NURS 505 Exam 3 PrepU (25, 27) (39, 40, 41)

The health care provider has ordered a variety of laboratory assessments on a client who will need estrogen replacement. The follow labs are ordered: blood urea nitrogen (BUN), creatinine, and liver function tests (LFTs). What is the nurse's best statement explaining to a client the need to draw the labs?

"The labs will identify your body's ability to filter and excrete medications."

Insufficient progesterone levels would lead to what complications?

1. insufficient blood supply for the embryo 2. increased risk for intrauterine infection pre-mature uterine contrations occur 3. increased risk to the embryo from the immune system 4. decreased blood glucose diffusion to the embryo

In a 28 day menstrual cycle, the secretory phase occurs during which days?

15 to 28

After teaching a woman using an intravaginal estrogen preparation, the nurse determines that the teaching was successful when the client states that she will remain lying for at least how long after instilling the drug?

30 minutes

The nurse is reviewing the structure and function of various organs in the female reproductive system. Which information should the nurse include about the ovum?

All the ova a female will ever have are present at birth

The nurse instructs a client to use benzocaine to soothe the itching and pain related to an insect bite. Benzocaine is considered to be what type of dermatologic agent?

Anesthetic Anesthetics are sprays, lotions, or creams used for pruritus (itching) and pain from wounds, minor burns, prickly heat, chickenpox, insect bites, and sunburn. Pain relief drugs are lotions and solutions that provide temporary pain relief, soothing emollients relieve itching and aid in healing mild skin irritations, and antiseptics are germicidal agents.

The health care provider has prescribed testosterone for a 77-year-old client with a low testosterone level. The nurse will evaluate this client for what condition that may develop in this client in response to this medication?

Benign prostatic hypertrophy Older adults who receive testosterone should be evaluated for the development of benign prostatic hypertrophy.

The extra pyramidal tract is made up of cells from which areas?

Cerebral Cortex The extra pyramidal tract is composed of cells from the cerebral cortex, as well as those from several subcortical areas, including the basal ganglia and the cerebellum.

A client is taking androgens and warfarin (Coumadin). What effect will these two medications have on the client's coagulation?

Coagulation will be decreased Clients taking androgens and warfarin will increase the concentration of warfarin in the blood; thus, the coagulation will be decreased, placing the client at risk for hemorrhage.

A nurse is preparing a teaching plan for a client who is receiving baclofen therapy. Which would the nurse include as possible adverse effects?

Drowsiness, Urinary Frequency, Constipation Adverse effects associated with baclofen therapy include drowsiness, urinary frequency, constipation, hypotension, fatigue, weakness, and dry mouth.

A client is receiving androgen therapy. Which would cause the nurse the greatest concern?

Elevated liver enzyme levels Indicating impaired hepatic function that could be related to the development of hepatocellular cancer

A nurse should review a client's medical conditions prior to administering a dantrolene (Dantrium) as its use is contraindicated in clients with which issues?

Hepatic disease & Lactation The use of dantrolene (Dantrium) is contraindicated during lactation and in clients with active hepatic disease and muscle spasm caused by rheumatic disorders.

Dantrolene should be avoided in all patients who are 35 or older because of the increased risk of:

Hepatocellular disease

Fertilization of the ovum and implantation in the uterine wall result in the production of what hormone?

Human chorionic gonadotropin

Which adverse effect of muscle relaxants is most pronounced when a client is prescribed tizanidine therapy?

Hypotension Tizanidine (Zanaflex) has been associated with hypotension, which could be a safety risk, especially if the client is also taking an antihypertensive drug.

A client has received a prescription for baclofen. The home care nurse would schedule which laboratory tests to monitor this client?

Liver Function Tests Baclofen is metabolized in the liver and excreted in urine. The client must be monitored for adverse effects on liver function.

Which hormone is responsible for ovulation?

Luteinizing hormone

Dantrolene

Only skeletal muscle relaxant that acts peripherally on the muscle itself; it inhibits the release of calcium in skeletal muscle cells, thereby decreasing the strength of muscle contraction.

During pregnancy, what becomes a massive endocrine gland?

Placenta The placenta serves as a massive endocrine gland during pregnancy, maintaining high levels of estrogen and progesterone to support the uterus and developing fetus. The umbilical cord is important for nutrient and oxygen exchange between the fetus and the mother. The embryo implants in the wall of the uterus and becomes the developing fetus. The uterus provides the area for implantation of the embryo and growth of the fetus.

Sildenafil is used to treat what in females?

Pulmonary hypertension works by causing vasodilation in the pulmonary vascular bed

Menarche

Refers to the onset of the first menstrual cycle

A patient who has suffered a crushing injury to his thumb and two fingers in an accident at a factory is relieved to be administered a local anesthetic prior to treatment. The drugs that were administered decrease the permeability of the nerve cell membrane to:

Sodium

Which agent is available for use as a daily dose? a) Tadalafil b) Vardenafil c) Sildenafil d) Alprostadil

Tadalafil Tadalafil is approved for daily used in men who are very active sexually. This drug may be selected if the timing of sexual stimulation is not known and may be several hours away. Vardenafil must be taken approximately 1 hour before sexual stimulation. Sildenafil must be taken approximately 1 hour before sexual stimulation. Alprostadil is injected directly into the cavernosum.

Castration involves the removal of what structure of the male reproductive system?

Testes

A client's health care provider has prescribed baclofen in an effort to treat neuropathic cancer pain. What education should the nurse prioritize when teaching the client about this new medication?

The importance of ensuring safety related to possibly sedation.

When epinephrine is mixed with a local injectable anesthetic, it is done for what purpose?

To cause vasoconstriction When a local anesthetic is administered, the drug may be mixed with epinephrine to cause local vasoconstriction. The drug stays in the tissue longer when epinephrine is used.

True or False. Spinal reflexes are the simplest nerve pathways that monitor movement and posture.

True

Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation? a) Baclofen b) Allopurinol c) Alendronate d) Hydroxychloroquine

a) Baclofen Baclofen is an example of a skeletal muscle relaxant. Allopurinol would be administered to treat gout. Alendronate would be administered to treat osteoporosis. Hydroxychloroquine would be used to treat rheumatoid arthritis.

An older adult man has moved to a long-term care facility and the nurse is performing a medication reconciliation. The resident's current medication regimen includes alfuzosin. After considering the most likely indication for this drug, the nurse should include what potential problem in the resident's interdisciplinary plan of care? a) impaired urinary elimination b) ineffective sexual pattern c) sexual dysfunction d) functional urinary incontinence

a) impaired urinary elimination

A nurse is obtaining a history from an older adult woman. During the interview, the woman states, "When I feel like I have to urinate, the urge is really strong and I go to the bathroom really frequently, often waking up several times during the night to go." The nurse would most likely identify this as which condition? a) overactive bladder syndrome b) stress incontinence c) urge incontinence d) neurogenic bladder

a) overactive bladder syndrome Overactive bladder syndrome involves conditions of urgency, frequency, and nocturia, with or without incontinence. Stress incontinence involves losing urine without meaning to during physical activity. Urge incontinence involves the strong, sudden need to void due to bladder spasms or contractions. Neurogenic bladder refers to impaired bladder function caused by a nervous system abnormality.

Intrathecal

administered in the spinal region

Sildenafil should be taken...

approximately one hour before sexual stimulation

By about which day in the menstrual cycle does ovulation occur? a) 5 b) 14 c) 21 d) 28

b) 14

A client is started on terbutaline therapy. What would indicate that the therapy has been successful? a) The mother did not require any labor induction. b) Premature birth is avoided for at least 24 hours. c) There has been less or no bleeding in the delivery. d) The mother does not experience adverse effects.

b) Premature birth is avoided for at least 24 hours Terbutaline drug therapy is considered effective when all the following have been achieved: the premature contractions decrease in intensity and frequency; the woman and fetus do not experience adverse effects; and premature birth is avoided for at least 24 hours so that administered corticosteroids can exert their beneficial effects. Terbutaline is not to be given for labor induction but to stop preterm labor.

Which skeletal muscle relaxant is also available in intrathecal form? a) Cyclobenzaprine (Flexeril) b) Tizanidine (Zanafelx) c) Baclofen (Lioresal) d) Carisoprodol (Soma)

c) Baclofen (Lioresal) Baclofen is available in oral and intrathecal forms and can be administered via a delivery pump for the treatment of central spasticity.

A client with amyotrophic lateral sclerosis is experiencing muscle spasticity. Which drug would the nurse expect the physician to order? a) Chlorzoxazone b) Metaxalone c) Dantrolene d) Methocarbamol

c) Dantrolene Dantrolene is indicated for the control of spasticity resulting from upper motor neuron disorders such as amyotrophic lateral sclerosis. Chlorzoxazone, metaxalone, and methocarbamol are used to treat acute musculoskeletal conditions.

A nurse in the postanesthetic recovery unit is performing an assessment of a client whose balanced anesthesia includes the use of vecuronium. The nurse should recognize an increased risk of recurarization due to the client's history of what medical condition? a) depression b) type 2 diabetes c) myasthenia gravis d) deep vein thrombosis (DVT)

c) myasthenia gravis Clients at risk for recurarization include those with liver and kidney disease, acid-base or electrolyte imbalance, hypothermia, critical illness, myopathic disorders, and neuromuscular diseases such as myasthenia gravis or myasthenic (Eaton-Lambert) syndrome. DVT, depression, and diabetes are not noted risk factors.

A nurse is reviewing the medication history of a client. The nurse understands that a PDE5 inhibitor would be inappropriate for a client taking: a) Ketoconazole. b) Indinavir. c) Nitroglycerin. d) Erythromycin.

c) nitroglycerin The PDE5 inhibitors cannot be taken in combination with any organic nitrates or alpha-adrenergic blockers because serious cardiovascular effects may occur, including death. Increased PDE5 inhibitor levels and effects may be seen with ketoconazole, indinavir, and erythromycin; the dosage of the inhibitor would need to be reduced.

The human sexual response involves the activation of which system? a) Endocrine system b) Parasympathetic nervous system c) Sympathetic nervous system d) Urinary system

c) sympathetic nervous system The human sexual response involves activation of the sympathetic nervous system to allow a four-phase response: stimulation, plateau, climax, and resolution.

If pregnancy does not occur during the menstrual cycle, the corpus luteum involutes and becomes the:

corpus albicans becomes a white scar called corpus albicans

When prescribed dantrolene, what is the most serious adverse effect the client should be instructed about? a) metabolic acidosis b) hypercarbia c) renal calculi d) hepatitis

d) hepatitis The most serious adverse effect of oral dantrolene is fatal hepatitis. Metabolic acidosis, hypercarbia, and renal calculi are not adverse effects of oral dantrolene.

Using herbal or dietary supplements as safe, natural alternatives for building muscle may result in:

feminizing effects Androstenedione may be converted to estrogens, and the testosterone that is produced may be further converted to estradiol, which may produce feminizing effects, instead of the intended masculinizing effects.

Examples of local anesthetics...

marcaine, cylocaine, novocain

Tocolytics are...

prescribed to stop pre-term labor

There are different stages of anethesia the client will go through in surgery. The circulating nurse is aware that extra caution is needed during which stage of general anesthesia, when the client may experience brief periods of delirium and excitement?

Stage II During Stage II, the client may experience delirium and excitement. During Stage I, anesthesia induction is accomplished. During Stage III, the client is usually ready for the surgical procedure. Stage IV is a stage of respiratory paralysis and the client may lose all vital signs.

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

a)Masculinization The patient will need to be instructed on masculinization. The patient should have increased joint mobility. Obesity is not a reaction to the anabolic steroids. The patient is at risk for hypertension, not hypotension.

A patient has been diagnosed with cervical dystonia. The nurse would expect which medication to be ordered for this patient? a) Metaxalone (Skelaxin) b) Baclofen (Lioresal) c) Cyclobenzaprine (Flexeril) d) Botulinum toxin type B

d) Botulinum toxin type B The botulinium toxin type B is used to reduce the severity of abnormal head position and neck pain associated with cervical dystonia.

A client with myasthenia gravis has been prescribed dantrolene for the treatment of muscle spasticity. What education should the nurse provide to the client?

"You might experience some urinary frequency and urgency. Tell me promptly if it becomes problematic." Dantrolene often causes urinary frequency and urgency. It is not linked with anorexia and is administered orally each day. Dantrolene is not associated with a high risk for dependence.

A client, prescribed finasteride, asks the nurse how the medication works. Which statement best addresses the client's question?

Decreases proliferative prostatic cells

After teaching a group of students about hormonal secretion of the reproductive system, the instructor determines that the teaching was successful when the students identify what as initiating hormone secretion from the ovaries and testes?

Gonadrotropin releasing hormone The gonadotropin releasing hormone (GnRH) is the hormone responsible for the sequence of events that eventually leads to hormonal secretion from the ovaries and testes. GnRH released from the hypothalamus stimulates the release of follicle-stimulating hormones and luteinizing hormones (sometimes called interstitial cell stimulating hormones in males) from the anterior pituitary gland. These in turn stimulate the male and female glands to secrete their hormones. The release of the gonadotropin releasing hormone by the hypothalamus occurs at puberty. -- signals the onset

Botox (incobotulinumtoxin A) has been successful in use

Migraines

The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first?

Penile vasodilation With sexual stimulation, the arteries leading to the penis dilate and increase blood flow into erectile tissue. Blood accumulates, causing the penis to swell and elongate. Sperm emission (movement of sperm from the testes and fluid from the accessory glands) occurs with orgasm. Orgasm results in a pleasurable feeling of physiologic and psychological release. Ejaculation results in the discharge of semen from the urethra.

Common cause of erectile dysfunction...

Taking medications for high blood pressure Causes of ED may include drugs such as antidepressants, antihypertensive agents, and histamine receptor antagonists. Injuries are a rare cause. Addressing the impact of the problem and the client's perceptions of health are important, but neither question addresses causation.

Which hormone would be initially responsible for hormone secretion from the ovaries and testes?

The gonadotropin-releasing hormone (GnRH) is the hormone responsible for the sequence of events that eventually lead to hormonal secretion from the ovaries and testes. GnRH released from the hypothalamus stimulates the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH; sometimes referred to as the interstitial cell-stimulating hormone in males) from the anterior pituitary gland. These in turn stimulate the male and female glands to secrete their hormones.

Oxytoxin

The nurse should administer oxytocin intranasally to a client to stimulate the milk ejection reflex. Oxytocin can be given intramuscularly (IM) during the third stage of labor (period from the time the baby is born until the placenta is expelled) to produce uterine contractions and control postpartum bleeding and lessen hemorrhage potential. The other uterine stimulants may be given orally, rectally, or IM during the postpartum period to reduce the possibility of postpartum hemorrhage and to prevent relaxation of the uterus. Oxytocin is not given topically. Can cause dangerous effects to the CNS, musculoskeletal, and cardiovascular system caused by water intoxication. Oxytocin increases the water permeability of the nephron, which causes more water retention than sodium reabsorption and, in turn, leads to water intoxication.

A 24-year-old female athlete is using high doses of anabolic steroids to enhance her performance. She may be at risk for which condition? a) Acne b) Fluid deficiency c) Excessive sedation d)Hypotension

a) acne Virilization in a woman is the most common reaction associated with anabolic steroids, especially when higher doses are used. Acne occurs frequently in all age groups and both sexes. Nausea, vomiting, diarrhea, fluid and electrolyte imbalances (the same as for the androgens, discussed previously), testicular atrophy, jaundice, anorexia, and muscle cramps may also be seen. Fluid retention, not deficiency, is a common side effect of anabolic steroid use. Sedation and hypotension are not adverse reactions to this hormone.

The post-anesthetic recovery unit nurse is caring for a client whose balanced anesthesia included midazolam. The nurse should prioritize assessments for what health problems? a) Respiratory depression and CNS suppression b) Myoclonic and tonic movements c) Nausea and vomiting d) Chills and hypotension

a) respiratory depression and CNS suppression Respiratory depression and CNS suppression may occur during recovery from midazolam, making these areas priorities for post-operative assessment.

The nurse is discussing the human response to sexual stimulation with a client experiencing an arousal problem. In which phase of sexual response should the client begin to feel the effects of the sympathetic nervous system? a) Stimulation b) Plateau c) Climax d) Recovery

a) stimulation A period of stimulation with mild increases in sensitivity and beginning stimulation of the sympathetic nervous system. None of the remaining phases are associated with the initiation of the sympathetic nervous system.

A nurse teaching a 57-year-old client about the factors that must be considered around the use of hormone replacement therapy (HRT) should discuss what increased risk associated with the therapy? a) venous thromboembolism b) bronchiectasis c) malignant hyperthermia d) Crohn's disease

a) venous thromboembolism Studies have demonstrated no evidence for HRT in secondary prevention of heart disease and showed increased rates of CHD, thromboembolic stroke, venous thromboembolism, dementia, and breast cancer.

A client who was prescribed doxazosoin is talking with the nurse about adverse effects of the medication. What is the priority nursing diagnosis? a) Impaired oral mucous membranes b) Deficient knowledge c) Risk for Injury d) Acute pain

b) deficient knowledge Discussion with the nurse centers on the knowledge of the client. The client is asking about additional information regarding the medication. The nurse would document deficient knowledge and document how the medication works and the adverse effects. Impaired oral mucous membranes, risk for injury or acute pain are not the priority nursing diagnosis.

The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first? a) Sperm emission b) Penile vasodilation c)Psychological release d)Ejaculation

b) penile vasodilation With sexual stimulation, the arteries leading to the penis dilate and increase blood flow into erectile tissue. Blood accumulates, causing the penis to swell and elongate. Sperm emission (movement of sperm from the testes and fluid from the accessory glands) occurs with orgasm. Orgasm results in a pleasurable feeling of physiologic and psychological release. Ejaculation results in the discharge of semen from the urethra.

A surgical client has developed malignant hyperthermia. Which medication can be used to treat this health emergency? a) metaxalone b) methocarbamol c) dantrolene d) carisoprodol

c) dantrolene Dantrolene acts directly on skeletal muscle to inhibit muscle contraction. It is used to relieve spasticity in neurologic disorders (e.g., MS, spinal cord injury) and to prevent or treat malignant hyperthermia, a rare but life-threatening complication of anesthesia characterized by hypercarbia, metabolic acidosis, skeletal muscle rigidity, fever, and cyanosis. None of the other medications are prescribed for this emergency.

Sildenafil has been prescribed to a client in his 60s, and the nurse is providing health education about the safe and effective use of the drug. The nurse should teach the client to: a) avoid taking sildenafil if he experiences heartburn. b) take the drug every 30 minutes if necessary, to a maximum of three doses. c)take the drug on an empty stomach. d) avoid taking the drug more than once in any 24-hour period.

d) avoid taking the drug more than one in any 24-hour period It is important not to take sildenafil more than once in a 24-hour period. A recent high-fat meal may delay drug action, but it is not essential to take it on an empty stomach. Heartburn is not a common adverse effect and would not necessarily require discontinuing treatment.

A nurse caring for a 43-year-old client explains to the client that ovarian functions gradually decrease around this age. What is the implication of decreased ovarian function? a) Susceptibility to fractures b) Increases the risk of heart disease c) Changes in sexual response d) Inability to become pregnant

d) inability to become pregnant Because of the decrease in ovarian functions, the client loses the ability to become pregnant. Loss of estrogen makes the client susceptible to fractures and also increases the risk of heart disease. Changes in sexual response are usually related to physical changes in the vagina.

A nurse is caring for a 28-year-old patient who is taking exogenous testosterone for treatment of cryptorchidism. What statement by this patient would lead the nurse to believe that patient teaching has been ineffective? a) "I may grow more body hair." b) "My sexual desire may increase." c) "My voice may become deeper." d) "My sperm count should increase."

d) my sperm count should increase The effects of testosterone include increased body hair, thickening of the skin, deepening of the voice, and increased sexual desire. The medication isn't expected to increase sperm count.