NUR 2092 Pharmacology Ch 41 Drugs affecting the male reproductive system
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 nurse should advise a female client beginning therapy with methyltestosterone for the treatment of inoperable advanced breast carcinoma of which of the following adverse reactions? Select all that apply:
Amenorrhea Acne Facial hair growth
A 52-year-old male client 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?"
The nurse is caring for a client who has been prescribed vardenafil. What question should the nurse ask when assessing for therapeutic effects of the drug?
"Have you found that you're better able to get and maintain erections?"
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."
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 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 educating a young adult client diagnosed with androgen deficiency about the prescribed testosterone transdermal system, apply two systems (dose of 5 mg) nightly. Which statement made by the client establishes the need for further clarification?
"One transdermal patch is applied to my back, upper arm, or abdomen to dry, clean skin, and the other to my groin."
A client is seeking treatment for penile erectile dysfunction. Which assessment questions demonstrates the nurse's knowledge related to the cause of this disorder? Select all that apply.
"When were you born?" "Have you ever been diagnosed with any vascular disorders?" "Are you currently being treated for any neurological conditions?"
A 24-year-old female athlete is using high doses of anabolic steroids to enhance her performance. She may be at risk for which condition?
Acne
A client is prescribed testosterone gel. Which would the nurse include in the teaching plan? Select all that apply.
Allowing the application site to dry before getting dressed. Applying the gel once daily in the morning. Washing hands with soap and water after applying.
A patient with erectile dysfunction is receiving an injection directly into the cavernosum. The nurse identifies this drug as:
Alprostadil
Matt, age 16, has been taking testosterone since age 7 for the treatment of hypogonadism. He is in the health care provider's office today for follow-up care. He asks about taking anabolic steroids instead of testosterone because he heard this will increase his growth. What is the primary difference between anabolic steroids and testosterone?
Anabolic steroids have a greater anabolic effect.
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
The nurse is aware that a client receiving which category of medication will not be prescribed vardenafil?
Antiarrhythmics
A patient with delayed puberty has been advised to take testosterone 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.
Which agent would a client most likely be prescribed for penile erectile dysfunction if the client is very sexually active and the timing of sexual stimulation is not known?
Avanafil
An older adult client has prided himself in maintaining good health for the entire adult life. For this reason, the recent diagnosis of benign prostatic hypertrophy (BPH) is a source of frustration, and the client asks, "I don't understand why I got this because I've always taken such good care of myself." How would the nurse best respond to the client?
BPH is thought to be a normal part of the male aging process.
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 has begun treatment for penile erectile dysfunction. What explanation should the nurse provide regarding the primary effect a prescribed phosphodiesterase type 5 inhibitor will have on this condition?
Blood flow to the penis will be improved
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
Which would be most important to assess in a client receiving testosterone for a prolonged period of time?
Liver function studies
The nurse determines that teaching about testosterone therapy via a transdermal patch is effective when the male client states that he will change the patch in which time frame?
Daily
A female patient receiving fluoxymesterone, an androgenic drug, for metastatic breast cancer is disturbed by the physical changes seen in her body. Which feature of virilization may be seen in the patient receiving this therapy?
Deepening of the voice
When fluoxymesterone is administered to a 14-year-old male, what is the expected result?
Development of sexual organs
The nurse is instructing the parents of an 11-year-old male who has testosterone deficiency. Which symptom, if found in this child, would cause the discontinuation of this medication? erapy?
Enlarged penis
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
A student asks the pharmacology instructor what effect the administration of androgens can have on a fetus if administered during pregnancy. What should the instructor respond?
Female child may have masculinized features
The nurse is obtaining a history from a 23 year-old client. What symptom would lead the nurse to suspect that the client may be using DHEA?
Hirsutism
A client is admitted to the hospital with benign prostatic hypertrophy, and the health care provider prescribed tamsulosin. The nurse knows that other drugs in this class of medications are used to treat which condition?
Hypertension
And older client has been prescribed long-term androgen therapy. Which preexisting condition should the nurse monitor regularly to identify signs of exacerbation? Select all that apply.
Hypertension Coronary artery disease Heart failure
When teaching a group of high school students about using anabolic steroids, the nurse would include information that these drugs are classified as which class of controlled substances?
III
A woman who has been prescribed high doses of anabolic steroids should be instructed on which effects?
Masculinization
A client is receiving a medication that has androgenic effects. Which would the nurse expect to assess?
Oily skin
After teaching a group of students about anabolic steroids, the instructor determines that the teaching was successful when the students identify which agent as an example?
Oxandrolone
A teenage client who is using testosterone to treat a hormone deficiency calls the clinic to report acne-like skin eruptions on the face. How should the nurse counsel this client?
Practice frequent and thorough skin cleansing.
A group of students are reviewing the drugs available for treating penile erectile dysfunction. The students demonstrate understanding when they identify which drug as a PDE5 inhibitor?
Sildenafil
The nurse is instructing a client who will be taking finasteride for treatment of benign prostatic hypertrophy and gives the client information about which possible sexual side effects? (Select all that apply.)
Reduced libido Decreased volume of ejaculate Impotence
A woman is diagnosed with pulmonary hypertension. The nurse explains the drug prescribed and the patient states, "That's a drug that used to treat erectile dysfunction." Which drug would this most likely be?
Sildenafil
A nurse is preparing a class on the various drugs used to treat erectile dysfunction. Which would the nurse include?
Tadalafil
A client diagnosed with benign prostatic hypertrophy (BPH) is prescribe tamsulosin. The client communicates with the nurse about a friend that was prescribed sildenafil for his BPH. Which is the nurse's best response regarding the difference in the use of the two drugs for BPH?
Tamsulosin relaxes muscles in the prostate and bladder and increases ability to urinate.
A client is using a transdermal system for androgen administration. Which drug would the client most likely be using?
Testosterone
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.
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 young man has received a diagnosis of androgen deficiency and has been prescribed testosterone. At clinic follow-up appointments, the nurse should prioritize which assessment?
Weight and measurement of blood pressure
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.
An older adult client has developed an androgen deficiency, and treatment options are being considered. The client's nurse should be aware that the use of exogenous testosterone has the potential to exacerbate what problem?
benign prostatic hypertrophy (BPH)
A 52-year-old male with type 2 diabetes is using an anabolic steroid for treatment of hormonal deficiency. He is taking the sulfonylurea glyburide to treat his diabetes. The nurse caring for this client would closely monitor his:
blood glucose level.
Which is an example of an androgen that can be used to treat hypogonadism?
fluoxymesterone
After teaching a group of nursing students about testosterone, the nurse determines that additional teaching is needed when they identify that testosterone can be given by which route?
intravenous
A client has been prescribed vardenafil. Which medication in the client's history would the nurse be <b>most</b> concerned about?
nitroglycerin
The etiology of secondary hypogonadism may involve which condition?
pituitary dysfunction
A client with a recent history of benign prostatic hypertrophy (BPH) will soon begin treatment with finasteride. Before beginning this course of therapy, the nurse should caution the client to be aware of what potentially adverse effect?
sexual dysfunction
A 70-year-old man has enjoyed good overall health for all of his adult life, but he has been experiencing urinary frequency and dribbling that has culminated in a diagnosis of benign prostatic hypertrophy (BPH). As a result, the client has been prescribed finasteride. When teaching the client about the potential adverse effects of the drug, the nurse should ensure that he knows about the possibility of:
sexual dysfunction.
A middle-aged client with erectile dysfunction has sought care and is receiving health education from the nurse. The client has expressed a desire to understand the physiology of the sex hormone production and the sexual response. The nurse should describe the fact that testosterone is normally secreted in response to:
stimulation by luteinizing hormone.
A nurse is educating a group of young sports persons about the adverse effects associated with the use of anabolic steroids. Which of the following would the nurse include as occurring typically only in females?
virilization
A client is receiving androgen therapy. Which would cause the nurse the greatest concern?
Elevated liver enzyme levels
An older adult male prescribed anabolic steroids for a deficiency condition has presented with blood pressure above the normal baseline. What might be the cause for an increase in blood pressure associated with anabolic steroid therapy?
Fluid and sodium retention
A 9-year-old boy is taking testosterone injections for treatment of hypogonadism. What should be measured every 6 months on this child?
Hand and wrist epiphyseal growth plates
A male taking anabolic steroids may experience which side effects?
Jaundice
A client has been given a prescription for sildenafil (Viagra) for treatment of erectile dysfunction. The nurse will instruct the client to take this medication at what time prior to the onset of sexual intercourse?
30 minutes
Testosterone therapy would be recommended for all these patients except for a:
35-year-old male with erectile dysfunction due to diabetes mellitus.
A client diagnosed with erectile dysfunction has been advised to take Viagra. For up to how many hours does the action of the drug persist?
4 hours
A nurse is instructing a client about vardenafil. The nurse would instruct the client to take the drug how many minutes before sexual stimulation?
60 minutes
What effect can administration of androgens have on fetal development?
A female fetus may experience masculinization.
A client is taking androgens and warfarin. What effect will these two medications have on the client's coagulation?
Coagulation will be decreased.
A 9 year old child has been prescribed testosterone. What information should the nurse provide the client's parents regarding the continuation of the therapy?
If signs of early puberty are identified the therapy should be stopped
An older adult man has moved to a long-term care facility, and the nurse is performing a medication reconciliation. The resident's current medication regimen includes alfuzosin. After considering the most likely indication for this drug, the nurse should include what potential problem in the resident's interdisciplinary plan of care?
Impaired urinary elimination
The pharmacology students are learning about androgens. What would the students learn is an effect of an androgen on the body?
Increase of nitrogen
When describing the action of sildenafil, which would the nurse include?
Increased nitrous oxide levels in the corpus cavernosum
Which would a nurse expect to occur with the administration of anabolic steroids?
Increased red blood cell mass
A male client informs his physician that sildenafil therapy is not working for him. What is most likely to be the reason for this and needs to be carefully assessed for by the nurse?
Ingestion of high-fat meal along with the drug
A client with a history of benign prostatic hypertrophy (BPH) is seeking androgenic medication treatment for penile erectile dysfunction. What information should the nurse provide the client regarding this therapy?
It increases the risk for prostate cancer
The nurse is providing education to a client who has expressed interest in using anabolic steroids to gain muscle mass. What potentially serious adverse effects should the nurse describe related to the use of large doses of anabolic steroids? Select all that apply.
Jaundice Addiction Liver cancer Aggressive behavior
A client who uses a transdermal testosterone gel for the treatment of 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.
A client has been receiving long-term testosterone therapy. The nurse would expect to monitor:
Liver function studies
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.
The nurse will provide a client, prescribed alprostadil, with information regarding which method of administration?
Self-injection
An 8-year-old boy has been diagnosed with a sex hormone deficiency and has begun a course of treatment with testosterone. What change in the boy's health status would necessitate a stop to the course of treatment?
Signs of puberty
A female client expresses the desire to suppress her female sex characteristics to facilitate a transition to being male. Which androgen does the nurse anticipate the provider will prescribe?
Testosterone
Which would the nurse expect to administer as a depot injection?
Testosterone
It has been determined that a 33-year-old male client would likely benefit from treatment with testosterone. What aspect of the client's medical history could contraindicate this treatment?
The client has been diagnosed with hepatitis C.
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 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this client would contraindicate the use of tadalafil for his ED?
has unstable angina and uses a nitroglycerin patch
