M/W pharm
2. 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
4. 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
5. 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
Bone marrow suppression caused by chemotherapy drugs may cause which of the following adverse effects? Select ALL that apply. A. Thrombocytopenia B. Anemia C. Neutropenia D. Alopecia
A,B,C
Which baseline data should the nurse collect on a client having an IV oxytocin (Pitocin) induction at 41 weeks gestation? A. pulse rate and blood pressure B. deep tendon reflexes C. uterine activity D. fetal heart rate
A,C,D
Fertility drugs- what to know
AE- DVT, urticaria, ovarian hyperstimulation, multiple pregnancy, breast pain
What to know about contraceptives?
AE- HTN, thromboembolic events, alteration in lipid levels and horomone concentrations, amenorrhea, and dysmenorrhea Educate patients about need for alternative birth control for at least 1 month during and after antibiotics
Oxytocics- what to know
AE- vaginitis, vaginal pain, cramping
1. 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
18. 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
5. 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
A client is to receive sildenafil citrate (Viagra) for erectile dysfunction. In teaching the client, the nurse discovers that the client is taking nitroglycerin (NTG) prn angina. Which instruction is a priority at this time? A. Tell the client to take both medications as ordered by the healthcare provider. B. Tell the client not to take the NTG until 1 hour after a dose of Viagra if angina occurs. C. Ask the client to watch for signs of postural hypotension, including dizziness. D. Refer the client to the healthcare provider because taking both medications is contraindicated.
D
The client has been started on androgen therapy. As a result of this therapy, the nurse plans to closely monitor which laboratory value? A. Renal function B. Blood sugar C. Phosphorus D. Cholesterol
D
When administering medications, the nurse remembers that the action of alpha1-adrenergic antagonists such as tamsulosin (Flomax) is best described by which statement? A. Blocks beta receptors and promotes relaxation of smooth muscle in the bladder wall, improving urinary flow B. Blocks alpha1 receptors and promotes relaxation of smooth muscle in the bladder neck, improving urinary flow C. Stimulates alpha1 receptors and promotes contraction of smooth muscle in the bladder neck, improving urinary flow D. Potentiates beta receptors and the effects of acetylcholine, improving urinary flow
B
Which factor has the greatest potential to increase the risk of thromboembolic events in a client taking norethindrone and ethinyl estradiol (Loestrin 1/20)? A. Eating red meats B. Smoking every day C. Being overweight D. Sedentary lifestyle
B
Tamsulosin (alpha 1 blockers)
Treats BPH and shrinks prostate
Sildenafil or viagra- Phosphodiesterase inhibitors
Used to treat erectile dysfunction AE- headache, flushing, dyspepsia Use caution in patients with cardiac disease and angina especially if taken with nitrates ( hypotension) Take one hour before sex
Finasteride (BPH)
Takes 3-6 months, male pattern baldness Effects are limited to the prostate Finasteride is teratogenic to pregnant woman, must wear gloves if handling
Uterine relaxants are tocolytic
which stops labor
2. 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
3. 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
Transdermal contraceptives
1 patch weekly for 3 weeks Watch for density loss
Intravaginal contraceptives
1 ring in the vagina for 3 weeks
10. 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
2. 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
Estrogen
Do not use estrogen with estrogen-dependent cancers, undiagnosed vaginal bleeding, pregnancy, or active thromboembolic disorder or a history of this disorder. AE- thromboembolic disorder, nausea, photosensitive, chloasma Interacts- anticoagulants, rifampin, St. John's wort, TCA and SMOKING Synthesized in the ovaries
Do not use BPH drugs with what other drug?
Erectile Dysfunction
What do you want to monitor with Testosterone?
LDL levels Pelliosis of liver with long term use Abused because of muscle gain
Testosterone/ androgens
MOA- Horomone receptor complex acts cellular DNA to promote mRNA molecules and production of proteins Develops sex traits Increase skeletal muscles
Finasleride- 5-alpha reductase inhibitor
MOA- Reduces size of prostate Aides in pattern baldness- low dose Prostate shrink- high dose Do not let PREGNANT women touch!!!
Progestins
MOA- induce secretory changes in endometrium (+) body temp Diminished endometrium tissue proliferation (decrease periods) Thicken vaginal mucosa Relax uterine smooth muscle Grow boobs
Sildenafil- erectile dysfunction
MOA- inhibits effects of nitric oxide released during stimulation, resulting in enhanced blood flow and penile erection. Hypotension is known happen with nitrates 1 hour before sexual activity
Clomiphene/ Menotropins- fertility drugs
MOA- stimulate production of FSH/LH and increase ovulation Also increase maturation of ovarian follicle Treats infertility issues
Pitocin- oxytocin
MOA- stimulates uterine contractions Stimulates milk lactation Used to stop vagina bleeding Used to stimulate birth Only given if the mother and baby are healthy
tamsulosin / Alpha-1 blocker
MOA-Relax of bladder neck allows urinary stream
Progestins indications
Menopause Dysfunction uterine bleeding Amenorrhea PMS Contraceptive Miscarriage
Oral contraceptives
Most effective- estrogen and progesterone combo Take missed dose with the next day dose Increase stroke risk
Prolonged erections (longer than 4 hours)
Must be reported immediately and is a medical emergency
All contraceptive drugs
No smoking or give to patients over 35
Inject contraceptives
Only progesterone Every 3 months
Progestins
Progesterone is produced by the corpus luteum after ovulation and during pregnancy by the placenta AE- liver dysfunction and thromboembolic events, amenorrhea Medroxyprogesterone- (Depo-provera)- given IM- last 3 months Megestrol- (Megace)- given PO
The nurse concludes that the client has understood teaching when she makes which statement about clomiphene? A. "This medication will help make me ovulate." B. "I'll take this medication for one month". C. "My husband is going to ask if he can ingest the medication as well." D. "This medication prepares the wall of the uterus for fertilization."
A
1. 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
11. 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
12. 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
13. 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
16. 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
8. 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
9. 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
If the client had a low white blood cell count before his next round of chemotherapy for colon cancer, the nurse would plan to include which statement in a teaching plan designed to help the client prevent infection? A. Take protective measures or avoid visiting with friends or family members who have a cold. B. Take Tylenol or any fevers. C. Contact health care provider for temperature of 102 or above F. D. Perform oral care gently.
A
1. 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
1. 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
2. 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
2. 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
1. 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
10. 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
11. 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
14. 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
15. 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
B
17. 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
3. 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
4. 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
6. 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
6. 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
6. 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
7. 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
7. 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
8. 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
A client beginning oral contraceptive therapy with deseogestrel and ethinyl estradiol asks the nurse why 2 different drugs are needed in the pill. Which explanation by the nurse is best? A. "Desogestrel is a weak estrogen and progestin combinations require additional estrogen to work." B. "Together the hormones prevent the ovum from maturing and the sperm from penetrating through the cervical mucus." C. Estrogens alone would prevent pregnancy, but progestins are added so spotting doesn't occur." D. "Taking each hormone separately would prevent most pregnancies, but the combination taken together in one pills is more effective.
B
A client taking oral contraceptives calls the office to report that she missed her pill last evening and needs advice about how to proceed. The nurse's best response is: A. Continue pills as prescribed, this will not cause a problem. B. Take one pill this morning and one pill this evening and then continue as prescribed. C. Double the dose for the rest of the cycle to prevent reduced effectiveness. D. Stop the pills and wait for your next period.
B
A patient is experiencing gastrointestinal symptoms associated with chemotherapy. What is the nurse's best explanation for this effect? A. The illness of cancer predisposes patients to gastrointestinal symptoms. B. Anticancer drugs exert adverse effects on rapidly growing cells such as the GI Tract. C. The drugs cause paralysis of the gastric musculature, producing reduced peristalsis D. Nausea and vomiting are strictly psychogenic in origin in the cancer patient.
B
The nurse recognizes that the most effective mode of treating cancer is: A. Single drug therapy B. Combination drug therapy C. Surgery D. Cell-phase specific chemotherapy
B
1. 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
5. 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
8. 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
9. 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
A client is to receive chemotherapy for the treatment of cancer. What should the nurse know concerning the side effects of chemotherapy? Side effects: A. are minimal because chemotherapy drugs are highly selective B. are minimal because chemotherapy does not affect normal cells C. of chemotherapy are caused by toxicities to normal cells D. of chemotherapy are usually permanent
C
3. 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
4. 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
7. 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
9. 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
Testosterone- what to know?
Used for hypogonadism, know different types of administration and where it is applied