drug exam 3
After teaching a group of students about hormonal secretion of the reproductive system, the instructor determines that the teaching was successful when the students identify what as initiating hormone secretion from the ovaries and testes?
Gonadotropin releasing hormone
Signs and symptoms of what would necessitate discontinuation of dantrolene therapy?
Hepatic dysfunction
After the administration of procaine to a client with a history that suggests a possible hypersensitivity to the drug, the nurse should prioritize what assessment?
respiratory
A client is scheduled for dental surgery and will be given nitrous oxide. What assessment should the nurse prioritize before administering the medication?
respiratory status
Which of these terms describes changes in the uterus between days 15-28 of an ideal menstrual cycle?
secretory phase
A patient is receiving estrogen therapy. What would the nurse instruct the patient to report immediately?
shortness of breath
The client is undergoing surgery for a small bowel resection. At this time the client is experiencing complete respiratory paralysis and is in the most dangerous stage of general anesthesia. Which stage is this?
stage 4
Which would the nurse expect to administer as a depot injection?
testosterone
A client has returned to the health care provider's office for follow up after receiving estrogen for symptoms of menopause. Which question should be included in the follow up?
"Can you describe in detail the difference in how you are feeling today and the last visit?"
What assessment question is most appropriate when assessing a 58-year-old woman for therapeutic effects of prescribed estrogen therapy?
"Have you been having as many hot flashes and night sweats lately?"
What question should the nurse ask when assessing for therapeutic effects of vardenafil?
"Have you found that you're better able to get and maintain erections?"
A client alerts the nurse that they have been in menopause for a couple of months. The nurse teaches the client how menopause occurs. Which statement reflects the teaching has been effective?
"Estrogen and progesterone diminish."
Which statement made by an adult man prescribed sildenafil suggests that the nurse's teaching has been ineffective?
"I know that sildenafil can cause hypertension if I use my angina medicine."
A patient is prescribed pre-anesthetic drugs prior to surgery. Which nursing intervention should the nurse perform when caring for this patient before the administration of preanesthetic drugs?
Demonstrate and explain postoperative patient activities.
Which are true in regards to oxytocin? (Select all that apply.)
Oxytocin has vasopressor effects. Oxytocin stimulates milk ejection. Oxytocin has uterine-stimulating properties.
Which hormone serves to stimulate the development of female characteristics and prepares the body for pregnancy?
Estrogen
which of these terms describes changes in the uterus between days 15-28 of an ideal menstrual cycle?
secretory phase
Gonadotropin-releasing hormone (GnRH) stimulates the anterior pituitary to release which hormones? (Select all that apply.)
LH and FSH
A male clent who uses a transdermal testosterone gel for treatment of his oligospermia applies the medication first thing in the morning and washes it off before bed. What client education is necessary?
Leave the gel on until the next application is due.
Which would be most important to assess in a client receiving testosterone for a prolonged period of time?
Liver function studies
An operating room nurse is assisting the anesthesiologist in the preparation of an intravenous dose of dantrolene. What emergent issue most likely prompted the need to give the patient dantrolene?
Malignant hyperthermia
During pregnancy, what complication is related to insufficient progesterone production?
Premature uterine contractions occur
After teaching a group of students about female reproductive hormones, the instructor determines that the teaching was successful when the students identify which hormone as being primarily responsible for maintaining pregnancy?
Progesterone
The nurse is scheduled to administer testosterone transdermal patch to a client admitted with primary hypogonadism. What is the priority teaching that would be provided regarding this medication?
Report to primary care provider any leg pain, redness, and swelling right away.
When reviewing a client's history, which condition would the nurse identify as contraindicating the use of a centrally acting skeletal muscle relaxant?
Rheumatic disorder
A client sustained a severe laceration to the right thumb and index finger that will require local anesthetic to facilitate suturing. Which statement should prompt the nurse to provide further client health education?
"I'm feeling pretty queasy about getting stitches, so I'm glad they'll be knocking me out."
After teaching a woman using an intravaginal estrogen preparation, the nurse determines that the teaching was successful when the client states that she will remain lying for at least how long after instilling the drug?
30 minutes
The nurse is working in the postanesthesia care unit, and several patients are having surgery today. Which patient would be at greatest risk for complications after surgery?
A 72-year-old female who had general anesthesia for lung removal
What effect can administration of androgens have on fetal development?
A female fetus may experience masculinization.
A client has been prescribed a PDE5 inhibitor for penile erectile dysfunction. Medication education should strongly discourage the use of what drug classification while on this medication?
Alpha-blockers
A patient with delayed puberty has been advised to take testosterone (Androderm) transdermal therapy. Which instruction should the nurse provide the patient to help promote an optimal response to this therapy?
Apply immediately after removing the cover.
What aspect of a client's current health status may contraindicate the use of a PDE5 inhibitor?
The client has a history of unstable angina pectoris.
Centrally acting skeletal muscle relaxants lyse or destroy the spasm. T or F
True
When prescribed dantrolene, what is the most serious adverse effect the client should be instructed about?
hepatitis
A 52-year-old has made an appointment with his primary care provider and has reluctantly admitted that his primary health concern is erectile dysfunction (ED). He describes the problem as increasing in severity and consequent distress. Which of the nurse's assessment questions is most likely to address a common cause of ED?
"Are you taking any medications for high blood pressure?"
A client alerts the nurse she has been in menopause for a couple of months. The nurse teaches the client how menopause occurs. Which statement reflects the teaching has been effective?
"Estrogen and progesterone diminish."
After teaching a client who is prescribed sildenafil about using the drug, the nurse determines that the teaching was successful when the client states:
"I need to take the pill about an hour before any sexual stimulation."
A 56-year-old woman with a diagnosis of multiple sclerosis has begun taking dantrolene. What client teaching should the nurse provide?
"Make sure to see your health care provider promptly if you develop yellowish skin or eyes."
A patient has been prescribed methocarbamol (Robaxin) for fibromyalgia. The nurse has spent an hour educating the patient on the use of methocarbamol for muscle pain. Which statement by the patient indicates that the patient has an understanding of at least one of the significant side effects of methocarbamol?
"My urine could be discolored while I take this drug."
A client with a lower back injury was recently prescribed chlorzoxazone 250 mg PO t.i.d. The client has phoned the clinic, telling the nurse, "My pain's better, but I'm worried that my bladder is bleeding because there's been blood in my urine." What is the nurse's best response"
"This drug causes your urine to change color, so it's not likely blood that you're seeing."
A 59-year-old man with a recent history of erectile dysfunction has been assessed and prescribed sildenafil (Viagra). When providing patient education to this man, the nurse should tell him:
"You might find that your face becomes flushed or you get a headache after you take Viagra."
The nurse is on the phone with a woman who is taking an antispasmodic for overactive bladder syndrome. The woman states that her mouth is very dry, but she is afraid to drink because she does not want the urge to urinate to increase. What is the nurse's best response to this client?
"You shouldn't restrict your fluid intake because it will only make your bladder problems worse."
A client diagnosed with erectile dysfunction has been advised to take sildenafil. For up to how many hours does the action of the drug persist?
4 hours
An adult client is suspected of having an androgen deficiency and has spoken with his primary care provider about the possibility of treatment with testosterone. The use of testosterone would be most complicated by the presence of what preexisting health problem?
BPH
A client with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?
Baclofen
Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation?
Baclofen
The health care provider has prescribed testosterone for a 77-year-old client with a low testosterone level. The nurse will evaluate this client for what condition that may develop in this client in response to this medication?
Benign prostatic hypertrophy
A client with a foreign body embedded in her hand requires local anesthesia for removal. What drug would be most appropriate?
Benzocaine
Mark, age 42, is prescribed sildenafil for the treatment of pulmonary hypertension. The nurse caring for Mark would explain that sildenafil works by what mechanism?
Causing vasodilation in the pulmonary vascular bed
A 44-year-old woman has been admitted to the hospital for lower abdominal surgery. She appears anxious and expresses concerns about the epidural procedure. What would be a therapeutic way to manage this client's anxiety?
Demonstrate active listening through eye contact and posture and then ask open-ended questions.
When fluoxymesterone is administered to a 14-year-old male, what is the expected result?
Development of sexual organs
Patients receiving chlorzoxazone (Paraflex) should be cautioned that what will occur with administration?
Discoloration of urine
Muscle spasticity is the result of damage to peripheral structures rather than to injured neurons. T or F
False
A man with no significant medical history is being prepared for outpatient surgery under general anesthesia. As part of the preparation for surgery, the anesthesiologist administers atropine, a anticholinergic agent. What is the purpose of administering this medication at this time?
Dry up secretions in the respiratory tract.
A client is receiving androgen therapy. Which would cause the nurse the greatest concern?
Elevated liver enzyme levels
A nurse should administer skeletal muscle relaxants cautiously and monitor a client closely if they have which medical conditions? (Select all that apply.)
Epilepsy Pregnancy Cerebrovascular accident Parkinsonism
An older adult resident of a long-term care facility is experiencing muscle spasticity and has just been prescribed a centrally acting skeletal muscle relaxant. The client has comorbidities of early stage Alzheimer's disease and chronic obstructive pulmonary disease (COPD). What nursing action should the nurse prioritize for adding to the client's care plan?
Falls prevention measures
The nurse is caring for a client whose current medication regimen includes baclofen 60 mg PO daily. What assessment should the nurse nurse prioritize when assessing for therapeutic effects?
Inspection for muscle spasticity and range of motion assessment
The client is menopausal but refuses to take estrogen because she fears having a stroke. She is currently on HydroDIURIL for hypertension. She asks if taking a natural herb, such as cohosh, would be safe. In addition to referring her to her medical care provider for further information, the nurse's best response would be:
It must be used cautiously as the herb may increase the hypotensive effects of antihypertensive drugs.
Which hormone is responsible for ovulation?
LH
After teaching a group of students about the use of estrogens, the instructor determines that additional teaching is needed when the students identify which as a contraindication?
Metabolic bone disease
A client received fentanyl during a surgical procedure. The nurse will have what drug available to treat any possible respiratory depression associated with the use of fentanyl?
Naloxone
A 21-year-old woman is prescribed an oral contraceptive pill to prevent pregnancy. The nurse should inform the client of which adverse effects of this medication?
Nausea
A nurse is reviewing the medication history of a client. The nurse understands that a PDE5 inhibitor would be inappropriate for a client taking:
Nitroglycerin
A client diagnosed with multiple sclerosis-induced spasticity asks why deep tissue massages do not relieve the associated pain. What facts about spasticity should be the basis of the nurse's response?
Spasticity is caused by nerve damage in the brain and spinal cord, and it is a permanent condition.
A 29-year-old female client in labor has just received epidural anesthesia. Before the procedure her blood pressure was 120/78 and her pulse was 60 bpm. Now her blood pressure is 100/60 and her pulse is 80 bpm. She reports a metallic taste in her mouth, hears a ringing in her ears, and appears confused. What is this client most likely experiencing?
Systemic toxicity from local anesthesia
A 37-year-old client has received procaine hydrochloride (Novocain) in the mouth for a dental procedure. How would the nurse evaluate that the outcome of reduced pain related to a dental procedure has been met?
The client's facial expressions are calm and relaxed.
A male adolescent is prescribed testosterone. In order to help the client deal with the added social stress that the medication may cause, the nurse should discuss which possible adverse effect?
The development of acne
A male client is prescribed sildenafil for the treatment of erectile dysfunction. What mechanism of action of sildenafil causes a sustained erection?
The drug inhibits phosphodiesterase (PDE) type 5, consequently decreasing the metabolism of cGMP.
A woman of childbearing age is diagnosed with breast cancer. She is currently taking hormonal contraceptives. What information should the woman be given regarding the hormonal contraceptives?
The hormonal contraceptives will stimulate tumor growth.
A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which instruction?
Wear appropriate clothing and sunscreen whenever he is in direct sunlight.
The health care provider orders short-term skeletal muscle relaxants for an 11-year-old client. The nurse is responsible for the family education plan and teaches the parents that the medications should be used only under which condition?
When close supervision is available for monitoring drug effects
A client is going through menopause. She informs you that her health care provider has prescribed estrogen and progesterone. She asks why she should take two medications. The nurse's best response is:
When estrogens are used alone, they cause endometrial hyperplasia and may cause endometrial cancer.
Prior to elective hip replacement surgery, the nurse is explaining the basic characteristics of general anesthesia to the client. The nurse should perform this education in the understanding that general anesthesia is best understood as what result?
a state of reversible unconsciousness
The nurse is describing changes in the male that occur with aging and parallel the changes that occur in women. The nurse is describing:
andropause
On the advice of his brother, a 53-year-old man has made an appointment to request a prescription for sildenafil. The nurse who works at the clinic is reviewing the man's medical history and would recognize what health problem as being prohibitive to this treatment?
angina, treated with nitroglycerin
Sildenafil has been prescribed to a client in his 60s, and the nurse is providing health education about the safe and effective use of the drug. The nurse should teach the client to:
avoid taking the drug more than once in any 24-hour period.
A nurse is working with a patient in the clinic who has erectile dysfunction. The patient has been prescribed sildenafil (Viagra). The patient wants to do everything he can to promote effectiveness of the drug. The nurse will instruct him to
avoid taking the drug with a high-fat meal.
The nurse is reviewing the history of a client who is to receive testosterone. Which of the following would alert the nurse to the need for close monitoring of the client?
cardiovascular disease
What medication belongs to the category of inhaled anesthetics?
desflurane
A nurse administers carisoprodol to a client for the treatment of an acute musculoskeletal condition. The nurse would be alert for which adverse effect after administering the drug?
drowsiness
When developing a teaching plan for a client who is to receive carisoprodol, which sign or symptom would the nurse include as the most common adverse reaction?
drowsiness
Which adverse effects would a nurse most likely assess in a client who is receiving a centrally acting skeletal muscle relaxant? (Select all that apply.)
drowsiness, insomnia, dry mouth, constipation
The nurse would instruct a client who is using a transdermal system for testosterone administration to apply a new patch at which frequency?
every day
Which would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a client taking estrogen?
headaches
Which is NOT a common adverse effect of spinal anesthesia?
hypertension
A perioperative nurse is explaining the process of general anesthesia in anticipation of the adult client's imminent bowel resection. When describing the phase of induction, the nurse should explain that this is usually achieved by what means?
intravenous administration of anesthetics
When teaching an adolescent about ovulation, the nurse would include that ovulation is initiated by a surge in:
luteinizing hormone.
A group of students are reviewing information about the menstrual cycle. The students demonstrate understanding when they identify what as the onset of the menstrual cycle?
meharche
The nurse is discussing proper use of oral contraceptives with a client. The nurse should instruct the client to immediately contact a health care provider if she:
misses a menstrual period.
A postmenopausal woman is receiving raloxifene as part of a treatment plan for osteoporosis. The nurse would instruct the patient that this drug is administered by which route?
oral
The patient in the intensive care unit (ICU) is intubated and on a respirator. What drug would the nurse be told to give so that the patient receives continuous sedation while intubated?
propofol
A 12-year-old client will undergo surgery with spinal anesthesia. The client expresses a severe fear of needles. Which nurse response is appropriate and therapeutic for this client?
"I understand that you are nervous, but I'll hold your hand and be right there with you."
The nurse is educating an adult male client diagnosed with erectile dysfunction about the prescribed sildenafil. Which statement made by the client establishes the need for further clarification?
"If I eat a fatty meal I will need to take two pills instead of one, so the drug will take effect faster."
A male clent has been diagnosed with impotence and is started on a regimen of androgens. Which statement by the client indicates that he has understood the teaching?
"If my skin appears yellow or my urine turns dark, I will contact my health care provider."
A 50-year-old woman has begun taking baclofen to treat her recently diagnosed multiple sclerosis (MS). What teaching point should the nurse provide to the patient about her new drug regimen?
"Make sure that you don't stop taking baclofen suddenly because it might cause your symptoms to rebound quite sharply."
A client has been prescribed baclofen and will be taking the drug on an outpatient basis. The client asks the nurse if it is still okay to drink wine with meals or end the day with a "nightcap." What is the nurse's best response?
"The combination of baclofen and alcohol could depress your nervous system to a dangerous level."
Which adverse effect of muscle relaxants is most pronounced when a client is prescribed tizanidine therapy?
hypotension
A 63-year-old woman taking estrogen and progestin for several years has recently changed to estrogen alone. What medical event would prompt such a change in treatment?
hysterectomy
A nurse caring for a 43-year-old client explains to the client that ovarian functions gradually decrease around this age. What is the implication of decreased ovarian function?
inability to become pregnant
Anabolic steroids are analogs of testosterone with increased protein-building effects. T or F
true
Muscle spasms are thought to arise from the flood of sensory impulses coming to the spinal cord from an injured area. T or F
true
Spinal reflexes are the simplest nerve pathways that monitor movement and posture. T or F
true
After experiencing several months of worsening nocturia, a client has been assessed for benign prostatic hypertrophy (BPH) and has begun drug treatment. In addition to nocturia, what other sign or symptom is the most likely to accompany BPH?
urinary frequency
A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman's nurse provide?
"You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity."
A new client telephones the clinic requesting a renewal prescription for contraceptives she has been taking for 4 years. It has been more than a year since her last health care visit, but she is unable to come into the clinic until next month. She insists she is "doing fine" on this medication and must have her prescription now. Considering the circumstances and related safety issues, how should the clinic nurse respond?
*"Before the drugs are prescribed, a complete medical history, physical examination, Pap test, urinalysis, and weight and blood pressure measurements are recommended."
The nurse is preparing a teaching plan for a group of high school girls about the female reproductive system. Which would the nurse incorporate into the teaching?
One-half of the genetic material is contained in a single ovum.
Kalie, age 18, is prescribed progesterone for the treatment of primary amenorrhea. Which adverse effect would need to be reported immediately to the health care provider?
Pain in one leg
When reviewing the history of a patient, which would the nurse identify as a contraindication for the use of progestins?
Pelvic inflammatory disease
The following sensations are lost when local anesthetics are administered in increasing doses. Place the sensations in the proper sequence starting with the sensation lost first.
temperature, touch, proprioception, skeletal muscle tone
Medroxyprogesterone acetate is indicated for the treatment of women with:
uterine bleeding.
A nurse teaching a 57-year-old client about the factors that must be considered around the use of hormone replacement therapy (HRT) should discuss what increased risk associated with the therapy?
venous thromboembolism
A nurse is caring for a 28-year-old patient who is taking exogenous testosterone for treatment of cryptorchidism. What statement by this patient would lead the nurse to believe that patient teaching has been ineffective?
"My sperm count should increase."
The nurse is caring for a client who has cancer and who until recently took estrogen. The nurse knows that estrogen may have increased the risk of development of which types of cancer? (Select all that apply.)
breast and endometrial
An older adult client's current medication regimen includes tamsulosin and sildenafil. The combination of these two medications should prompt what action by the nurse?
assessing the client regularly for signs of orthostatic hypotension
A nurse should advise a female client beginning therapy with methyltestosterone (Testred) for the treatment of inoperable advanced breast carcinoma of which of the following adverse reactions? Select all that apply:
facial hair, acne or Amenorrhea
