Pharmacology II Unit 10
A female client with inoperable advanced breast cancer is prescribed methyltestosterone. The nurse would be alert for the development of which of the following? Select all that apply. A. Amenorrhea B. Acne C. Facial hair growth D. Somnolence E. Mania
A. Amenorrhea B. Acne C. Facial hair growth Feedback: A nurse should advise a female client beginning therapy with methyltestosterone (Testred) for the treatment of inoperable advanced breast carcinoma of the following adverse reactions: amenorrhea, other menstrual irregularities, acne, male-pattern baldness, and virilization (facial hair growth, voice deepening, and clitoromegaly).
A client is admitted for tocolytic therapy for preterm labor. The client states, "I'm so afraid that I'm so early. Is my baby okay? What if the drug doesn't help?" Based on the client's statement, the nurse would identify which nursing diagnosis as the priority? A. Anxiety B. Risk for Injury C. Impaired Gas Exchange D. Excess Fluid Volume
A. Anxiety Feedback: Based on the client's statements, the nurse would identify Anxiety as the priority nursing diagnosis because of the client's stated concern for her fetus and cessation of labor. Risk for Injury and Excess Fluid Volume would be more appropriate for a client receiving oxytocin. Impaired Gas Exchange would be appropriate if the client was experiencing adverse reactions related to the tocolytic.
While conducting a health promotion presentation for a local group of women who are in their 30s and 40s, one of the women asks the nurse, "I've heard horror stories about menopause. Are there any herbal products that can help?" Which of the following would the nurse include in the response? Select all that apply. A. Black cohosh B. Sage C. Calendula D. Saw palmetto E. Dandelion
A. Black cohosh B. Sage C. Calendula E. Dandelion Feedback: Black cohosh, sage, dandelion, and calendula are herbs that may be used to address menopausal symptoms. Saw palmetto is used to relieve the symptoms of benign prostatic hypertrophy.
When completing the ongoing assessment of clients receiving estrogen, progestin, or combination products, which of the following would the nurse include? Select all that apply. A. Blood pressure B. Pulse C. Respiratory rate D. Temperature E. Therapeutic effects
A. Blood pressure B. Pulse C. Respiratory rate E. Therapeutic effects Feedback: The nurse's ongoing assessment of clients receiving estrogen, progestin, or combination products should include blood pressure, pulse, respiratory rate, weight, and questioning about adverse effects and therapeutic effects.
After administering an injection of oxytocin (Pitocin), the nurse continues to assess which of the following? Select all that apply. A. Blood pressure B. Blood glucose C. Pulse D. Temperature E. Respiratory rate
A. Blood pressure C. Pulse E. Respiratory rate Feedback: After an injection of oxytocin (Pitocin), during ongoing assessment the nurse monitors the following: the client's blood pressure, pulse, and respiratory rate.
A nursing instructor is describing the role of androgens to a nursing class. The instructor determines that the class was successful when the students identify that from puberty onward, androgens continue to aid in the development and maintenance of secondary sex characteristics that include which of the following? Select all that apply. A. Body fat distribution B. Muscle development C. Epiphyseal growth D. Glucose metabolism E. Body hair
A. Body fat distribution B. Muscle development E. Body hair Feedback: From puberty onward, androgens continue to aid in the development and maintenance of secondary sex characteristics, which include facial hair, deep voice, body hair, body fat distribution, and muscle development.
A nurse is caring for a client receiving goserelin acetate for prostate cancer. The nurse would monitor the client for which of the following adverse reactions? A. Breast atrophy, sexual dysfunction B. Pharyngitis, asthenia C. Breast tenderness, edema D. Hyperglycemia, leukocytosis
A. Breast atrophy, sexual dysfunction Feedback: Breast atrophy and sexual dysfunction may be seen as adverse reactions of goserelin acetate therapy. Pharyngitis and asthenia are seen with the use of anastrozole. Breast tenderness and edema are seen with drugs such as estramustine. Hyperglycemia and leukocytosis are seen as adverse reactions of mitotane.
A nurse is caring for a client receiving norethindrone for endometriosis. After administering the drug, the nurse would assess the client for which of the following? Select all that apply. A. Breast tenderness B. Edema C. Somnolence D. Hyperglycemia E. Thinning hair
A. Breast tenderness B. Edema Feedback: Adverse reactions associated with norethindrone, a progestin, include breast tenderness, edema, insomnia, breakthrough bleeding, weight changes, and acne. Hyperglycemia and thinning hair are not associated with norethindrone.
The nurse is preparing to administer a prescribed drug to help prevent hemorrhage caused by uterine atony. Which drug would the nurse most likely administer? Select all that apply. A. Carboprost (Hemabate) B. Indomethacin (Indocin) C. Methylergonovine (Methergine) D. Terbutaline (Brethine) E. Misoprostol (Cytotec)
A. Carboprost (Hemabate) C. Methylergonovine (Methergine) E. Misoprostol (Cytotec) Feedback: Carboprost (Hemabate), methylergonovine (Methergine), misoprostol (Cytotec), and ergonovine (ergotrate) are used postpartum to prevent hemorrhage caused by uterine atony. Indomethacin and Terbutaline are used as tocolytics.
After reviewing information about estrogens and their use, the instructor determines that the teaching was successful when the students identify which of the following as true? Select all that apply. A. Changes in lipids levels occur with the use of estrogens B. Progestin use is recommended when estrogen is used after a hysterectomy C. Estrogen replacement therapy (ERT) helps to lessen the changes to the aging tissues D. Estrogens increase a woman's risk for gallbladder disease E. The use of estrogens is associated with relatively few adverse reactions
A. Changes in lipids levels occur with the use of estrogens C. Estrogen replacement therapy (ERT) helps to lessen the changes to the aging tissues D. Estrogens increase a woman's risk for gallbladder disease Feedback: Estrogens can relieve symptoms of menopause but can lead to blood pressure and lipid changes. ERT can help lessen the changes to aging tissues, but the estrogen does increase a woman's risk for gallbladder disease. The addition of progestin is recommended when estrogen alone may be used for estrogen replacement therapy after a hysterectomy. The administration of estrogen by any route may result in many adverse reactions, although these reactions vary in incidence and intensity.
A client is receiving methylergonovine (Methergine). After administering the drug, the nurse would be alert for which of the following? Select all that apply. A. Chest pain B. Hypoglycemia C. Increase in blood pressure D. Diarrhea E. Water intoxication
A. Chest pain C. Increase in blood pressure D. Diarrhea Feedback: Adverse reactions associated with methylergonovine include temporary chest pain, hypertension, diarrhea, nausea, vomiting, dizziness, and headache.
A nurse understands that methylergonovine (Methergine) should not be administered to which client because excessive vasoconstriction may result? Select all that apply. A. Client who is a heavy smoker B. Client taking a diuretic C. Client receiving insulin D. Client taking an antihypertensive E. Client taking a vasopressor
A. Client who is a heavy smoker E. Client taking a vasopressor Feedback: When methylergonovine (Methergine) is administered concurrently with vasopressors or to clients who are heavy smokers, excessive vasoconstriction may result.
Immediately before starting an IV infusion of oxytocin (Pitocin), the nurse assesses which of the following? Select all that apply. A. Client's blood pressure B. Fetal heart rate C. Client's blood glucose D. Client's temperature E.. Client's respiratory rate
A. Client's blood pressure B. Fetal heart rate E. Client's respiratory rate Feedback: Immediately before starting an IV infusion of oxytocin (Pitocin), the nurse assesses the fetal heart rate and the client's blood pressure, pulse, and respiratory rate.
A client is to receive indomethacin as tocolytic therapy. Which of the following laboratory tests would the nurse expect to be performed as a baseline? Select all that apply. A. Complete blood count B. Serum creatinine level C. Liver function tests D. Amniotic fluid index E. Blood glucose level
A. Complete blood count B. Serum creatinine level C. Liver function tests D. Amniotic fluid index Feedback: Baseline laboratory testing includes a complete blood count, creatinine level, liver function tests, and amniotic fluid index. Blood glucose level may be done if diabetes is suspected or confirmed.
A client is receiving oxybutynin for treatment of overactive bladder. The client also takes haloperidol (Haldol) as an antipsychotic agent. What effect of the interaction of these two drugs should the nurse observe for in the client? A. Decreased effect of the antipsychotic drug B. Increased risk for bleeding C. Lowered plasma concentrations D. Increased effect of the antispasmodic drug
A. Decreased effect of the antipsychotic drug Feedback: The nurse should observe for decreased effectiveness of the antipsychotic drug in the client as the effect of the interaction of the antispasmodic drug and haloperidol. Increased risk for bleeding results from the interaction of oral anticoagulants with anti-infective drugs. Increased effect of the antispasmodic drug occurs with the interaction of an antispasmodic drug with a tricyclic antidepressant. Plasma concentrations are lowered due to the interaction of Fosfomycin, which is an anti-infective, with metoclopramide, which is used to relieve gastric upset.
A female client receiving fluoxymesterone for metastatic breast cancer is disturbed by the physical changes seen in her body. The nurse provides support to the client based on assessment of which of the following features the client is experiencing related to this therapy? A. Deepening of the voice B. Hypopigmentation of the skin C. Decrease in clitoris size D. Increase in body weight
A. Deepening of the voice Feedback: Deepening of the voice may be seen as a feature of virilization following male hormone therapy in a female client. Virilization is the acquisition of male characteristics in the female. Other features of virilization include pigmentation, and not hypopigmentation, of the skin and an increase, not a decrease, in the size of the clitoris. An increase in body weight is not a sign of virilization. It may occur due to impaired nutrition of the body.
A client is prescribed flavoxate. When reviewing the client's history, the nurse would expect to find which of the following complaints? Select all that apply. A. Dysuria B. Nocturia C. Leakage D. Suprapubic pain E. Inability to void
A. Dysuria B. Nocturia D. Suprapubic pain Feedback: Flavoxate, an antispasmodic, is used to relieve symptoms of dysuria, urinary urgency, Nocturia, suprapubic pain, and frequency and urge incontinence. Other antispasmodics are used to treat bladder instability, such as leakage caused by a neurogenic bladder. The drug is not used to treat an inability to void.
A client is prescribed finasteride to treat his symptoms of BPH. When teaching the client about this drug, the nurse would most likely include a discussion about the possibility of which of the following? A. Erectile dysfunction B. Dry mouth C. Constipation D. Decreased libido E. Weight gain
A. Erectile dysfunction D. Decreased libido Feedback: Androgen hormone inhibitors such as finasteride have been associated with the adverse reaction of erectile dysfunction and decreased libido. Dry mouth and constipation are associated with antispasmodics. Weight gain is associated with alpha-adrenergic blockers.
A nurse should monitor a client for which of the following adverse reactions during the administration of tocolytic therapy to prevent uterine contractions? Select all that apply. A. Fatigue B. Diaphoresis C. Diplopia D. Hypertension E. Prolonged vaginal bleeding
A. Fatigue B. Diaphoresis C. Diplopia Feedback: A nurse should monitor a client for the following adverse reactions during tocolytic therapy to prevent uterine contractions: fatigue, flushing, headache, diplopia, diaphoresis, hypotension, depressed reflexes, ad flaccid paralysis.
A nurse is administering magnesium to a client as part of therapy to halt preterm labor. The nurse is alert to the possibility of increased central nervous system depression if the client is also receiving which of the following? Select all that apply. A. Fentanyl (Duragesic) B. Glyburide (DiaBeta) C. Lorazepam (Ativan) D. Meperidine (Demerol) E. Enalapril (Vasotec)
A. Fentanyl (Duragesic) C. Lorazepam (Ativan) D. Meperidine (Demerol) Feedback: The administration of magnesium with the following drugs results in increased central nervous system depression: opioids (fentanyl and meperidine), sedatives (lorazepam), and analgesics.
A nurse is preparing to administer oxytocin (Pitocin) intravenously to a client based on the understanding that this drug is used for which of the following reasons? Select all that apply. A. Gestational diabetes and a large fetus B. Rh problems C. Premature rupture of membranes D. Uterine inertia E. Pregnancy-induced hypertension
A. Gestational diabetes and a large fetus B. Rh problems C. Premature rupture of membranes D. Uterine inertia E. Pregnancy-induced hypertension Feedback: A nurse may be asked to administer oxytocin (Pitocin) intravenously to a client with the following: gestational diabetes and a large fetus, Rh problems, premature rupture of membranes, uterine inertia, or pregnancy-induced hypertension.
A nurse is teaching a client about transdermal estrogen therapy. The nurse understands that this method of delivery has been found to be safer especially for women with which of the following conditions? Select all that apply. A. Hypertriglyceridemia B. Type 2 diabetes C. Migraine headaches D. Hypertension E. Rheumatoid arthritis
A. Hypertriglyceridemia B. Type 2 diabetes C. Migraine headaches D. Hypertension Feedback: Transdermal delivery of estrogens has been found to be safer especially for women with hypertriglyceridemia, type 2 diabetes, hypertension, and migraine headaches and those who smoke.
A nurse should advise a client beginning therapy with testosterone (Androderm) about which of the following adverse effect? Select all that apply. A. Impotence B. Fluid retention C. Male-pattern baldness D. Somnolence E. Mania
A. Impotence B. Fluid retention C. Male-pattern baldness Feedback: A nurse should advise a client beginning therapy with testosterone (Androderm) of the following adverse effects: Gynecomastia, testicular atrophy, inhibition of testicular function, impotence, enlargement of the penis, nausea, vomiting, jaundice, headache, anxiety, male-pattern baldness, acne, depression, and fluid and electrolyte imbalances (which include sodium, water, chloride, potassium, calcium, and phosphate retention).
A client taking oral contraceptive drugs complains of occasional bloating of the abdomen. Which of the following instructions should the nurse offer the client to help alleviate the condition? A. Limit fluid intake with meals B. Take the drug along with food C. Decrease the intake of salt D. Elevate the legs when sitting
A. Limit fluid intake with meals Feedback: The nurse should instruct the client to limit fluid intake with meals if she experiences bloating of the abdomen after oral contraceptive use. Light to moderate exercise also may be helpful. Taking the drug with food alleviates nausea and GI irritation, and not the bloating of the abdomen. A decrease in salt intake causes a decrease in the intake of sodium, which may be beneficial when there is an excess fluid volume, and not when there is bloating of the abdomen. Elevating the legs when sitting prevents thromboembolism seen with oral contraceptive use. It does not prevent bloating of the abdomen.
A client is receiving estrogen therapy. When teaching the client about this therapy, the nurse would inform the client about which of the following as a possible adverse reaction? Select all that apply. A. Migraines B. Breakthrough bleeding C. Changes in libido D. Weight gain E. Breast tenderness
A. Migraines B. Breakthrough bleeding C. Changes in libido D. Weight gain E. Breast tenderness Feedback: Adverse reactions associated with estrogens include headache, including migraines; breakthrough bleeding, spotting, or changes in menstrual flow; changes in libido; weight gain or loss; and breast pain, enlargement, and tenderness.
Prior to administering oxybutynin (Ditropan) to a client, the nurse should get a full medical history because the use of oxybutynin (Ditropan) is contraindicated in clients with which of the following? Select all that apply. A. Myasthenia gravis B. Urinary tract blockage C. Diabetes D. Intestinal blockage E. Hypertriglyceridemia
A. Myasthenia gravis B. Urinary tract blockage D. Intestinal blockage Feedback: The use of oxybutynin (Ditropan) is contraindicated in clients with the following: known hypersensitivity, glaucoma, myasthenia gravis, abdominal bleeding, and intestinal, gastric, or urinary tract blockages.
A group of nursing students are reviewing information about male and female hormones. The students demonstrate understanding of the information when they identify which of the following as an anabolic steroid? Select all that apply. A. Nandrolone B. Oxymetholone C. Oxandrolone D. Testosterone E. Fluoxymesterone
A. Nandrolone B. Oxymetholone C. Oxandrolone Feedback: Anabolic steroids include nandrolone, oxymetholone, and oxandrolone. Testosterone and fluoxymesterone are testosterones.
A client with estrogen excess may report which of the following symptoms to the nurse during ongoing assessment during treatment with Ortho-Novum 7/7/7? Select all that apply. A. Nausea B. Early breakthrough bleeding C. Cervical mucorrhea D. Edema E. Increased spotting
A. Nausea C. Cervical mucorrhea D. Edema Feedback: Signs of excess estrogen include nausea, bloating, cervical mucorrhea, polyposis, hypertension, migraine headache, breast fullness or tenderness, and edema.
When monitoring uterine contractions of a client receiving an oxytocin infusion, the nurse should notify the primary health care provider immediately if which of the following occur? Select all that apply. A. No palpable relaxation of the uterus B. Significant change in client's blood pressure C. Significant change in fetal heart rhythm D. Significant change in rhythm of uterine contractions E. Significant change in frequency of uterine contractions
A. No palpable relaxation of the uterus B. Significant change in client's blood pressure C. Significant change in fetal heart rhythm D. Significant change in rhythm of uterine contractions E. Significant change in frequency of uterine contractions Feedback: When monitoring uterine contractions, the nurse should notify the physician immediately if any of the following occur: a significant change in fetal heart rate of rhythm; a marked change in the frequency, rate, or rhythm of uterine contractions; uterine contractions lasting longer than 60 seconds; contractions occurring more frequently than every 2 to 3 minutes; no palpable relaxation of the uterus; a marked increase or decrease in the client's blood pressure or pulse; or any significant change in the client's general condition.
After teaching a group of students about uterine drugs, the instructor determines that the teaching was successful when the students identify which of the following oxytocic drugs? Select all that apply. A. Oxytocin (Pitocin) B. Methylergonovine (Methergine) C. Estradiol (Estrace) D. Indomethacin (Indocin) E. Misoprostol (Cytotec)
A. Oxytocin (Pitocin) B. Methylergonovine (Methergine) E. Misoprostol (Cytotec) Feedback: Oxytocin (Pitocin), methylergonovine (Methergine), and misoprostol (Cytotec) are classified as oxytocic drugs. Indomethacin is a tocolytic. Estradiol is an estrogen.
Before beginning an IV infusion of oxytocin (Pitocin) to induce labor, the nurse obtains an obstetric history that included which of the following? Select all that apply. A. Parity B. Stillbirths C. Abortions D. Previous obstetric problems E. Type of labor
A. Parity B. Stillbirths C. Abortions D. Previous obstetric problems E. Type of labor Feedback: Before beginning an IV infusion of oxytocin (Pitocin) to induce labor, the nurse obtains an obstetric history that includes parity, gravidity, previous obstetric problems, type of labor, stillbirths, abortions, and live-birth infant abnormalities.
A nurse prepares to administer oxytocin (Pitocin) intramuscularly during the third stage of labor for which of the following reasons? Select all that apply. A. Production of uterine contractions B. Stimulation of milk ejection C. Control of postpartum bleeding D. Initiation of labor E. Control of postpartum hemorrhage
A. Production of uterine contractions C. Control of postpartum bleeding E. Control of postpartum hemorrhage Feedback: Oxytocin (Pitocin) may be given intramuscularly during the third stage of labor to produce uterine contractions and control postpartum bleeding and hemorrhage.
A client receiving prescribed magnesium sulfate shows signs of dyspnea, tachycardia, and increased respiratory rate and rales. The nurse notices frothy sputum. Which of the following conditions should the nurse suspect? A. Pulmonary edema B. Water intoxication C. Renal failure D. Cardiac arrest
A. Pulmonary edema Feedback: The client is most likely experiencing pulmonary edema. If there is an increase in respiratory rate of more than 20 respirations/min with the administration of magnesium sulfate, the nurse should assess the respiratory status for symptoms of pulmonary edema such as dyspnea, tachycardia, rales, and frothy sputum. In such cases, the primary health care provider is notified immediately because use of the drug may be discontinued or the dosage may be decreased. The danger of water intoxication is associated with oxytocin as it has an antidiuretic effect, and not with magnesium sulfate. Renal failure and cardiac arrest are not associated with magnesium sulfate.
A nurse developing a teaching plan for a client who is prescribed testosterone gel. The nurse instructs the client to apply the gel to which location? Select all that apply. A. Shoulders B. Upper arms C. Abdomen D. Thighs E. Groin
A. Shoulders B. Upper arms C. Abdomen Feedback: Testosterone gel (AndroGel) is applied once daily (preferably in the morning) to clean, dry, intact skin of the shoulders, upper arms, or abdomen.
A nurse suspects that a client receiving an oxytocic drug is developing water intoxication based on assessment of which of the following? Select all that apply. A. Tachypnea B. Wheezing C. Confusion D. Hypoglycemia E. Hypotension
A. Tachypnea B. Wheezing C. Confusion Feedback: The nurse immediately reports any signs of water intoxication or fluid overload, which include drowsiness, confusion, headache, listlessness, wheezing, coughing, and tachypnea, to the physician.
Hormones may be used in cancer therapy, especially for advanced disease. Which of the following are hormones used as antineoplastic drugs? Select all that apply. A. Testolactone (Teslac) B. Leuprolide (Lupron) C. Megestrol (Megace) D. Bicalutamide (Casodex) E. Goserelin (Zoladex)
A. Testolactone (Teslac) B. Leuprolide (Lupron) C. Megestrol (Megace) E. Goserelin (Zoladex) Feedback: Testolactone (Teslac), Leuprolide (Lupron), Megestrol (Megace), Bicalutamide (Casodex), and goserelin (Zoladex) are hormones used as antineoplastic drugs.
When caring for a client receiving estrogen replacement therapy for postmenopausal symptoms, the nurse documents a diagnosis of Ineffective Tissue Perfusion. Which of the following conditions is the nurse referring to in the diagnosis? A. Thromboembolism B. Edema of the feet C. Gastrointestinal upset D. Chloasma
A. Thromboembolism Feedback: The nursing diagnosis of Ineffective Tissue Perfusion is related to thromboembolism, which is a complication of estrogen replacement therapy. A nurse may note other female hormone-related adverse reactions such as edema of the feet due to excess fluid volume or gastrointestinal upset, which manifests as nausea, vomiting, abdominal cramps, and bloating. Chloasma is a dermatologic reaction due to female hormones, which results in excessive pigmentation of the skin.
A female client is prescribed norethindrone (Aygestin). The nurse understands that this drug is indicated for which of the following? Select all that apply. A. Treatment of amenorrhea B. Treatment of edema C. Treatment of endometriosis D. Pregnancy prevention E. Prevention of estrogen-dependent breast carcinoma
A. Treatment of amenorrhea C. Treatment of endometriosis D. Pregnancy prevention Feedback: Progestins, like norethindrone (Aygestin), are used to treat amenorrhea, endometriosis, and functional uterine bleeding and to prevent pregnancy.
A nurse suspects a client might be abusing anabolic steroids. Which of the following signs might a client exhibit that would indicate abuse of anabolic steroids? Select all that apply. A. Uncontrolled rage B. Jaundice C. Inability to concentrate D. Acne E. Severe depression
A. Uncontrolled rage B. Jaundice C. Inability to concentrate D. Acne E. Severe depression Feedback: A client abusing anabolic steroids might exhibit the following signs: uncontrolled rage, severe depression, suicidal tendencies, malignant or benign liver tumors, aggressive behavior, inability to concentrate, personality changes, acne, jaundice, anorexia, male-pattern baldness, fluid and electrolyte imbalances, and muscle cramps.
A nurse educating a client on Ortho Tri-Cyclen Lo should strongly caution the client not to smoke because smoking increases the risk of which of the following adverse events? Select all that apply. A. Venous thromboembolism B. Arterial thromboembolism C. Hemorrhagic stroke D. Myocardial infarction E. Thrombotic stroke
A. Venous thromboembolism B. Arterial thromboembolism C. Hemorrhagic stroke D. Myocardial infarction E. Thrombotic stroke Feedback: Smoking while taking oral contraceptives, like Ortho Tri-Cyclen Lo, increases a client's risk for venous and arterial thromboembolism, myocardial infarction, and thrombotic and hemorrhagic stroke.
A nurse administering oxytocin (Pitocin) to a client should monitor the client should monitor the client for which of the following? Select all that apply. A. Water intoxication B. Diarrhea C. Uterine rupture D. Headache E. Cardiac arrhythmias
A. Water intoxication C. Uterine rupture E. Cardiac arrhythmias Feedback: A nurse should monitor a client receiving oxytocin (Pitocin) for the following adverse reactions: fetal bradycardia, uterine rupture, uterine hypertonicity, nausea, vomiting, cardiac arrhythmias, and anaphylactic reactions. Serious water intoxication (fluid overload, fluid volume excess) may occur, particularly when the drug is administered by continuous infusion and the patient is receiving fluids by mouth.
A nurse's preadministration assessment for a client about the receive oxymetholone (Anadrol-50) should include which of the following? Select all that apply. A. Weight B. Blood glucose C. Serum lipid levels D. Hepatic function tests E. Pain assessment
A. Weight C. Serum liquid levels D. Hepatic function tests Feedback: A nurse's preadministration assessment for a client about the receive oxymetholone (Anadrol-50) should include weight, blood pressure, pulse, respiratory rate, complete blood count, hepatic function tests, serum electrolytes, and serum lipid levels.
After reviewing the various contraceptive options with a client, the client opts for the etonogestrel/ethinyl estradiol vaginal ring. After teaching the client about this choice, the nurse determines that the teaching was effective when the client states which of the following? A. "Once I insert the ring, it won't come out" B. "The ring should stay in place for 3 weeks" C. "When bleeding starts, that's the signal to change the ring" D. "I can reuse the ring several times before discharging it"
B. " The ring should stay in place for 3 weeks" Feedback: When using the vaginal ring, the client should insert the ring and keep it in place for 3 weeks and then remove it on the same day of the week it was inserted. The ring can be expelled accidentally, such as with straining on defecation of removing a tampon. Typically, bleeding occurs once the ring is removed. The ring should be discarded after each use.
After teaching a client how to use an estradiol transdermal system, the nurse determines that the teaching was successful when the client states which of the following? Select all that apply. A. "I can put the patch on my breasts" B. "I should rotate the sites, staying away from the same site for about a week" C. "When I apply it, I should rub the patch vigorously for about 10 seconds" D. "I apply the patch immediately after I open the pouch" E. "If the area is oily or irritated, I need to avoid that area"
B. "I should rotate the sites, staying away from the same site for about a week" D. "I apply the patch immediately after I open the pouch. Feedback: When using a transdermal system, the client should apply the system immediately after opening the pouch with the adhesive side down, applying it to the clean, dry skin of the buttocks, truck, abdomen, upper inner thigh, or upper arm. The system should not be applied to the breasts, waistline, or a site exposed to sunlight. The area should not be oily or irritated. Once the patch is applied, the client should press on it firmly with the palm of the hand for about 10 seconds. The application site is rotated with at least 1-week intervals between applications to a particular site.
A nurse is caring for a pregnant client receiving oxytocin. The client is in the third stage of labor. The nurse would expect to administer oxytocin by which route? A. Intravenous B. Intramuscular C. Subcutaneous D. Intranasal
B. Intramuscular Feedback: Oxytocin is given intramuscularly (IM) during the third stage of labor. It is the time period from when the neonate is expelled until the placenta is expelled. Oxytocin is given intramuscularly to produce uterine contractions and control postpartum bleeding and hemorrhage. Oxytocin is not given intravenously, subcutaneously, or intranasally during the third stage of labor.
A nurse is describing the action of estrogen in the female body to a client. Which of the following would the nurse include? Select all that apply. A. Diuresis B. Calcium and phosphorus conservation C. Thinning of the cervical mucus D. Protein catabolism E. Stimulation of fallopian tube contraction
B. Calcium and phosphorus conservation C. Thinning of the cervical mucus E. Stimulation of fallopian tube contraction Feedback: The actions of estrogen of the female body include fluid retention, calcium and phosphorus conservation, protein anabolism, thinning of the cervical mucus, stimulation of fallopian tube contraction, growth of axillary and pubic hair, restoration of the endometrium after menstruation, and at puberty promotion of growth and development of the vagina, uterus, fallopian tubes, and breasts.
A nurse identifies a nursing diagnosis of Impaired Mucous Membranes based on the client's complaints of dry mouth for a client with urge incontinence who is receiving drug therapy. The nurse would most likely identify this nursing diagnosis as related to the use of which of the following? A. Sildenafil b. Fesoterodine C. Dutasteride D. Silodosin
B. Fesoterodine Feedback: Fesoterodine is an antispasmodic that can cause dry mouth. Sildenafil, Dutasteride, and silodosin are not associated with this adverse reaction.
A nurse is providing care to a client diagnosed with benign prostatic hypertrophy. The nurse understands that which of the following drugs inhibit the conversion of testosterone into 5-alpha-dihydrotestosterone (DHT), resulting in a decrease in prostate gland size? Select all that apply. A. Terazosin (Hytrin) B. Finasteride (Proscar) C. Methyltestosterone (Testred) D. Dutasteride (Avodart) E. Doxazosin (Cardura)
B. Finasteride (Proscar) D. Dutasteride (Avodart) Feedback: Finasteride (Proscar) and Dutasteride (Avodart) inhibit the conversion of testosterone into 5-alpha-dihydrotestosterone (DHT), which results in a decrease in prostate gland size, making them useful in the treatment of benign prostatic hypertrophy.
Nurses who are pregnant or may become pregnant should not handle which drugs if they are crushed or broken due to the drugs' substantial risk of abnormal growth to a male fetus? Select all that apply. A. Methyltestosterone (Testred) B. Finasteride (Proscar) C. Testosterone (Striant) D. Dutasteride (Avodart) E. Oxandrolone (Oxandrin)
B. Finasteride (Proscar) D. Dutasteride (Avodart) Feedback: Women of childbearing age should not handle androgen hormone inhibitors, such as Finasteride (Proscar) or Dutasteride (Avodart) tablets, if they are crushed or broken due to the drugs' substantial risk of abnormal growth to a male fetus.
A 30-year-old pregnant woman has been prescribed oxytocin. When assessing the client's drug regimen, the nurse understands that the client is taking vasopressors. Which of the following risks is the client most susceptible to if oxytocin is administered along with vasopressors? A. Anaphylactic shock B. Hypertension C. Respiratory failure D. Heart attack
B. Hypertension Feedback: Combining oxytocin with vasopressor drugs increases the risk of severe hypertension. Combining oxytocin and vasopressors does not increase the risk of heart attack or respiratory failure. Anaphylactic shock is associated with a hypersensitivity reaction and does not occur with the interaction of vasopressors and oxytocin.
A nurse may be asked to administer androgen drugs to clients with which of the following medical conditions? Select all that apply. A. Anemia of renal insufficiency B. Hypogonadism C. Postmenopausal metastatic breast carcinoma D. Male-pattern baldness E. Benign prostatic hypertrophy
B. Hypogonadism C. Postmenopausal metastatic breast carcinoma Feedback: A nurse may be asked to administer androgen drugs to clients with the following medical conditions: testosterone deficiency after puberty, postmenopausal metastatic breast carcinoma, and premenopausal, hormone-dependent metastatic breast carcinoma.
A nurse is preparing to administer a drug that is used to prevent uttering contractions. Which drug might the nurse be preparing to administer? Select all that apply. A. Misoprostol (Cytotec) B. Indomethacin (Indocin) C. Terbutaline (Brethine) D. Oxytocin (Pitocin) E. Dinoprostone (Cervidil)
B. Indomethacin (Indocin) C. Terbutaline (Brethine) Feedback: Tocolytics, like indomethacin (Indocin) and Terbutaline (Brethine), are used to prevent uterine contractions. Misoprostol and oxytocin are uterine stimulants. Dinoprostone is used to ripen the cervix.
A client is receiving terbutaline for preterm labor. After administering the drug, the nurse would be alert for which of the following as an adverse reaction? Select all that apply. A. Diplopia B. Nervousness C. Tremor D. Palpitations E. Heartburn
B. Nervousness C. Tremor D. Palpitations Feedback: Adverse reactions associated with terbutaline include nervousness, restlessness, tremor, headache, anxiety, hypertension, palpitations, arrhythmias, hypokalemia, and pulmonary edema. Diplopia and heartburn are associated with indomethacin.
A 32-year-old pregnant woman has been prescribed an IV infusion of oxytocin to induce labor. Which of the following interventions would be most appropriate for the nurse to implement before starting the IV infusion of oxytocin for the client? A. Ask the client to drink plenty of water B. Obtain an obstetric and general health history C. Examine for signs of water intoxication D. Place the client in an upright position
B. Obtain an obstetric and general health history Feedback: Before starting an IV infusion of oxytocin to induce labor, the nurse should obtain a complete obstetric history (e.g., parity, gravidity, previous obstetric problems, type of labor, stillbirths, abortions, live-birth infant abnormalities) and a general health history. Clients should not have water before labor, as the oxytocin may lead to water intoxication. The nurse would examine for any signs of water intoxication or fluid overload as a sign of an adverse reaction to the drug and need not assess this before administration of the medication. Placing the client in an upright position is advised when oxytocin is administered intranasally to facilitate the letdown of milk for breastfeeding.
A 31-year-old pregnant woman has been prescribed a tocolytic drug. The nurse understand that this drug is primarily indicated for which of the following? A. Antepartal hypertension B. Preterm labor C. Postpartum hemorrhage D. Protracted labor
B. Preterm labor Feedback: Drugs used to prevent uterine contractions are called tocolytics. They are useful in the management of preterm labor. These drugs will decrease uterine activity and prolong the pregnancy to allow the fetus to develop more fully, thereby increasing the chance of neonatal survival. Oxytocic drugs are used antepartum (before birth of the neonate) to induce uterine contractions and initiate or augment labor. Tocolytics are not used for postpartum hemorrhage or protracted labor.
A client is beginning therapy with prescribed terazosin for treatment of BPH. Based on the nurse's understanding of the action of this drug, the nurse would identify which nursing diagnosis as most likely? A. Acute Pain B. Risk for Injury C. Impaired Mucous Membranes D. Deficient Knowledge
B. Risk for Injury Feedback: Terazosin, an antiadrenergic drug, can cause a hypotensive reaction. Thus, the client may experience an immediate lowering of blood pressure when first starting this drug and be at risk for injury. Acute Pain would be more appropriate for a client experiencing priapism from erectile dysfunction drugs. Impaired Mucous Membranes would be appropriate for the client receiving antispasmodics. Deficient Knowledge could apply to any client receiving medication.
A nurse is conducting a presentation for a group of middle-aged women about menopause and the changes that occur to the female genitourinary system. Which of the following would the nurse include in the discussion? Select all that apply. A. Lengthening of the vaginal wall B. Slowed rate of lubrication during sexual arousal C. Decreased risk of yeast infection from pH changes D. Weakening of the pelvic floor muscles E. Thinning of the vaginal walls
B. Slowed rate of lubrication during sexual arousal D. Weakening of the pelvic floor muscles E. Thinning of the vaginal walls Feedback: Genitourinary changes associated with aging include thinning of the vaginal walls with shortening and loss of elasticity; decreased lubrication with a slowing of the rate during sexual arousal; increased risk of yeast infections due to changes in the pH of the environment; and weakening of the pelvic floor muscles, which can lead to stress incontinence.
When explaining the action of oxytocin to a client, the nurse integrates knowledge of which of the following about the drug? Select all that apply. A. Secretion by the anterior pituitary gland B. Uterine-stimulating properties C. Diuretic effects D. Vasopressor effects E. Stimulation of milk ejection
B. Uterine-stimulating properties D. Vasopressor effects E. Stimulation of milk ejection Feedback: Oxytocin is a hormone secreted by the posterior pituitary gland that has uterine-stimulating properties, exerts antidiuretic and vasopressor effects, and stimulates milk ejection.
A nurse educating a client receiving tolterodine (Detrol) should warn the client about which of the following common adverse reactions? Select all that apply. A. Anorexia B. Xerostomia C. Decreased lacrimation D. Blurred vision E. Diarrhea
B. Xerostomia C. Decreased lacrimation E. Diarrhea Feedback: Common adverse reactions seen with the use of tolterodine (Detrol) include xerostomia, drowsiness, constipation, headache, decreased lacrimation, decreased sweating, GI disturbances, blurred vision, and urinary hesitancy.
A client has a levonorgestrel implant contraceptive system inserted. The nurse understands that this type of contraceptive provides protection for how long? A. 1 year B. 2 years C. 5 years D. 8 years
C. 5 years Feedback: Levonorgestrel, a progestin, is available as an implant contraceptive system (Norplant System). Six capsules, each containing levonorgestrel , are implanted using local anesthesia in the subdermal (below the skin) tissues of the midportion of the upper arm. The capsules provide contraceptive protection for 5 years but may be removed at any time at the request of the patient.
After teaching a group of nursing students about drugs used to treat genitourinary problems in the older adult, the instructor determines that the teaching was successful when the students identify which of the following as an alpha-adrenergic blocker used to treat BPH? Select all that apply. A. Darifenacin B. Oxybutynin C. Alfuzosin D. Tamsulosin E. Raloxifene
C. Alfuzosin D. Tamsulosin Feedback: Alpha-adrenergic drugs to hear BPH include alfuzosin and tamsulosin. Darifenacin and oxybutynin are antispasmodics. Raloxifene is a miscellaneous agent used to prevent and treat osteoporosis.
A nurse is caring for a client with advanced breast cancer who is receiving androgen therapy. Which of the following signs might alert the nurse to the possibility of liver toxicity? A. Edema of the feet B. Increase in appetite C. Clinical jaundice D. Increase in weight
C. Clinical jaundice Feedback: Liver toxicity is indicated by the presence of jaundice. Edema of the feet and an increase in weight may be seen because of fluid and electrolyte imbalance but does not indicate liver toxicity. An increase in appetite shows that the client is responding well to the drug and is not a sign of liver toxicity.
After teaching a group of nursing students about drugs that affect the uterus, the instructor determines that the teaching was successful when the students identify which drug as being used for cervical ripening? A. Terbutaline B. Nifedipine C. Dinoprostone D. Misoprostol
C. Dinoprostone Feedback: Dinoprostone is a cervical ripening agent. Terbutaline and Nifedipine are used for tocolysis. Misoprostol is used as a uterine stimulant.
A client with progestin excess may report which of the following symptoms to the nurse during ongoing assessment during treatment with Estrostep Fe? Select all that apply. A. Amenorrhea B. Late breakthrough bleeding C. Hair loss D. Weight gain E. Hirsutism
C. Hair loss D. Weight gain E. Hirsutism Feedback: Signs of excess progestin include increased appetite, weight gain, tiredness, fatigue, hypomenorrhea, acne, oily scalp, hair loss, Hirsutism, depression, monilial vaginitis, and breast regression.
A client with benign hypertrophy of the prostate has heard claims that the herb saw palmetto can help relieve his symptoms. The client is eager to know more about this herb. Which of the following pieces of information should the nurse provide the client regarding the use of the herb? A. Take the herb at tea, prepared in hot water B. Improvement can be seen within 2 to 3 weeks C. It may delay the need for prostatic surgery D. Stop the herb after 3 months of intake
C. It may delay the need for prostatic surgery Feedback: The nurse should inform the client that saw palmetto might help delay the need for prostatic surgery. The active components are not water soluble and should not be taken as a tea. Improvement can be seen after 1 to 3 months of taking the herb, and not within 2 to 3 weeks. The herb intake should not be stopped after 3 months but should be continued for 6 months, followed by evaluation by the health care provider.
A client who is receiving a tocolytic develops hypotension. The nurse would notify the primary health care provider and place the client in which position? A. Supine B. Lithotomy C. Left lateral D. Knee-chest
C. Left lateral Feedback: If a client develops hypotension while receiving a tocolytic drug, the nurse would notify the primary health care provider and place the client in the left lateral position to promote adequate fetal perfusion until the provider orders otherwise.
A client is receiving estrogen therapy but also takes phenytoin for seizure control. The nurse would alert the client to the possibility of which of the following? A. Potential for blood clots B. Increased risk for infection C. Possibility of breakthrough bleeding D. Increased risk for seizures
C. Possibility of breakthrough bleeding Feedback: When estrogen is given with phenytoin, a hydantoin, the client is at increased risk for breakthrough bleeding. Blood clots can be an adverse reaction with estrogen therapy alone. There is no increased risk for infection. When given together, these drugs do not increase the risk for seizures.
A client has received a special formulation of oxytocin for intranasal use. The nurse understands that the rationale for using this formulation of the drug involves which effect? A. Antistimulating properties on the uterus B. Diuretic effect C. Stimulation of the milk ejection reflex D. Control of antepartum bleeding
C. Stimulation of the milk ejection reflex Feedback: Oxytocin, when administered intranasally, stimulates the milk ejection (milk letdown) reflex. Oxytocin has uterine-stimulating properties, not Antistimulating properties, on the uterus. Tocolytics have an Antistimulating effect on the uterus. Oxytocin has an antidiuretic effect, which might lead to a danger of excessive fluid volume (water intoxication), and not a diuretic effect. Oxytocin is given IM during the third stage of labor to produce uterine contractions and control postpartum, and not antepartum, bleeding and hemorrhage.
A client comes to the emergency department and reports that he is in extreme pain. Physical assessment reveals priapism. When obtaining the client's medication history, which of the following would the nurse expect the client to report using? A. Tamsulosin B. Terazosin C. Tadalafil D. Tolterodine
C. Tadalafil Feedback: Priapism occurs with the use of phosphodiesterase type 5 inhibitors, such as Tadalafil. It is not associated with use of antiadrenergic drugs or antispasmodics.
A nurse is conducting a presentation for a young adult women's group about oral contraceptives and the risks. Which of the following would the nurse include as an increased risk? A. Fibrocystic breast disease B. Ovarian cysts C. Endometrial cancer D. Hepatic adenoma
D. Hepatic adenoma Feedback: The risks of hepatic adenoma may be increased with the use of oral contraceptives. Oral contraceptives also increase the risk of cardiovascular diseases, thromboembolic disorders, strokes, visual disturbances, gallbladder disease, hypertension, and fetal abnormalities. The risks of fibrocystic breast disease, ovarian cysts, and endometrial cancer are decreased, not increased, with the use of oral contraceptives.
A client with delayed puberty has been advised to undertake transdermal androgen therapy, Androderm. Which of the following instructions should the nurse provide the client to help promote an optimal response to this therapy? A. Apply the Androderm to the underside of the scrotum. B. Repeat the application to the scrotum after 3 days C. Moisten the skin before the application D. Apply immediately after removing the cover
D. Apply immediately after removing the cover Feedback: Applying the system immediately after opening the pouch and removing the protective cover may help obtain an optimal response to the transdermal androgen delivery system. The drug should not be applied to the underside of the scrotum. It is applied to clean, dry skin on the abdomen, thigh, back, or upper arm. Thus, the skin should not be moistened before the application; rather, it should be dry. Seven days should be allowed between applications to a specific site, and application to the same site should not be repeated after 3 days.
A client is receiving tamsulosin for treatment of BPH. The client also has hypertension, for which he takes atenolol. Which assessment would be most important for the nurse to obtain? A. Temperature B. Pulse rate C. Respiratory rate D. Blood pressure
D. Blood pressure Feedback: Tamsulosin, an alpha-adrenergic blocker, when given with a beta blocker such as atenolol can cause an increase in hypotension. Therefore, assessment of the client's blood pressure would be most important.
An 80-year-old client with chronic renal insufficiency is prescribed anabolic steroid therapy for the management of anemia associated with renal insufficiency. The nurse understands that this client is at increased risk for which of the following? A. Hypoglycemic attacks B. Serious cardiac disease C. Hypotensive shock D. Cancer of the prostate
D. Cancer of the prostate Feedback: Elderly clients undergoing anabolic steroid therapy are at an increased risk of developing cancer of the prostate gland. Therefore, anabolic steroid therapy needs to be administered cautiously in these clients. Hypoglycemic attacks, serious cardiac disease, and hypotensive shock are not seen in elderly clients on anabolic steroid therapy.
A nurse is teaching a client about the use of estradiol (Estrace). The nurse warns the client of which of the following dermatologic reactions that may continue after drug discontinuation? Select all that apply. A. Dermatitis B. Stevens-Johnson syndrome C. Pruritus D. Chloasma E. Melasma
D. Chloasma E. Melasma Feedback: Chloasma and melasma are dermatologic reactions that can result from the use of estrogens, like estradiol (Estrace), and may continue when use of the drug is discontinued.
