Chapter 45: Menopause and Andropause Drugs Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. A nurse is preparing to administer goserelin to a client with prostate cancer. Which assessment findings should the nurse prioritize on the ongoing assessment? a. Breast atrophy, sexual dysfunction b. Pharyngitis, asthenia c. Breast tenderness, edema d. Hyperglycemia, leukocytosis Answer: A pharma Rationale: Breast atrophy and sexual dysfunction may be seen as adverse reactions of goserelin therapy. Pharyngitis and asthenia are seen with the use of anastrozole. Breast tenderness and edema are seen with drugs such as estramustine. Hyperglycemia and leukocytosis are seen as adverse reactions of mitotane. Question format: Multiple Choice Chapter: 45 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 617, Summary Drug Table 2. A nurse is preparing to administer oxybutynin to a client and discovers the client is also prescribed haloperidol. The nurse predicts the client has the increased risk of which reaction related to the concomitant use of both drugs? a. Decreased effect of haloperidol b. Increased risk for bleeding c. Lowered plasma concentrations d. Increased effect of oxybutynin Answer: A Rationale: The nurse should observe for decreased effectiveness of the antipsychotic drug (haloperidol) in the client as the effect of the interaction of the antispasmodic drug (oxybutynin) and haloperidol. Increased risk for bleeding results from the interaction of oral anticoagulants with anti-infective drugs. Increased effect of the antispasmodic drug occurs with the interaction of an antispasmodic drug with a tricyclic antidepressant. Plasma concentrations are lowered due to the interaction of fosfomycin, which is an anti-infective, with metoclopramide, which is used to relieve gastric upset. Question format: Multiple Choice Chapter: 45 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 610, Antispasmodics 3. A client with benign prostatic hypertrophy is questioning the nurse about saw palmetto. Which is the best response from the nurse related to the use of this herb? a. Take the herb as tea, prepared in hot water. b. Improvement can be seen within 2–3 weeks. c. Need to be reevaluated after 6 months of use. d. Stop the herb after 3 months of intake. Answer: C Rationale: The nurse should inform the client that saw palmetto might help relief the symptoms of benign prostatic hypertrophy. The active components are not water soluble and should not be taken as a tea. Improvement can be seen after 1– 3 months of taking the herb, and not within 2–3 weeks. The herb intake should not be stopped after 3 months but should be continued for 6 months, followed by evaluation by the health care provider. Question format: Multiple Choice Chapter: 45 Learning Objective: 2 Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Integrated Process: Teaching/Learning Reference: p. 611, Drugs to Treat BPH 4. A nurse has administered estrogen and phenytoin to a client. Which reaction should the nurse plan to monitor the client carefully for? a. Potential for blood clots b. Increased risk for infection c. Possibility of breakthrough bleeding d. Increased risk for seizures Answer: C Rationale: When estrogen is given with phenytoin, a hydantoin, the client is at increased risk for breakthrough bleeding not seizures. Blood clots can be an adverse reaction with estrogen therapy alone. There is no increased risk for infection. When given together, these drugs do not increase the risk for seizures. Question format: Multiple Choice Chapter: 45 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Teaching/Learning Reference: p. 608, Miscellaneous Reactions 5. A client is prescribed tamsulosin and atenolol. Which assessment would the nurse prioritize when conducting the ongoing assessment? a. Intake and output b. Pulse rate c. Respiratory rate d. Blood pressure Answer: D Rationale: Tamsulosin, an alpha-adrenergic blocker, when given with a beta-blocker such as atenolol can cause an increase in hypotension. Therefore, assessment of the client's blood pressure would be most important. Individuals with BPH may experience a variety of urinary symptoms such as frequency, reduced flow, nocturia, and dysuria; however, monitoring the intake and output would not be the priority in this situation. Question format: Multiple Choice Chapter: 45 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 611, Drugs to Treat BPH 6. A client comes to the emergency department and reports extreme pain. Physical assessment reveals a 6-hour erection. When obtaining the client's medication history, which drug would the nurse expect the client to report using? a. Tamsulosin b. Terazosin c. Tadalafil d. Tolterodine