NURS 6521N WEEK 10 MEN AND WOMEN HEALTH

Question 1 1 out of 1 points A 54-year-old woman with a history of osteoporosis has been prescribed ciprofloxacin for recurrent cystitis. Because of the patient's history, the nurse would be sure to discuss with the woman the use of Response Feedback : Patients who take ciprofloxacin should avoid taking the drug with food that contains iron, calcium, magnesium, and other cations because the presence of these elements may reduce the bioavailability of ciprofloxacin. Because the woman has a history of osteoporosis, she is very likely taking a calcium supplement. Alcohol and nicotine should be avoided while on any drug therapy. Grapefruit juice is not known to interact with ciprofloxacin. • Question 2 A female patient has been prescribed estrogen therapy. Which of the 1 out of 1 points following will the nurse advise the patient is a common adverse effect of estrogen therapy? Response Feedback : The nurse will advise the patient that common adverse effects include breakthrough bleeding, changes in menstrual flow, dysmenorrhea, premenstrual-like syndrome, headache, nausea and vomiting, bloating, abdominal cramps, chloasma, and photosensitivity. Migraine headaches, dizziness, and changes in libido are less common adverse effects. • Question 3 1 out of 1 points A 38-year-old pregnant patient admits to the nurse that she is an alcoholic and has been consuming alcohol during her pregnancy. The nurse knows that using alcohol during pregnancy may result in a child who presents with Response Feedback : Fetal alcohol syndrome (FAS) can be the result of a mother using alcohol during pregnancy. Microcephaly or smallness of the head is a teratogenic characteristic of FAS. A high-pitched cry is a characteristic seen in children of mothers who used clemastine (Tavist) during pregnancy. Electrolyte imbalances and thrombocytopenia would not be common findings in mothers who abuse alcohol during their pregnancy. • Question 4 A patient is being discharged from the hospital and will be taking oxybutynin (Ditropan) for overactive bladder. The nurse will instruct the patient that she will be taking a medication 1 out of 1 points Response Feedback: Oxybutynin is available as a transdermal patch and causes dry mouth approximately 60% of patients. The drug is not noted to cause palpitations or lightheadedness and it is not administered as an IM injection. • Question 5 1 out of 1 points A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient to Response Feedback : To maximize the therapeutic effects of the drug, the nurse should encourage the patient to complete the entire drug therapy as prescribed. The dosage of ciprofloxacin is not reduced gradually but taken in the same dosage throughout the treatment period, and there is no indication that it is necessary for the patient to take the drug only at home. The prescriber would be the only person who could change the form of the drug to be used, and subcutaneous injection is not an identified route of administration for ciprofloxacin. • Question 6 A nurse is providing patient education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the patient to avoid which of the following drugs? 1 out of 1 points Response Feedback : Because MTX is secreted by the renal tubules, certain drugs that follow the same pathway, such as salicylates, sulfonamides, phenytoin, and penicillin, may compete with MTX excretion, resulting in accumulation and increased toxicity. Therefore, if these drugs cannot be avoided, they should be discontinued 2 days before and restarted 2 days after MTX therapy. Acetaminophen, furosemide, and digoxin do not cause drug–drug interactions with MTX. • Question 7 A nurse is working with a 16-year-old pregnant teen and assessing for 1 out of 1 points behavior that may put the baby at risk. The most important assessment the nurse can make is Response Feedback: Adolescents are prone to experimentation with various substances, both legal and nonlegal; assessments related to this phenomenon are important during pregnancy. Insurance coverage, exercise, and dietary habits are considered less important. • Question 8 1 out of 1 points A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following? Response Feedback: Because a prominent anticholinergic effect is dry mouth, good oral hygiene is very important to prevent dental caries and gum disorders. Dryness may be relieved with hard candies, chewing gum, or lip gloss. Chronic diarrhea, headaches, and a special diet are not issues with this drug. • Question 9 1 out of 1 points A patient is taking etoposide for a testicular tumor refractory to treatment. The nursing assessment reveals that he is also taking warfarin. The nurse must carefully monitor for which of the following? Response Feedback: In a patient receiving warfarin concomitantly with etoposide, prothrombin time can become elevated and place the patient at an increased risk of bleeding. The heart rate, drug serum levels, and liver enzymes are not affected by concomitant use of warfarin. • Question 10 1 out of 1 points A 68-year-old man is being treated for benign prostatic hypertrophy (BPH) and began treatment with finasteride (Proscar) 3 months ago. When planning the care of this patient, what desired outcome should the nurse prioritize? Response Feedback : The primary goal of treatment with finasteride is to facilitate complete bladder emptying, resulting in less urgency and decreased frequency of voiding. Urethral pain, sexual side effects, and hematuria are possible but less commonly associated with BPH. Consequently, outcomes relating to bladder emptying would be prioritized. • Question 11 1 out of 1 points A male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at each clinic visit? Response Feedback: It is important to assess the patient's urinary patterns in order to gauge a therapeutic effect. Changes in serum cholesterol levels, bone growth, and hemoglobin levels are not associated with finasteride therapy. • Question 12 A woman is receiving prolonged drug therapy during her complicated 1 out of 1 points pregnancy, and it may pose a risk to both the mother and the fetus. The primary care physician has made dosage adjustments to minimize adverse effects and prevent toxicity. The nurse should make sure Response Feedback : If prolonged drug use is necessary and poses a risk to the woman or the fetus, the pregnant woman and the fetus need to be monitored for both therapeutic and adverse effects of drug therapy. Serum levels of the drug should be monitored to detect elevations that may lead to adverse effects and the need for dosage adjustments. The FDA would not need to be informed that the woman is receiving drug therapy. At this point, with the patient already taking the drug, it is not necessary to check the FDA category of the drug. The use of nonpharmacologic alternatives is a good idea but would not be as critical as monitoring drug levels. • Question 13 On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement 1 out of 1 points therapy in controlling the symptoms of menopause. Which of the following responses by the nurse is most appropriate? Response Feedback : Research from the WHI trial indicates that estrogen given to postmenopausal women in combination with progestin significantly increases the risk of stroke and coronary heart disease (CHD). HRT is associated with increased, not decreased, risk of breast cancer and it may complicate early diagnosis of the disease. HRT does not exacerbate low bone density or constitute a risk factor for osteoporosis. • Question 14 1 out of 1 points A pregnant patient who has diabetes has been admitted to the hospital to begin labor. Since the patient has diabetes, the physician has decided to use oxytocin (Pitocin) to initiate labor contractions. When talking to the patient about the adverse effects of the drug, the nurse should understand that the most common adverse effects of the drug include Response Feedback: Adverse effects of oxytocin are dose related and take two forms —maternal and fetal. The most common maternal adverse effects are nausea, vomiting, uterine tachysystole, and cardiac arrhythmias. Less common but potentially fatal are severe water intoxication and hyponatremia. • Question 15 A male patient with a medical background tells the nurse that he is not 1 out of 1 points satisfied with the oral synthetic testosterone that has been prescribed for him and he would like to try a natural form of oral testosterone. Which of the following would be an appropriate response by the nurse? Response Feedback : Natural testosterone undergoes a high first-pass effect and is therefore not used orally. The form of testosterone that is used orally is a synthetic androgen that is less extensively metabolized and has a longer half-life than natural testosterones. Natural testosterone does not pose a higher risk of gynecomastia. • Question 16 1 out of 1 points A 36-year-old woman with a history of dysmenorrhea has begun treatment with progesterone, which she will be receiving by the intramuscular route. The nurse participating in the woman's care should prioritize which of the following potential nursing diagnoses? Response Feedback: Progesterone therapy carries risks of thrombotic events and vision loss. It is not associated with fluid loss, incontinence, or cognitive changes. • Question 17 1 out of 1 points A nurse is discussing with a 58-year-old male patient the causes of erectile dysfunction in men over 50 years of age. Which of the following will the nurse inform the patient is the primary physical cause of erectile dysfunction of men in this age group? Response Feedback : Vascular disease is the most common physical cause of erectile dysfunction. Atherosclerosis of the penile artery is the primary cause of erectile dysfunction in more than half of men over age 50. Men with diabetes are more prone to erectile dysfunction because of a combination of vascular disease and neuropathy. A decrease in testosterone levels is not a common cause of erectile dysfunction. Emotional stress is not a physical factor. • Question 18 1 out of 1 points A male patient is trying to decide if he should use finasteride (Proscar) to treat benign prostatic hypertrophy (BPH). When providing information about the drug, the nurse will include which of the following as a risk associated with finasteride therapy? Response Feedback : Adverse effects are usually uncommon with finasteride therapy. However, there is a risk of sexual dysfunction related to the use of the drug. Excess fluid volume related to potential effects of drug therapy and hypercalcemia related to drug therapy, immobility, and breast cancer are risks associated with testosterone therapy. Finasteride does not present a risk of neoplasms.