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5. A nurse is caring for a client who has angina and asks about obtaining a prescription for sildena l to treat erectile dysfunction. Which of the following medications is contraindicated with sildena l? A. Aspirin B. Isosorbide C. Clopidogrel D. Atorvastatin E. Inhibiting ovulation

5. A. Aspirin is contraindicated in clients who have a bleeding disorder, but there are no contradictions for concurrent use of sildena l. B. CORRECT: Isosorbide is an organic nitrate that manages pain from angina. Concurrent use of it is contraindicated because fatal hypotension can occur. The client should avoid taking a nitrate medication for 24 hr after taking isosorbide. C. Clopidogrel is contraindicated in clients who are actively bleeding, but there is no contradiction for concurrent use of clopidogrel and sildena l. D. Atorvastatin is contraindicated in clients who have hepatic disease, but there is no contradiction for concurrent use of atorvastatin and sildena l.

5. A nurse is reviewing a new prescription for terbutaline with a client who has a history of preterm labor. Which of the following client statements indicates understanding of the teaching? A. "I can increase my activity now that I've started on this medication." B. "I will increase my daily uid intake to 3 quarts." C."I will report increasing intensity of contractions to my doctor." D."I am glad this will prevent preterm labor."

5. A. The action of terbutaline is to relax uterine smooth muscle. Clients taking this medication are instructed to limit activity, which stimulates smooth muscle, to delay preterm labor. B. Fluid intake should be limited to 2,400 mL/day. C. CORRECT: The client should report increasing intensity, frequency, or duration of contractions to the provider because these are manifestations of preterm labor. D. Terbutaline delays preterm labor; it does not prevent it.

"A patient will be receiving chemotherapy with IV cladribine (Leustatin). The order reads, "Give 0.09 mg/kg each day for 7 days." The medication is to be added to 500 mL of normal saline and is available in a 1-mg/mL solution. The patient weighs 200 pounds." "How many mg is each daily dose?" "How many milliliters of medication will be added to each infusion?"

8.2 mg 8.2 mL

A patient wants to try an oral soy product to relieve perimenopausal symptoms. The nurse will assess the patient's medication history for which potential drug interaction? A. Thyroid replacement therapy B. Oral anticoagulant therapy C. Nonsteroidal anti-inflammatory drugs D. Beta blockers

A woman is preparing for a 10 hour trans-Atlantic flight. She has been taking the SERM raloxifene (Evista) for 6 months. The nurse will provide which instructions to this patient? A. She needs to stop taking the drug at least 72 hours before the trip. B. She must remember to take this drug with a full glass of water each morning. C. She will not take the drug while traveling on the plane. D. No change in how the drug is taken will be needed.

The nurse recognizes that the risk of osteoporosis is higher in an individual with which risk factor? A. White or Asian race B. African-American race C. History of participation in active sports D. Obesity

One patient has cancer of the bone; another has cancer in the connective tissues of the thigh muscles; a third patient has cancer in the vascular tissues. Which of these is the correct term for these tumors? a. Sarcoma b. Leukemia c. Carcinoma d. Lymphoma

A (Sarcomas are malignant tumors that arise from connective tissues. These tissues can be found in bone, cartilage, muscle, blood, lymphatic, and vascular tissues. The other options are incorrect.)

The nurse is monitoring a patient who has severe bone marrow suppression following antineoplastic drug therapy. Which is considered a principal early sign of infection? a. Fever b. Diaphoresis c. Tachycardia d. Elevated white blood cell count

A (Fever and/or chills may be the first sign of an oncoming infection. Elevated white blood cell count will not occur because of the bone marrow suppression. The other options are incorrect.)

During treatment of a patient who has brain cancer, the nurse hears the oncologist mention that the patient has reached the "nadir." The nurse knows that this term means which of these? a. The lowest level of neutrophils reached during therapy. b. The highest level of neutrophils reached during therapy. c. The point at which the adverse effects of chemotherapy will stop. d. The point at which the cytotoxic action against cancer cells is the highest.

A (The lowest neutrophil count reached after a course of chemotherapy is known as the nadir. The other options are incorrect.)

A woman who lives in Seattle is preparing to take a plane trip to London. She has been taking the SERM raloxifene (Evista) for 6 months. The nurse will provide which instructions to this patient? a. She needs to stop taking the drug at least 72 hours before the trip. b. She must remember to take this drug with a full glass of water each morning. c. She will not take the drug while traveling on the plane. d. No change in how the drug is taken will be needed.

A A patient taking a SERM must be informed to discontinue the drug 72 hours before and during prolonged immobility so as to prevent the development of a thrombosis.

The nurse is reviewing the medication list of a patient who will be starting androgen therapy. Which drug classes, if taken with androgens, may have an interaction with them? a. Oral anticoagulants b. Nitrates c. Beta blockers d. Proton pump inhibitors

A Androgens, when used with oral anticoagulants, can significantly increase or decrease anticoagulant activity. The other options are incorrect.

A Fever and/or chills may be the first sign of an oncoming infection. Elevated white blood cell count will not occur because of the bone marrow suppression. The other options are incorrect.

When a male patient is receiving androgen therapy, the nurse will monitor for signs of excessive androgens such as: a. fluid retention. b. dehydration. c. restlessness. d. visual changes.

A Fluid retention is an undesirable effect of androgens. The other options are incorrect.

A 21-year-old male athlete admits to using androgenic steroids. The nurse tells him that which of these is a possible adverse effect of these drugs? a. Liver damage b. Renal failure c. Heart failure d. Stevens-Johnson syndrome

A Peliosis of the liver, the formation of blood-filled cavities, is a potential effect of androgenic anabolic steroid therapy and may be life threatening. Other serious hepatic effects are hepatic neoplasms (liver cancer), cholestatic hepatitis, jaundice, and abnormal liver function. The other options are incorrect.

The nurse recognizes that the risk of osteoporosis is higher in an individual with which risk factor? a. White or Asian race b. African-American race c. History of participation in active sports d. Obesity

A Risk factors for postmenopausal osteoporosis include white or Asian descent, slender body build, early estrogen deficiency, smoking, alcohol consumption, low-calcium diet, sedentary lifestyle, and family history of osteoporosis.

A Sarcomas are malignant tumors that arise from connective tissues. These tissues can be found in bone, cartilage, muscle, blood, lymphatic, and vascular tissues. The other options are incorrect.

A The lowest neutrophil count reached after a course of chemotherapy is known as the nadir. The other options are incorrect.

Combinations of chemotherapeutic drugs are frequently used for which purpose? (Select all that apply.) A. Preventing drug resistance B. Providing a synergistic action C. Decreasing cost of treatment D. Decreasing the severity of adverse effects E. Decreasing drug tolerance

A B D Administering a combination of antineoplastic drugs allows for smaller doses of each, which can minimize the severity of side effects and help prevent drug resistance. Additionally, there is a synergistic action between some of the medications. Decreasing cost is not a benefit of combination therapy.

A patient is prescribed sildenafil for erectile dysfunction. Which is the best time to take the dose? A) 1 hour before sexual intercourse B) 2 hours before sexual intercourse C) 30 minutes before sexual intercourse D) 10 minutes before sexual intercourse

A) 1 hour before sexual intercourse

Which medication is an alpha 1-adrenergic blocker? A) Alfuzosin B) Goserelin C) Nilutamide D) Nandrolone

A) Alfuzosin

A patient is sterile because of low testosterone levels. Which other complication should the nurse suspect in this patient? A) Anemia B) Fatty liver C) Hyperacidity D) Hypoglycemia

A) Anemia

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? A) Baldness B) Infertility C) Hypertension D) Benign prostate hyperplasia (BPH)

A) Baldness

A patient receiving finasteride has increased hair growth. What is the nurse's priority action? A) Continue to assess. B) Hold the medication. C) Measure testosterone levels. D) Call the health care provider.

A) Continue to assess.

What primary roles does testosterone play in the male body? A) Helps in production of red blood cells B) Helps development of facial hair in men C) Triggers better metabolic bodily functions D) Helps develop the male sex characteristics E) Triggers erectile dysfunction (ED), leading to delayed ejaculation

A) Helps in production of red blood cells B) Helps development of facial hair in men D) Helps develop the male sex characteristics

Which conditions are contraindications for treatment with testosterone? A) Pregnancy B) Oligospermia C) Renal disease D) Hypogonadism E) Hepatic disease

A) Pregnancy C) Renal disease E) Hepatic disease

The nurse is instructing a male patient about application of transdermal testosterone gel (AndroGel). Which body location is preferred for this medication? (Select all that apply.) a. Back b. Chest c. Thigh d. Scrotum e. Abdomen f. Upper arms

A, C, E, F AndroGel is applied to the skin of the back, abdomen, upper arms, or thighs. Testoderm patches are applied to the scrotal skin.

The nurse notes in a patient's medication history that the patient is taking the synthetic androgen danazol (Danocrine). Indications for danazol include which conditions? (Select all that apply.) a. Endometriosis b. Decreased sexual libido c. Postpartum breast engorgement d. Fibrocystic breast disease in women e. Hereditary angioedema f. Metastatic breast cancer

A, D, E Danazol is used to treat hereditary angioedema and to treat women who have endometriosis or fibrocystic breast disease. The other options are incorrect.

How would the nurse define the term nadir to a patient? A. The average number of days it takes the bone marrow to recover from a dose of chemotherapy B. The average number of days it takes for chemotherapy to have its peak effect on the bone marrow C. The patient's tolerance to the chemotherapy's bone marrow suppressant effect Incorrect D. The maximum dose for a chemotherapy drug in reference to bone marrow suppression

B Nadir refers to the average number of days it takes for a chemotherapeutic drug to have its peak effect on the bone marrow, which would coincide with the patient's lowest blood count and highest risk for infection and/or bleeding.

The nurse is administering a combination of three different antineoplastic drugs to a patient who has metastatic breast cancer. Which statement best describes the rationale for combination therapy? a. There will be less nausea and vomiting. b. Increased cancer-cell killing will occur. c. The drugs will prevent metastasis. d. Combination therapy reduces the need for radiation therapy.

B Because drug-resistant cells commonly develop, exposure to multiple drugs with multiple mechanisms and sites of action will destroy more subpopulations of cells. The other options are incorrect.

The nurse is preparing to administer the contraceptive form of medroxyprogesterone (DepoProvera). What route is appropriate? a. Subcutaneous b. Intramuscular c. Vaginal d. Transdermal

B Depo-Provera is a progestin-only injectable contraceptive that is given by the intramuscular route. The other options are incorrect.

A patient, diagnosed with lymphoma, has an allergy to one of the proposed chemotherapy drugs. The tumor has not responded to other types of treatment. The nurse expects the oncologist to follow which course of treatment? a. The physician will choose another drug to use. b. The chemotherapy will be given along with supportive measures to treat a possible allergic reaction. c. The patient will receive reduced doses of chemotherapy for a longer period of time. d. The chemotherapy cannot be given because of the patient's allergy.

B Even if a patient has a known allergic reaction to a given antineoplastic medication, the urgency of treating the patient's cancer may still necessitate administering the medication and then treating any allergic symptoms with supportive medications, such as antihistamines, corticosteroids, and acetaminophen.

During the administration of finasteride (Proscar), the nurse must remember which important precaution? a. It must be taken on an empty stomach. b. It must not be handled by pregnant women. c. It is given by deep intramuscular injection to avoid tissue irritation. d. The patient needs to be warned that alopecia is a common adverse effect.

B Finasteride must not be handled by pregnant women because of its teratogenic effects. It is taken orally and without regard to meals. The other options are incorrect.

A patient is receiving high doses of methotrexate and is experiencing severe bone marrow suppression. The nurse expects which intervention to be ordered with this drug to reduce this problem? a. A transfusion of whole blood b. Leucovorin rescue c. Therapy with filgrastim (Neupogen) d. Administration of allopurinol (Zyloprim)

B High-dose methotrexate is associated with bone marrow suppression, and it is always given in conjunction with the rescue drug leucovorin, which is an antidote for folic acid antagonists. Basically, leucovorin rescues the healthy cells from methotrexate. The other options are incorrect.

A 73-year-old male patient is in the clinic for a yearly physical and is asking for a prescription for sildenafil (Viagra). He has listed on his health history that he is taking a nitrate for angina. The nurse is aware that which problem may occur if sildenafil is taken with a nitrate? a. Significant increase in pulse rate b. Significant decrease in blood pressure c. Increased risk of bleeding d. Reduced effectiveness of the sildenafil

B In patients with pre-existing cardiovascular disease, especially those on nitrates, erectile dysfunction drugs such as sildenafil lower blood pressure substantially, potentially leading to more serious adverse events. The other options are incorrect.

The nurse is administering oxytocin (Pitocin). Which situation is an indication for the use of oxytocin? a. Decreased fetal heart rate and movements b. Stimulation of contractions during labor c. Cervical ripening near term in pregnant patients d. To reverse premature onset of labor

B Oxytocin is used to induce labor at or near full-term gestation and to enhance labor when uterine contractions are weak and ineffective.

The nurse is reviewing infection-prevention measures with a patient who is receiving antineoplastic drug therapy. Which statement by the patient indicates the need for further teaching? a. "I will avoid those who have recently had a vaccination." b. "I will eat only fresh fruits and vegetables." c. "I will report a sore throat, cough, or low-grade temperature." d. "It is important for both my family and me to practice good hand washing."

B Patients who are neutropenic and susceptible to infections need to adhere to a low-microbe diet by washing fresh fruits and vegetables and making sure foods are well cooked. The other options are correct.

During a follow-up visit, a patient who has been on estrogen therapy admits that she has continued to smoke cigarettes. The nurse will remind the patient that smoking while on estrogen may lead to increased: a. incidence of nausea. b. risk for thrombosis. c. levels of triglycerides. d. tendency to bleed during menstruation.

B Smoking should be avoided during estrogen therapy because it adds to the risk for thrombosis formation. The other options are incorrect.

A patient who is taking the bisphosphonate alendronate (Fosamax) has been instructed to lie flat in bed for 2 days after having ophthalmic surgery. Which intervention is appropriate at this time? a. She will continue to take the alendronate with water. b. She cannot take the alendronate until she can sit up for 30 minutes. c. She can take the medication with breakfast. d. She will stop taking the medication 72 hours before her surgery.

B The nurse must emphasize that the patient should remain upright in either a standing or sitting position for approximately 30 minutes after taking a bisphosphonate so as to help prevent esophageal erosion or irritation. Because this patient will be required to lie flat in bed for 2 days after the surgery, the prescriber will need to be notified that the patient cannot take the medication during this time.

The nurse is reviewing the use of uterine tocolytics, such as indomethacin (Indocin). Which statement best describes the indication for these drugs? a. Prevention of preterm labor in the 15th week of pregnancy b. Prevention of preterm labor in the 22nd week of pregnancy c. Stimulation of contractions in prolonged labor d. Stimulation of ovulation as part of infertility treatments

B Tocolytics relax uterine smooth muscles and stop the uterus from contracting and are used along with nonpharmacologic measures to prevent preterm labor between 20 and 37 weeks of pregnancy.

Which are general adverse effects of chemotherapy? (Select all that apply.) A. Leukocytosis B. Thrombocytopenia C. Alopecia D. Urinary retention E. Hypertension

B C Bone marrow suppression (leukopenia, thrombocytopenia, and anemia) and alopecia are common adverse reactions to antineoplastic drugs. Urinary retention, hypertension, and leukocytosis are not expected side effects.

Which is an off-label use of oxandrolone? A) Anemia B) Alcoholic hepatitis C) Hereditary angioedema D) Metastatic breast cancer

B) Alcoholic hepatitis

Which is a contraindication to the use of nandrolone? A) Metastatic breast cancer B) Androgen-sensitive tumor C) Male hormone replacement D) To reverse muscle debilitation

B) Androgen-sensitive tumor

The nurse will administer testosterone to a patient. Which route will provide the best absorption? A) Oral B) Buccal C) Injection D) Transdermal

B) Buccal

Which condition is an indication for a primary health care provider to prescribe danazol for a female patient? A) Facial hair B) Endometriosis C) High testosterone levels D) Cardiovascular disorder

B) Endometriosis

The nurse is caring for a patient receiving androgen therapy. For which conditions is androgen therapy indicated? A) Priapism B) Endometriosis C) Prostate cancer D) Hypergonadism E) Refractory anemias

B) Endometriosis E) Refractory anemias

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

B) It helps stop a growing prostate.

Which medication is used to treat baldness in both men and women? A) Sildenafil B) Minoxidil C) Finasteride D) Methyltestosterone

B) Minoxidil

Which group of college students does the nurse need to include in a teaching session on the risks of androgen abuse? A) Students who are often tardy B) Students who are on athletic teams C) Students who do not socialize well in school D) Students who perform extraordinarily in class

B) Students who are on athletic teams

The nurse is assessing a patient at a follow-up visit after starting treatment with sildenafil for erectile dysfunction. Which assessment finding would indicate that the treatment needs to be revised? A) The patient's cardiac output is 5.6 L/min. B) The patient's blood pressure is 90/60 mm Hg. C) The patient verbalizes the ability to maintain an erection. D) The patient does not have dry mouth, nausea, or vomiting.

B) The patient's blood pressure is 90/60 mm Hg.

An older adult female patient is receiving the progestin drug megestrol (Megace). Which is the most likely reason megestrol is ordered for this patient? A. Migraine headaches B. Osteoporosis C. Appetite stimulant D. Reduction of hot flashes

The nurse is providing teaching for a patient who is to receive progestin therapy. Which statement is correct to include in the teaching session? A. "If you miss a dose, double-up on the next dose." B. "There's no need to be concerned about breast lumps or bumps that occur." C. "Be sure to report any weight gain of 5 pounds or more per week." D. "Take the medication on an empty stomach to enhance absorption."

When considering the various types of contraceptive drugs, the nurse is aware that which type most closely duplicates the normal hormonal levels of the female menstrual cycle? A. Monophasic B. Biphasic C. Triphasic D. Short acting

Current research has lead to discovery of cancer-causing viruses. Which virus that is linked to cancer can be prevented by vaccination in humans? A. Rous sarcoma virus B. Shope papillomavirus C. Human papillomavirus D. Leukemia viruses

C Extensive research has indicated that there are cancer-causing viruses that can affect most mammalian species. Examples include human papillomavirus (HPV in humans), the various cat leukemia viruses, the Rous sarcoma virus in chickens, and the Shope papillomavirus in rabbits. The HPV now has a vaccination on market which is likely to decrease the chance of getting the virus which can lead to several different types of cancers.

Nausea and vomiting are frequent adverse effects associated with antineoplastic therapy. Patients who are experiencing this unpleasant effect will be advised A. to avoid eating any food during chemotherapy. B. that nothing can be done for this effect and that it will pass with time. C. to try to maintain hydration and nutrition, which are very important during treatment. D. to use antacids to relieve the irritation to the stomach, which should stop the nausea.

C It is very important for patients undergoing chemotherapy to maintain adequate nutrition and hydration. Several antiemetic drugs are available that are very successful in controlling this side effect.

A patient who has been on methotrexate therapy is experiencing mild pain. The patient is asking for aspirin for the pain. The nurse recognizes that which of these is true in this situation? a. The aspirin will aggravate diarrhea. b. The aspirin will masks signs of infection. c. Aspirin can lead to methotrexate toxicity. d. The aspirin will cause no problems for the patient on methotrexate.

C (Methotrexate interacts with weak organic acids, such as aspirin, and can lead to toxicity by displacing the methotrexate from protein-binding sites.)

A patient is receiving oxytocin (Pitocin) to induce labor. During administration of this medication, the nurse will also implement which action? a. Giving magnesium sulfate along with the oxytocin b. Administering the medication in an intravenous (IV) bolus c. Administering the medication with an IV infusion pump d. Monitoring fetal heart rate and maternal vital signs every 6 hours

C Oxytocin is infused via an infusion pump, not via an IV bolus. Magnesium sulfate is not administered with oxytocin. Fetal heart rate and maternal vital signs should be monitored continuously.

A patient is receiving irinotecan (Camptosar), along with other antineoplastic drugs, as treatment for ovarian cancer. The nurse will monitor for which potentially life-threatening adverse effect that is associated with this drug? a. Severe stomatitis b. Bone marrow suppression c. Delayed-onset cholinergic diarrhea d. Immediate and severe nausea and vomiting

C In addition to producing hematologic adverse effects, irinotecan has been associated with severe diarrhea, known as cholinergic diarrhea, which may occur during infusions. Delayed diarrhea may occur 2 to 10 days after infusion of irinotecan. It is recommended that this condition be treated with atropine unless use of that drug is strongly contraindicated. This diarrhea can be severe and even life threatening.

An older adult female patient is receiving the progestin drug megestrol (Megace). Which is the most likely reason megestrol is ordered for this patient? a. Migraine headaches b. Osteoporosis c. Appetite stimulant d. Reduction of hot flashes

C Megestrol can cause appetite stimulation and weight gain, and therefore is used in the management of anorexia, cachexia, or unexplained substantial weight loss in patients with acquired immunodeficiency syndrome (AIDS) and in patients with cancer. The other options are incorrect.

C Methotrexate interacts with weak organic acids, such as aspirin, and can lead to toxicity by displacing the methotrexate from protein-binding sites.

The nurse is providing teaching for a patient who is to receive estrogen replacement therapy. Which statement is correct to include in the teaching session? a. "If you miss a dose, double-up on the next dose." b. "There's no need to be concerned about breast lumps or bumps that occur." c. "Be sure to report any weight gain of 5 pounds or more per week." d. "Take the medication on an empty stomach to enhance absorption."

C Patients taking oral estrogen therapy should report weight gain of 5 pounds or more per week to a physician. The other statements are not true for estrogen replacement therapy.

A patient is to receive testosterone therapy via a transdermal patch. He asks the nurse, "Why am I getting a patch? Can't I just take a pill?" Which response by the nurse is correct? a. "The patch reduces the incidence of side effects." b. "If you don't take the patch, you will have to have injections instead." c. "The patch allows for better absorption of the medication." d. "You will only have to change the patch weekly."

C The transdermal form allows for better absorption of testosterone because of its high first-pass effect. Oral forms are poorly absorbed, and the transdermal form is preferable to an injection and is preferred for hormonal replacement therapy. The patch is changed daily.

When considering the various types of contraceptive drugs, the nurse is aware that which type most closely duplicates the normal hormonal levels of the female menstrual cycle? a. Monophasic b. Biphasic c. Triphasic d. Short acting

C The triphasic drugs most closely duplicate the normal hormonal levels of the female menstrual cycle. The other options are incorrect.

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? A) Impaired liver function B) Impaired thyroid activity C) Increased fluid retention D) Impaired lipid metabolism

C) Increased fluid retention

Of which adverse effect should the nurse be cognizant while providing care for a patient taking finasteride? A) Depression B) Hypotension C) Loss of libido D) Peliosis of the liver

C) Loss of libido

The nurse would question a prescription for estrogen replacement therapy in a patient with a history of which condition? a. Dysmenorrhea b. Deep vein thrombosis c. Vaginal bleeding d. Weight loss

Correct Answer: b b. Deep vein thrombosis Rationale: Increased coagulation and risk of deep vein thrombosis are serious adverse effects of hormone replacement therapy and is a Black Box Warning noted on many hormonal medications.

When teaching a patient who is taking oral contraceptive therapy for the first time, the nurse relates that adverse effects may include which of the following? (select all that apply) a. dizziness b. nausea c. tingling in the extremities d. breast tenderness e. fluid retention

Correct Answer: b, d, e b. nausea d. breast tenderness e. fluid retention

A woman comes into the emergency department. She says that she is pregnant and that she is having contractions every 3 minutes but she is "not due yet." She is very upset. While assessing her vital signs and fetal heart tones, what is the most important question the nurse must ask the patient? a. "What were you doing when the contractions started?" b. "Are you preregistered at this hospital to give birth?" c. "How many weeks have you been pregnant?" d. "Have you felt the baby move today?"

Correct Answer: c c. "How many weeks have you been pregnant?"

A patient is receiving her third course of 5-fluorouracil therapy and knows that stomatitis is a potential adverse effect of antineoplastic therapy. What will the nurse teach her about managing this problem? a. "You can take aspirin to prevent stomatitis." b. "Be sure to watch for and report black, tarry stools immediately." c. "You need to increase your intake of foods containing fiber and citric acid." d. "Be sure to examine your mouth daily for bleeding, painful areas, and ulcerations."

D (The symptoms of stomatitis consist of pain or burning in the mouth, difficulty swallowing, taste changes, viscous saliva, dryness, cracking, and fissures, with or without bleeding mucosa. Teach patients to avoid consuming foods containing citric acid and foods that are hot or spicy or high in fiber. Assessing stools is important but is not related to stomatitis, and aspirin must not be used during this therapy.)

A 63-year-old male patient is scheduled for a physical examination, and he tells the nurse that he wants to start taking a vitamin formula that includes saw palmetto for prostate health. Which is the nurse's best response? a. "I've heard many good things about saw palmetto." b. "It's not a good idea to start herbal therapy at your age." c. "There are very few adverse effects with saw palmetto therapy." d. "The doctor will need to draw some blood and do a digital rectal exam first."

D A prostatic-specific antigen test and digital rectal examination needs to be performed before initiation of treatment with saw palmetto for benign prostatic hyperplasia. Adverse effects may include gastrointestinal upset, headache, back pain, and dysuria.

The nurse is developing a plan of care for a patient who is experiencing gastrointestinal adverse effects, including anorexia and nausea, after the first course of antineoplastic therapy. What is an appropriate outcome for this patient when dealing with this problem? a. The patient will eat three balanced meals a day within 2 days. b. The patient will return to normal eating pattern within 4 weeks. c. The patient will maintain normal weight by consuming healthy snacks as tolerated. d. The patient will maintain a diet of small, frequent feedings with nutrition supplements within 2 weeks.

D Consuming small, frequent meals with nutritional supplements, and maintaining a bland diet help to improve nutrition during antineoplastic therapy.

The nurse recognizes that use of estrogen drugs is contraindicated in which patient? a. A patient who has atrophic vaginitis b. A patient who has inoperable prostate cancer c. A woman who has just given birth and wants to prevent postpartum lactation d. A woman with a history of thrombophlebitis

D Estrogenic drugs are contraindicated in people who have active thromboembolic disorders and in those with histories of thromboembolic disease. Atrophic vaginitis and inoperable prostate cancer are potential indications for estrogen therapy. Estrogen is not used to prevent lactation.

A patient is being treated for secondary amenorrhea. The nurse expects which drug to be used to treat this problem? a. Methylergonovine (Methergine) b. Estradiol transdermal (Estraderm) c. Raloxifene (Evista) d. Medroxyprogesterone (Provera)

D Medroxyprogesterone, a progestin, is one of the drugs most commonly used for secondary amenorrhea. Secondary amenorrhea is not an indication for the other drugs listed.

The nurse notes in a female patient's history that she has an order for the androgen methyltestosterone (Android). Based on this finding, the nurse interprets that the patient has which disorder? a. Fibrocystic breast disease b. Hereditary angioedema c. Hypertension d. Inoperable breast cancer

D Methyltestosterone can be used in cases of inoperable breast cancer in women. The other options are incorrect.

A woman visits a health center requesting oral contraceptives. Which laboratory test is most important for the nurse to assess before the patient begins oral contraceptive therapy? a. Complete blood count b. Serum potassium level c. Vaginal cultures d. Pregnancy test

D Pregnancy should be ruled out before beginning oral contraceptive therapy because the medications can be harmful to the fetus; they are classified as pregnancy category X.

A 51-year-old woman will be taking selective estrogen receptor modulators (SERMs) as part of treatment for postmenopausal osteoporosis. The nurse reviews potential contraindications, including which condition? a. Hypocalcemia b. Breast cancer c. Stress fractures d. Venous thromboembolism

D SERMs such as raloxifene are contraindicated in women with a venous thromboembolic disorder, including deep vein thrombosis, pulmonary embolism, or a history of such disorders. The other options are incorrect.

D The symptoms of stomatitis consist of pain or burning in the mouth, difficulty swallowing, taste changes, viscous saliva, dryness, cracking, and fissures, with or without bleeding mucosa. Teach patients to avoid consuming foods containing citric acid and foods that are hot or spicy or high in fiber. Assessing stools is important but is not related to stomatitis, and aspirin must not be used during this therapy.

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

D) "I should take the tablet 1 hour before intercourse."

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

D) "The seminiferous tubules produce testosterone."

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

D) 3 to 6 months

A patient who reports difficulty passing urine is prescribed finasteride by the primary health care provider. What condition should the nurse suspect to have caused difficulty in urination? A) Renal calculi B) Neurogenic bladder C) Urinary tract infection D) Benign prostatic hyperplasia

D) Benign prostatic hyperplasia

What are the clinical uses of sildenafil? A) Treatment of hypoglycemia B) Treatment of liver disorders C) Treatment of hypothyroidism D) Treatment of erectile dysfunction E) Treatment of pulmonary hypertension

D) Treatment of erectile dysfunction E) Treatment of pulmonary hypertension

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? A) Lipid profile B) Liver function test C) Exercise tolerance test D) Ultrasonography of the fetus

D) Ultrasonography of the fetus

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? A) Vardenafil reduces the efficacy of nitroglycerin. B) Vardenafil may cause erectile dysfunction in patients. C) Vardenafil is contraindicated for use in elderly patients. D) Vardenafil causes hypotension if taken with nitroglycerin.

D) Vardenafil causes hypotension if taken with nitroglycerin.

A patient taking oral contraceptives is being treated for a urinary tract infection with antibiotics. What information would the nurse include as education related to the oral contraceptives? a. "There is no drug interaction between oral contraceptives and antibiotics." b. "Report any abdominal pain, blood in the urine, or changes in vision." c. "Use an alternative method of birth control for up to 1 month during and after antibiotic use." d. "Your sexual partner should use a nonprescription test kit that will detect a urinary tract infection."

Correct Answer: c c. "Use an alternative method of birth control for up to 1 month during and after antibiotic use." Rationale: When a patient takes oral contraceptives and is prescribed an antibiotic, the oral contraceptive effectiveness can be decreased, and an alternative method of birth control should be used for at least 1 month during and after taking certain antibiotics.

The nurse is assessing a patient who is to receive dinoproston (Prostin E2). Which condition would be a contraindication to the use of this drug? a. Pregnancy at 15 weeks' gestation b. GI upset or ulcer disease c. Ectopic pregnancy d. Incomplete abortion

Correct Answer: c c. Ectopic pregnancy

What is the most common drug used for induction of labor in pregnant women and to promote ejection of milk during lactation? a. Mifepristone b. Misoprostol c. Oxytocin d. Clomiphene

Correct Answer: c c. Oxytocin Rationale: Oxytocin is a naturally occurring hormone that can be given in synthetic form for induction of labor.

A female patient arrives to the clinic for counseling on potential hormone replacement therapy. When taking the patient's history, what condition would the nurse consider as a contraindication to use of hormone replacement therapy for the patient? a. Osteoporosis b. Hyperlipidemia c. Thromboembolic events d. Early onset of menarche

Correct Answer: c c. Thromboembolic events Rationale: A contraindication for estrogen administration is any history of thromboembolic disorder.

The nurse is discussing therapy with clomiphene (Clomid) with a husband and wife who are considering trying this drug as part of treatment for infertility. It is important that they be informed of which possible effect of this drug? a. increased menstrual flow b. increased menstrual cramping c. multiple pregnancy (twins or more) d. sedation

Correct Answer: c c. multiple pregnancy (twins or more)

The nurse is reviewing the use of obstetric drugs. Which situation is an indication for an oxytocin (Pitocin) infusion? a. termination of a pregnancy at 12 weeks b. hypertonic uterus c. cervical stenosis in a patient who is in labor d. induction of labor at full term

Correct Answer: d d. induction of labor at full term

Which condition does the nurse anticipate when assessing a patient with tumor lysis syndrome? A. Hyperuricemia B. Hypophosphatemia C. Hypokalemia D. Hypercalcemia

Correct answer: A Rationale: Manifestations of tumor lysis syndrome include hyperphosphatemia, hyperkalemia, and hypocalcemia. These electrolyte abnormalities are often treated with diuretics such as mannitol, IV calcium supplementation, oral or rectal potassium exchange resin, and oral aluminum hydroxide. Hyperuricemia can lead to nephropathy, and hemodialysis may be required in severe cases of tumor lysis syndrome.

"A patient will be receiving daily doses of aspara- ginase (Elspar). The order is for 200 units/kg/day up to 40,000 units per dose IV. The patient weighs 275 pounds. How many units will the patient re- ceive per dose? Is this dose within the safe limit?

"25,000 units; yes"

"Mr. B. has just undergone a series of chemotherapeu- tic treatments when it is discovered that the antineo- plastic drug has leaked into surrounding tissues; in other words, __________ of the drug has occurred."

"Extravasation"

Which daily dose of finasteride is prescribed 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

1. A nurse is reviewing the health care record of a client who is asking about conjugated equine estrogens. The nurse should inform the client this medication is contraindicated in which of the following conditions? A. Atrophic vaginitis B. Dysfunctional uterine bleeding C. Osteoporosis D. Thrombophlebitis

1. A. Atrophic vaginitis occurs when there is estrogen de ciency. This medication is used to treated atrophic vaginitis. B. Dysfunctional uterine bleeding can occur when there is estrogen de ciency. This medication is used to treat dysfunctional uterine bleeding. C. Women are at risk for osteoporosis after the onset of menopause. Estrogen is used to slow the progression of osteoporosis. D. CORRECT: Estrogen increases the risk of thrombolytic events. Estrogen use is contraindicated for a client who has a history of thrombophlebitis.

1. A nurse is teaching a client about terbutaline. Which of the following statements by the client indicates understanding of the teaching? A. "This medication will stop my contractions." B. "This medication will prevent vaginal bleeding." C."This medication will promote blood ow to my baby." D."This medication will increase my prostaglandin production."

1. A. CORRECT: Terbutaline blocks beta2‐adrenergic receptors, which causes uterine smooth muscle relaxation. B. Terbutaline is used to suppress preterm labor and does not prevent bleeding. C. Terbutaline causes smooth muscle relaxation and does not promote placental blood ow. D. Terbutaline suppresses uterine contractions and does not increase prostaglandin production.

The nurse at the fertility clinic is instructing a patient about the adverse effects of clomiphene. Which effects would 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

A patient receiving finasteride has increased hair growth. Which nursing action is correct? 1. Continue to assess. 2. Hold the medication. 3. Measure testosterone levels. 4. Call the health care provider.

1. Continue to assess.

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 would the nurse instruct the patient to use a different method of birth control? 1. For at least 1 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 1 month after starting the antibiotic

Which information does the nurse provide to a patient regarding how oral contraceptives prevent pregnancy? 1. Inhibition of the release of gonadotropins 2. Diminished endometrial tissue proliferation 3. Interference with the proliferation of the fertilized ovum 4. Elevated progesterone levels inhibiting the release of the luteinizing hormone

1. Inhibition of the release of gonadotropins

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

1. Nausea

A patient has been taking sildenafil for erectile dysfunction. The patient reports episodes of dizziness and fainting spells after using this drug. For which other drug would the nurse assess while taking the drug history of the patient? 1. Nitrates 2. Antibiotics 3. Alpha agonists 4. Anticoagulants

1. Nitrates

A patient is to receive medroxyprogesterone (Depo-Provera) 700 mg weekly, intramuscularly, as part of palliative therapy for endometrial cancer. The medication is available in vials of 400 mg/mL. Identify how many milliliters will the nurse draw up and administer with each injection. (record answer using one decimal place)

1.8 mL

A patient who has been taking sildenafil has developed angina. The health care provider has prescribed isosorbide mononitrate. Which instruction will the nurse give the patient? 1. "Take your blood pressure before either medication." 2. "Do not take the sildenafil." 3. "Take the medications on opposite days." 4. "Take the isosorbide mononitrate before the sildenafil."

2. "Do not take the sildenafil."

2. A nurse is providing teaching to a female client who is taking testosterone to treat advanced breast cancer. The nurse should tell the client that which of the following are adverse effects of this medication? (Select all that apply.) A. Deepening voice B. Weight gain C. Low blood pressure D. Dry mouth E. Facial hair

2. A. CORRECT: Virilization, the development of adult male characteristics in a female, is an adverse effect of testosterone. The nurse should tell the client that a deepening voice is an adverse effect of testosterone. B. CORRECT: Edema and weight gain are adverse effects of testosterone. C. high blood pressure is an adverse effect of this medication. D. Nasal congestion is an adverse effect of this medication, not dry mouth. E. CORRECT: Virilization is an adverse effect of testosterone. The nurse should tell the client that the development of facial hair is an adverse effect of testosterone.

2. A nurse is caring for a client who has preeclampsia and is receiving magnesium sulfate IV continuous infusion. Which of the following ndings should the nurse report to the provider? A. 2+ deep tendon re exes B. 2+ pedal edema C. 24 mL/hr urinary output D. Respirations 12/min

2. A. This is an expected nding and does not need to be reported to the provider. B. This is an expected nding and does not need to be reported to the provider. C. CORRECT: Urine output less than 25 to 30 mL/hr is associated with magnesium sulfate toxicity and should be reported to the provider. D. A respiratory rate of 12/min is an expected nding and does not need to be reported to the provider.

Testosterone has which functions in the body? 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

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

2. Clomiphene

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 follicle-stimulating hormone (FSH)

2. Decreased level of progesterone

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

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

2. Indomethacin

The nurse would 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

Which group of college students does the nurse need to include in a teaching session on the risks of androgen abuse? 1. Those often tardy 2. Team athletes 3. Those who do not socialize well 4. High class performers

2. Team athletes

The nurse is assessing a patient at a follow-up visit after starting treatment with sildenafil for erectile dysfunction. Which assessment finding would indicate that the treatment needs to be revised? 1. The patient's cardiac output is 5.6 L/min. 2. The patient's blood pressure is 90/60 mm Hg. 3. The patient verbalizes the ability to maintain an erection. 4. The patient does not have dry mouth, nausea, or vomiting.

2. The patient's blood pressure is 90/60 mm Hg.

A patient is to receive a daily dose of fludarabine (Fludara), 25 mg/m2 /day for 5 consecutive days. Each dose is diluted in a 125-mL bag of normal saline and is to infuse over 30 minutes. The nurse will set the infusion pump to what rate in milliliters per hour? ______

250 mL/hr

The order for chemotherapy reads: "Give asparaginase (Elspar) IV 200 units/kg/day." The patient weighs 297 lb. The pharmacy department will prepare the medication for intravenous infusion. How much drug will be given per dose? Is this a safe dose?

27,000 units; yes

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."

3. A nurse is explaining the mechanism of action of combination oral contraceptives to a group of clients. The nurse should tell the clients that which of the following actions occur with the use of combination oral contraceptives? (Select all that apply.) A. Thickening the cervical mucus B. Inducing maturation of ovarian follicle C. Increasing development of the corpus luteum D. Altering the endometrial lining

3. A. CORRECT: Oral contraceptives cause thickening of the cervical mucus, which slows sperm passage. B. Inducing maturation of ovarian follicle is not an action of oral contraceptives. C. Increasing the development of the corpus luteum is not an action of oral contraceptives. D. CORRECT: Oral contraceptives alter the lining of the endometrium, which inhibits implantation of the fertilized egg. E. CORRECT: Oral contraceptives prevent pregnancy by inhibiting ovulation.

3. A nurse is caring for a client who has a new prescription for oxytocin to stimulate uterine contractions. Which of the following interventions should the nurse make? (Select all that apply.) A. Use an infusion pump for medication administration. B. Obtain vital signs frequently and with every dosage change. C. Stop infusion if uterine contractions occur every 4 min and last 45 seconds. D. Increase medication infusion rate rapidly. E. monitor fetal heart rate continuously.

3. A. CORRECT: Oxytocin must be administered by an infusion pump to ensure precise dosage. B. CORRECT: Vital signs are monitored to assess for hypertension, an adverse effect of oxytocin. C. Infusion should not be stopped because therapeutic effect has not been achieved. D. Oxytocin rate is increased gradually to prevent hypertonic uterine contractions. E. CORRECT: Continuous FhR monitoring is required to assess for fetal distress.

A pregnant patient is receiving magnesium sulfate to inhibit uterine contractions. The patient develops depressed reflexes and confusion. Which medication does the nurse anticipate administering? 1. Epinephrine 2. Protamine sulfate 3. Calcium gluconate 4. Atropine

3. Calcium gluconate

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

3. Esterified estrogens

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)

The U.S. Drug Enforcement Administration classifies anabolic steroids as Schedule III medications because they cause which adverse effects? 1. Endometriosis 2. Erectile dysfunction 3. Physical dependence 4. Sedation and hypnosis

3. Physical dependence

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

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."

4. A nurse is providing teaching to a client who will start alfuzosin for treatment of benign prostatic hyperplasia. The nurse should instruct the client that which of the following is an adverse effect of this medication? A. Bradycardia B. Edema C. hypotension D. Tremor

4. A. Alfuzosin can cause tachycardia. B. Alfuzosin can cause diarrhea or constipation. Edema is not an adverse effect of this mediation. C. CORRECT: Alfuzosin relaxes muscle tone in veins and cardiac output decreases, which leads to hypotension. Clients taking this medication are advised to rise slowly from a sitting or lying position. D. Alfuzosin can cause dizziness. Tremor is not an adverse effect of this medication.

4. A nurse is caring for a client who is in labor and receiving IV opioid analgesics. Which of the following actions should the nurse take? A. Instruct the client to self‐ambulate every 2 hr. B. Offer oral hygiene every 2 hr. C. Anticipate medication administration 2 hr prior to delivery. D. monitor fetal heart rate every 2 hr.

4. A. Clients should be assisted with ambulation due to the sedative effect of opioid analgesics. B. CORRECT: Oral hygiene should be offered on a regular basis to a client receiving opioid analgesics due to the adverse effects of dry mouth, nausea, and vomiting. C. Opioid analgesics should not be administered within 4 hr of delivery. D. Fetal heart rate should be monitored continuously in a client receiving opioid analgesics.

A patient tests positive for pregnancy even though she has been taking oral contraceptives. Which situation represents a possible cause of this unintended pregnancy? 1. Diabetes 2. Hypertension 3. Anticonvulsant therapy 4. Antibiotic therapy

4. Antibiotic therapy

A patient who reports difficulty passing urine is prescribed finasteride by the primary health care provider. Which condition would the nurse suspect to have caused difficulty in urination? 1. Renal calculi 2. Neurogenic bladder 3. Urinary tract infection 4. Benign prostatic hyperplasia

4. Benign prostatic hyperplasia

Anabolic steroids have which adverse effect? 1. Chest pain 2. Dermatitis 3. Tachycardia 4. Changes in libido

4. Changes in libido

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

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

A male patient is taking sildenafil. Which health problem would the nurse expect in the patient? 1. Gynecomastia 2. Decreased libido 3. Low sperm count 4. Erectile dysfunction

4. Erectile dysfunction

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

Which hormone initiates the cycle of events in the female ovary? 1. Antidiuretic hormone 2. Luteinizing hormone (LH) 3. Adrenocorticotropic hormone 4. Follicle-stimulating hormone (FSH)

4. Follicle-stimulating hormone (FSH)

Which method of administration is used for testosterone cypionate? 1. Oral 2. Topical 3. Transdermal 4. Intramuscular

4. Intramuscular

The nurse is providing care for a patient taking oxandrolone. Which test would the nurse evaluate to help prevent complications in the patient? 1. Glucose 2. Hematocrit 3. Hemoglobin 4. Liver function

4. Liver function

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 nurse finds that concentrated solutions of magnesium sulfate administered to prevent premature labor have caused toxicity in a patient. Which nursing intervention is most appropriate? 1. Obtain a prescription for terbutaline. 2. Decrease the drug dose immediately. 3. Obtain a prescription for indomethacin. 4. Request a prescription to give calcium gluconate.

4. Request a prescription to give calcium gluconate.

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

4. Termination of pregnancy

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.

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

The nurse is teaching a patient about the adverse effects of fertility drugs such as clomiphene (Clomid). Which is a potential adverse effect of this drug? A. Headache B. Drowsiness C. Dysmenorrhea D. Hypertension

The nurse is teaching a patient about the adverse effects of fertility drugs such as clomiphene (Clomid). Which is a potential adverse effect of this drug? a. Headache b. Drowsiness c. Dysmenorrhea d. Hypertension

A Headache is one of the possible adverse effects of the fertility drugs. They may also cause vomiting, restlessness, and urticaria. Drowsiness, dysmenorrhea, and hypertension are not potential adverse effects. See Table 34-5 for other adverse effects.

A patient wants to try an oral soy product to relieve perimenopausal symptoms. The nurse will assess the patient's medication history for which potential drug interaction? a. Thyroid replacement therapy b. Oral anticoagulant therapy c. Nonsteroidal anti-inflammatory drugs d. Beta blockers

A Orally administered soy may interfere with thyroid hormone absorption, so concurrent use must be avoided. The other options are incorrect.

Methotrexate is ordered for a patient with a malignant tumor, and the nurse is providing education about self-care after the chemotherapy is given. Which statements by the nurse are appropriate for the patient receiving methotrexate? (Select all that apply.) a. Report unusual bleeding or bruising. b. Hair loss is not expected with this drug. c. Prepare for hair loss. d. Avoid areas with large crowds or gatherings. e. Avoid foods that are too hot or too cold or rough in texture. f. Restrict fluid intake to reduce nausea and vomiting.

A, C, D, E Counsel patients who are taking methotrexate to expect hair loss and to report any unusual bleeding or bruising. Because of the possibility of infection, avoid areas with large crowds or gatherings. Foods that are too hot or too cold or rough in texture may be irritating to the oral mucosa. Fluid intake is to be encouraged to prevent dehydration.

The nurse is providing patient education for a patient taking an oral contraceptive. Which drugs may cause interactions with oral contraceptives? (Select all that apply.) A. Cephalexin (Keflex) B. Guaifenesin (Robitussin) C. Warfarin (Coumadin) D. Ibuprofen (Motrin) E. Theophylline (Uniphyl)

A, C, E

When giving chemotherapy as cancer treatment, the nurse recognizes that toxicity to rapidly growing normal cells also occurs. Which rapidly growing normal cells are also harmed by chemotherapy? (Select all that apply.) a. Bone marrow cells b. Retinal cells c. Hair follicle cells d. Nerve myelin cells e. Gastrointestinal (GI) mucous membrane cells

A, C, E Chemotherapy toxicities generally stem from the fact that chemotherapy drugs affect rapidly dividing cells—both harmful cancer cells and healthy, normal cells. Three types of rapidly dividing human cells are the cells of hair follicles, GI tract cells, and bone marrow cells. The other options are incorrect.

The nurse is providing patient education for a patient taking an oral contraceptive. Which drugs may cause interactions with oral contraceptives? (Select all that apply.) a. Cephalexin (Keflex) b. Guaifenesin (Robitussin) c. Warfarin (Coumadin) d. Ibuprofen (Motrin) e. Theophylline (Uniphyl)

A, C, E Patients must be educated about the need to use alternative birth control methods for at least 1 month during and after taking any of these drugs: antibiotics (especially penicillins and cephalosporins); barbiturates; isoniazid; and rifampin. The effectiveness of other drugs, such as anticonvulsants, beta blockers, hypnotics, antidiabetic drugs, warfarin, theophylline, tricyclic antidepressants, and vitamins, may be reduced when they are taken with oral contraceptives.

A.C.D.E (Counsel patients who are taking methotrexate to expect hair loss and to report any unusual bleeding or bruising. Because of the possibility of infection, avoid areas with large crowds or gatherings. Foods that are too hot or too cold or rough in texture may be irritating to the oral mucosa. Fluid intake is to be encouraged to prevent dehydration.)

A.C.E (Chemotherapy toxicities generally stem from the fact that chemotherapy drugs affect rapidly dividing cells—both harmful cancer cells and healthy, normal cells. Three types of rapidly dividing human cells are the cells of hair follicles, GI tract cells, and bone marrow cells. The other options are incorrect.)

A patient who is taking the bisphosphonate alendronate (Fosamax) has been instructed to lie flat in bed for 2 days after having ophthalmic surgery. Which intervention is appropriate at this time? A. She will continue to take the alendronate with water. B. She cannot take the alendronate until she can sit up for 30 minutes. C. She can take the medication with breakfast. D. She will stop taking the medication 72 hours before her surgery.

During a follow-up visit, a patient who has been on estrogen therapy admits that she has continued to smoke cigarettes. The nurse will remind the patient that smoking while on estrogen may lead to increased: A. incidence of nausea. B. risk for thrombosis. C. levels of triglycerides. D. tendency to bleed during menstruation.

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? A) Assess the patient's blood pressure. B) Perform a thorough history, including medication. C) Instruct the patient to take all cardiac medications first. D) Call the health care provider to change the prescription.

B) Perform a thorough history, including medication.

The nurse should inform a male patient about which potential type of cancer associated with testosterone therapy? A) Kidney cancer B) Prostate cancer C) Bladder cancer D) Intestine cancer

B) Prostate cancer

A patient is receiving oxytocin (Pitocin) to induce labor. During administration of this medication, the nurse will also implement which action? A. Giving magnesium sulfate along with the oxytocin B. Administering the medication in an intravenous (IV) bolus C. Administering the medication with an IV infusion pump D. Monitoring fetal heart rate and maternal vital signs every 2 hours

The nurse would anticipate administering which medication to patients receiving high-dose methotrexate (Trexall)? A. bleomycin (Blenoxane) B. cisplatin (Platinol) C. leucovorin D. dactinomycin (Cosmegen)

C Leucovorin is given to block the systemic toxic effect of high-dose methotrexate. It is a form of folic acid that does not require dihydrofolate reductase to produce folic acid. Therefore it is used to prevent or treat toxicity induced by methotrexate, a folic acid antagonist. All the other options are chemotherapeutic drugs, which are not specifically associated with methotrexate.

When teaching a patient receiving paclitaxel (Taxol), the nurse needs to prepare the patient for which adverse effect? A. Weight gain B. Vertigo C. Arthralgias D. Hypertension

C Myalgias and arthralgias are a common side effect of paclitaxel that the patient should be prepared to expect.

Which drug requires wearing gloves during administration? A) Minoxidil B) Stanozolol C) Dutasteride D) Tamsulosin

C) Dutasteride

The order reads "give calcitonin (Miacalcin) 100 international units subQ every other day." The medication is available in a vial that contains 200 international units/mL. How many mL will the nurse draw up in the syringe for this dose?

Correct Answer: 0.5 mL

When educating a patient about the use of oral contraceptives, the nurse provides what explanation for the pills having different colors each week? a. "The different color pills are because of different amounts of hormones in each week." b. "There isn't a reason for the color; it's just the choice of the drug company." c. "They help you remember which week you are taking." d. "They are color coded for the weeks of the month."

Correct Answer: a a. "The different color pills are because of different amounts of hormones in each week." Rationale: Oral contraceptive pills can be monophasic, biphasic, or triphasic. If the pills are different colors each week, they have different amounts of hormones and are likely the triphasic type of contraceptive.

The nurse has provided patient education regarding therapy with the SERM raloxifene (Evista). Which statement from the patient reflects a good understanding of the instruction? a. "when I take that long flight to Asia, I will need to stop taking this drug at least 3 days before I travel" b. "I can continue this drug even when traveling as long as I take it with a full glass of water each time" c. "after I take theis drug, I must sit upright for at least 30 minutes" d. "one advantage of this drug is that it will reduce my hot flashes"

Correct Answer: a a. "when I take that long flight to Asia, I will need to stop taking this drug at least 3 days before I travel"

An elderly female patient is being treated for osteoporosis with a selective estrogen receptor modulator (SERM). What condition note in the patient's history would be of concerns and indicate a need to notify the provider writing the SERM? a. Deep vein thrombosis b. Hypercalcemia c. Coronary heart disease d. Hypertension

Correct Answer: a a. Deep vein thrombosis Rationale: The use of SERMs is contraindicated in postmenopausal women with venous thromboembolic disorders, such as deep vein thrombosi

The nurse is caring for a patient who received chemotherapy 24 hours ago. The patient's white blood cell count is 4,400 mcL. Which symptom, if experienced by the patient, should the nurse report to the prescriber immediately? A. Fatigue B. Diarrhea C. Fever D. Nausea and vomiting

Correct answer: C Rationale: Fever is the principal early sign of infection, especially in those with a low white blood cell count. The presence of a fever is of utmost concern and should be reported immediately. Normal white blood cell count is 4,500-10,000 mcL.

Which condition is an indication of saw palmetto use? A) Dysuria B) Back pain C) Gastrointestinal upset D) Benign prostatic hyperplasia

D) Benign prostatic hyperplasia

The nurse notes that a patient is prescribed dutasteride. Which condition should the nurse suspect in the patient? A) Impotence B) Hypogonadism C) Testicular cancer D) Benign prostatic hyperplasia (BPH)

D) Benign prostatic hyperplasia (BPH)

Which is a benefit of synthetic androgens? A) Prolonged erection B) Increased hair growth C) Relief from fluid retention D) Enhancement of the male libido

D) Enhancement of the male libido

A male patient is taking sildenafil. What health problem should the nurse expect in the patient? A) Gynecomastia B) Decreased libido C) Low sperm count D) Erectile dysfunction

D) Erectile dysfunction

Which method of administration is used for testosterone cypionate? A) Oral B) Topical C) Transdermal D) Intramuscular

D) Intramuscular

Which action of finasteride helps in the treatment of benign prostatic hypertrophy? A) It relieves male urine retention. B) It relaxes the prostatic sphincter. C) It increases the penile blood flow. D) It inhibits the growth of the prostate.

D) It inhibits the growth of the prostate.

The nurse is providing care for a patient taking oxandrolone. Which test should the nurse evaluate to help prevent complications in the patient? A) Glucose B) Hematocrit C) Hemoglobin D) Liver function

D) Liver function

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? A) Sildenafil B) Doxazosin C) Finasteride D) Tamsulosin

D) Tamsulosin

Which drug is a Schedule III drug? A) Goserelin B) Minoxidil C) Doxazosin D) Testosterone

D) Testosterone

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? A) The patient is nonadherent to the medication. B) The patient may have hypersensitivity reaction. C) The patient may have increased risk of liver failure. D) The patient is responding effectively to the treatment.

D) The patient is responding effectively to the treatment.

"As the nurse is preparing to give the patient chemo- therapy, the patient asks the nurse why more than one drug is used. The nurse will explain that combinations of chemotherapeutic drugs are used to: a. reduce drug resistance. b. reduce the incidence of adverse effects. c. decrease the cost of treatment. d. reduce treatment time."

A patient is experiencing stomatitis after a round of chemotherapy. Which intervention by the nurse is correct? a Clean the mouth with a soft-bristle toothbrush and warm saline solution. b Rinse the mouth with commercial mouthwash twice a day. c Use lemon-glycerin swabs to keep the mouth moist. d Keep dentures in the mouth between meals.

"When administering antineoplastic drugs, the nurse needs to keep in mind that the general adverse ef- fects of these drugs include: (Select all that apply.) a. bone marrow suppression. b. infertility. c. diarrhea. d. urinary retention. e. nausea and vomiting. f. stomatitis."

a b c e f

"The nurse is monitoring a patient who has developed thrombocytopenia after two rounds of chemotherapy. Which signs or symptoms will the nurse look for in this patient? (Select all that apply.) a. Bruising b Increased fatigue c Ulcerations on mucous membranes inside the mouth d. Temperature above 100.5o F (38.1o C) e. Increased bleeding from venipunctures"

a e

"If extravasation of an antineoplastic drug occurs, what will the nurse do first? a. Remove the intravenous catheter immediately. b. Stop the drug infusion without removing the in- travenous catheter. c. Aspirate residual drug or blood from the tube if possible. d. Administer the appropriate antidote."

A patient receiving chemotherapy is experiencing severe bone marrow suppression. Which nursing diagnosis is most appropriate at this time? a Activity intolerance b Risk for infection c Disturbed body image d Impaired physical mobility

The nurse is caring for a patient who becomes severely nauseated during chemotherapy. Which intervention is most appropriate? a Encourage light activity during chemotherapy as a distraction. b Provide antiemetic medications 30 to 60 minutes before chemotherapy begins. c Provide antiemetic medications only upon the request of the patient. d Hold fluids during chemotherapy to avoid vomiting.

The nurse is assessing a patient who has experienced severe neutropenia after chemotherapy and will monitor for which possible signs of infection? (Select all that apply.) a Elevated WBC count b Fever c Nausea d Sore throat e Chills

b d e

"Ms. L. recently underwent biopsy of a lump near her breast. Several days later, her physician calls and tells her that the lump is noncancerous and therefore is not an immediate threat to life. She is relieved to hear, then, that it is __________."

benign

"During chemotherapy, the nurse will monitor the pa- tient for which symptoms of stomatitis? a. Indigestion and heartburn b. Severe vomiting and anorexia c. Pain or soreness of the mouth d. Diarrhea and perianal irritation"

If extravasation of an antineoplastic medication occurs, which intervention will the nurse perform first? a Apply cold compresses to the site while elevating the arm. b Inject subcutaneous doses of epinephrine around the IV site every 2 hours. c Stop the infusion immediately while leaving the catheter in place. d Inject the appropriate antidote through the IV catheter.

"A patient is receiving leucovorin as part of his che- motherapy regimen. The nurse expects that the patient is receiving which antineoplastic drug? a. cladribine (Leustatin) b. fluorouracil (Adrucil) c. vincristine (Vincasar PFS) d. methotrexate (Trexall)"

"A patient will be receiving chemotherapy with pacli- taxel (Taxol). What will the nurse expect to do along with administering this drug? a. Administer platelet infusions. b. Provide acetaminophen (Tylenol) as needed. c. Keep the patient on "nothing-by-mouth" status because of expected nausea and vomiting. d. Premedicate with a steroid, H2 receptor antago- nist, and antihistamine."

The nurse monitors a patient who is experiencing thrombocytopenia from severe bone marrow suppression by looking for a severe weakness and fatigue. b elevated body temperature. c decreased skin turgor. d excessive bleeding and bruising.

"Mr. Y.'s physician is not surprised to find that Mr. Y. has nausea and vomiting; the methotrexate therapy is displaying a strong __________ potential in this patient."

emetic

"Your patient is receiving methotrexate. Your instruc- tor asks for a full description of its mechanism of action, so you explain that it will inhibit dihydrofolic reductase from converting __________ acid to a reduced folate, and thus ultimately prevent the syn- thesis of DNA and cell reproduction. The result, you explain, is that the cell will die."

folic

"Mr. K. has been treated with methotrexate for its folate-antagonistic properties. Now, however, he seems to be experiencing a toxicity reaction. The treatment he will receive will be ________ rescue."

leucovorin

"Ms. P. had a biopsy performed on the same day that Ms. L. (6 Down) did. When her biopsy specimen is analyzed, however, the results are the opposite of Ms. L.'s; that is, her lump is considered __________."

malignant

A patient is receiving finasteride (Proscar) for treatment of benign prostatic hyperplasia. The nurse will tell him that a possible effect of this medication is: a. alopecia. b. increased hair growth. c. urinary retention. d. increased prostate size.

B Finasteride is given to reduce prostate size in men with benign prostatic hyperplasia. It has been noted that men taking this medication experience increased hair growth. The other options are incorrect.

The nurse is administering oxytocin (Pitocin). Which situation is an indication for the use of oxytocin? A. Decreased fetal heart rate and movements B. Stimulation of contractions during labor C. Cervical ripening near term in pregnant patients D. To reverse premature onset of labor

The nurse is preparing to administer the contraceptive form of medroxyprogesterone (Depo-Provera). What route is appropriate? A. Subcutaneous B. Intramuscular C. Vaginal D. Transdermal

The nurse is providing patient teaching about the oral bisphosphonate alendronate (Fosamax). Which statement by the patient indicates a good understanding of when this drug should be taken? A. "I will take it in the evening just before bedtime." B. "I will take it in the morning with an 8-ounce glass of water." C. "I will take it with the first bite of the morning meal." D. "I will take it between meals on an empty stomach."

The nurse is reviewing the use of uterine tocolytics, such as indomethacin (Indocin). Which statement best describes the indication for these drugs? A. Prevention of preterm labor in the 15th week of pregnancy B. Prevention of preterm labor in the 22nd week of pregnancy C. Stimulation of contractions in prolonged labor D. Stimulation of ovulation as part of infertility treatments

B (Because drug-resistant cells commonly develop, exposure to multiple drugs with multiple mechanisms and sites of action will destroy more subpopulations of cells. The other options are incorrect.)

B (Even if a patient has a known allergic reaction to a given antineoplastic medication, the urgency of treating the patient's cancer may still necessitate administering the medication and then treating any allergic symptoms with supportive medications, such as antihistamines, corticosteroids, and acetaminophen.)

B (High-dose methotrexate is associated with bone marrow suppression, and it is always given in conjunction with the rescue drug leucovorin, which is an antidote for folic acid antagonists. Basically, leucovorin rescues the healthy cells from methotrexate. The other options are incorrect.)

B (Patients who are neutropenic and susceptible to infections need to adhere to a low-microbe diet by washing fresh fruits and vegetables and making sure foods are well cooked. The other options are correct.)

The nurse is providing patient teaching about the oral bisphosphonate alendronate (Fosamax). Which statement by the patient indicates a good understanding of when this drug should be taken? a. "I will take it in the evening just before bedtime." b. "I will take it in the morning with an 8-ounce glass of water." c. "I will take it with the first bite of the morning meal." d. "I will take it between meals on an empty stomach."

B Bisphosphonates must be taken in the morning, with 6 to 8 ounces of plain water, to prevent esophageal erosion. In addition, the patient must sit upright for 30 minutes after taking them.

During a postpartum patient assessment, the nurse notes a boggy uterus and increased vaginal bleeding. Based on this assessment data, the nurse prepares to administer which medication? a. Oxytocin b. Dinoprostone c. Terbutaline d. Clomiphene

Correct Answer: a a. Oxytocin Rationale: Oxytocin is a uterine stimulant that causes uterine contractions, which would decrease the vaginal bleeding via the contract and treatment of the atonic uterus.

A patient calls the clinic because she realized she missed one dose of an oral contraceptive. Which statement from the nurse is appropriate? (select all that apply? a. "go ahead and take the missed dose now, along with today's dose." b. "don't worry, you are still protected from pregnancy." c. "please come to the clinic for a reevaluation of your therapy" d. "wait 7 days, and then start a new pack of pills" e. "you will need to use a backup form of contraception concurrently for 7 days"

Correct Answer: a, e a. "go ahead and take the missed dose now, along with today's dose." e. "you will need to use a backup form of contraception concurrently for 7 days"

Which statement by the patient indicates an understanding of discharge teaching for the medication alendronate? a. "I need to take this medication with food to prevent damage to my esophagus caused by reflux of stomach acid." b. "I will take the medication in the morning before I eat with 8 oz of water and remain upright for 30 minutes." c. "This medication will help relieve the bone pain I have from my osteoporosis." d. "I need to decrease my intake of dairy products to prevent hypercalcemia."

Correct Answer: b b. "I will take the medication in the morning before I eat with 8 oz of water and remain upright for 30 minutes." Rationale: Alendronate can cause erosive esophagitis. To prevent this adverse effect, it is important for the patient to take the medication with an 8-oz glass of water in the morning on an empty stomach without any other medications and maintain an upright position for 30 minutes. These actions facilitate rapid absorption and prevent reflux into the esophagus.

A pregnant woman has been diagnosed with cancer and is meeting with her oncologist to plan treatment. Which statement about chemotherapy and pregnancy is true? A She will have to wait until the baby is born before starting chemotherapy. B The greatest risk of fetal harm from chemotherapy is during the third trimester. C Chemotherapy treatment during the second or third trimester poses less risk to the fetus. D Chemotherapy is unsafe during pregnancy, but radiation therapy is safe in low doses.

Correct answer: C Rationale: Both radiation and chemotherapy treatments can cause significant permanent fetal harm or death. The greatest risk is during the first trimester. Chemotherapy treatment during the second or third trimester is more likely to improve maternal outcome without significant fetal risk. However, radiation treatment poses great risk to the fetus throughout pregnancy and should be reserved for the postpartum period if possible. Prepubertal patients are more resilient, however, and can have normal puberty and fertility.

When working with a patient who is neutropenic, the nurse identifies which as the most effective measure to prevent the patient from developing an infection? A. Administer prophylactic antibiotics B. Stop administration of the chemotherapeutic drug C. Perform hand hygiene D. Vaccinate the patient to prevent bacterial infection

Correct answer: C Rationale: Risk of infection from leukopenia or neutropenia and/or immunosuppression is one of the more significant adverse effects that requires close attention. Following Standard Precautions and using good handwashing technique are most important in preventing transmission of infection in the hospital and home settings.

The nurse identifies which of the following as the most significant neurotoxin of the cytotoxic drug class? A.paclitaxel (Taxol) B.docetaxel (Taxotere) C.vincristine (Vincasar PFS) D. etoposide (Toposar)

Correct answer: C Rationale: Vincristine is the most significant neurotoxin of the cytotoxic drug class, but it continues to be used in part because of its relative lack of bone marrow suppression. Special care must be taken not to inadvertently give vincristine via the intrathecal route. Several deaths have been reported due to this error.

A patient who is receiving high-dose chemotherapy with methotrexate is also receiving leucovorin. The purpose of the leucovorin is to: A.produce an additive effect with the methotrexate by increasing its potency against the cancer cells. B. reduce the incidence of cardiomyopathy caused by the methotrexate. C. add its antiinflammatory effects to the treatment regimen. D. reduce the bone marrow suppression caused by the methotrexate.

Correct answer: D Rationale: Leucovorin "rescue" is prescribed to reduce the bone marrow suppression that is associated with high-dose methotrexate therapy

The combined continuous administration of progestin and estrogen reduces the risk of which cancer? a. Breast b. Endometrial c. Vaginal d. Ovarian

Correct answer: b b. Endometrial Rationale: 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. The combined administration reduces risk of endometrial cancer as compared to estrogen only medications.

Which laboratory test would the nurse anticipate the health care provider to order to monitor a patient for adverse effects related to progestin medications? a. Complete blood count b. Cardiac enzymes c. Liver function tests d. Serum creatinine level

Correct: c c. Liver function tests Rationale: One of the most serious undesirable adverse effects of progestins is liver dysfunction, which would be assessed by monitoring liver enzymes.

A 51-year-old woman will be taking selective estrogen receptor modulators (SERMs) as part of treatment for postmenopausal osteoporosis. The nurse reviews potential contraindications, including which condition? A. Hypocalcemia B. Breast cancer C. Stress fractures D. Venous thromboembolism

A patient is being treated for secondary amenorrhea. The nurse expects which drug to be used to treat this problem? A. Methylergonovine (Methergine) B. Estradiol transdermal (Estraderm) C. Raloxifene (Evista) D. Medroxyprogesterone (Provera)

A woman visits a health center requesting oral contraceptives. Which laboratory test is most important for the nurse to assess before the patient begins oral contraceptive therapy? A. Complete blood count B. Serum potassium level C. Vaginal cultures D. Pregnancy test

The nurse recognizes that use of estrogen drugs is contraindicated in which patient? A. A patient who has atrophic vaginitis B. A patient who has inoperable prostate cancer C. A woman who has just given birth and wants to prevent postpartum lactation D. A woman with a history of thrombophlebitis

D (Consuming small, frequent meals with nutritional supplements, and maintaining a bland diet help to improve nutrition during antineoplastic therapy.)

"Ms. H. has a hematologic malignancy. Her bone marrow is being rapidly replaced with leukemic blasts; she also has abnormal numbers (and forms) of immature white blood cells in her circulation, and even her lymph nodes, spleen, and liver are be- ing infiltrated. Ms. H.'s type of cancer is known as _________."

leukemia

"Ms. F. has been given her first chemotherapy treat- ment. However, it soon becomes apparent that the adverse effects she is experiencing prevent her from being given dosages that will be high enough to be effective. These are dose-__________ adverse effects."

limiting

"Mr. C. is very interested in his chemotherapy process. As you are discussing a drug's action, he hears you use the term __________, and he asks you what it means. You explain that this is the point at which the lowest neutrophil count occurs after administration of a chemotherapy agent that causes bone marrow suppression."

nadir

"Mr. G. is receiving chemotherapy with a drug that is considered cytotoxic during any phase of the cellular growth cycle. This drug is known as cell cycle-________."

nonspecific

"Mr. H. is told that his cancer has metastasized. His physician explains to him that this means it has __________ to other areas of his body."

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