs to instruct patients to use alternative birth control methods during antibiotic therapy. Diabetes does not reduce the effect of oral contraceptives. Hypertension may be an adverse effect of oral contraceptives. The effectiveness of anticonvulsants is reduced when taken with oral contraceptives.

The nurse is assessing an elderly patient who has angina pectoris who has been prescribed nitroglycerin. After reviewing the patient's medical history, the nurse advises the patient to avoid vardenafil. What is the reason for giving this advice to the patient? 1. Vardenafil reduces the efficacy of nitroglycerin. 2. Vardenafil may cause erectile dysfunction in patients. 3. Vardenafil is contraindicated for use in elderly patients. 4. Vardenafil causes hypotension if taken with nitroglycerin.

4. Vardenafil causes hypotension if taken with nitroglycerin. Vardenafil is a phosphodiesterase inhibitor. It is contraindicated in patients with cardiovascular disorders. This medication will be discontinued when nitrates such as nitroglycerin are prescribed for the patient, because it causes hypotension. This effect is the result of synergistic action of the medications, which results in excessive vasodilation. Vardenafil does not reduce the efficacy of nitroglycerine, because it does not interact with the drug. Vardenafil is prescribed for the treatment of erectile dysfunction. Therefore, it does not cause erectile dysfunction. Vardenafil is not contraindicated in elderly patients. It can be prescribed for them unless they have cardiovascular disorders.