Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. A nurse is caring for an adolescent with hypogonadism who has been prescribed
fluoxymesterone (Androxy) for replacement. What adverse effect of this drug will
the nurse alert the patient to that could result in self-esteem concerns?
a. Acne
b. Dizziness
c. Insomnia
d. Fatigue
Ans: A
Feedback:
All these options are possible adverse effects of the drug. However, for the
adolescent, acne is the only one that could cause image concerns, which could lead to
low self-esteem. Dizziness, insomnia, and fatigue would not cause self-esteem
concerns.
2. A postmenopausal patient has been diagnosed with breast cancer. The patient is
being treated with methyltestosterone (Testred). What assessment finding would
the nurse suspect is a complication from the medication?
a. Increased blood pressure
b. Jaundice
c. Weight loss
d. High-pitched voice
Ans: B
Feedback:
, A potentially life-threatening effect of an androgen is hepatocellular cancer. Jaundice
would indicate that the liver function has been compromised. Usually weight gain and
deepening of the voice are adverse effects of this drug. An increase in blood pressure
is not associated with methyltestosterone.
3. The nurse administers an androgen and assesses the patient for what action caused
by this drug?
a. Decreased production of red blood cells
b. Decreased protein anabolism
c. Increased protein catabolism
d. Increased retention of nitrogen
Ans: D
Feedback:
Androgens act to increase the retention of nitrogen, sodium, potassium, and
phosphorous. They increase production of red blood cells and protein anabolism and
decrease protein catabolism.
4. An older male patient, who has difficulty swallowing pills and tablets, will begin
taking an androgen. What drug would the nurse identify as a good choice for this
patient?
a. Danazol (Danocrine)
b. Fluoxymesterone (Androxy)
c. Methyltestosterone (Testred)
d. Testosterone (Androderm)
Ans: D
Feedback:
A good choice for this patient would be testosterone because the drug can be
administered in long- acting depository forms and by dermatologic patch. These
forms would eliminate the need for the patient to swallow a pill or tablet. The other
options shown here are available only in oral form.
5. A 28-year-old female patient is taking danazol (Danocrine) as treatment for
endometriosis. The patient is upset about increased facial hair, a weight gain of 15
pounds, and a change in her voice; she discusses her concerns with the nurse. What
nursing diagnoses would be most appropriate for this patient?
a. Acute pain related to need for injections
b. Deficient knowledge regarding drug therapy
c. Disturbed body image related to drug therapy
d. Sexual dysfunction related to androgenic effects
Ans: C
Feedback:
, The patient is concerned about the way she looks and the sound of her voice. The
most appropriate nursing diagnosis would be disturbed body image. Danazol is not
administered by injections; therefore, acute pain would not be applicable. Sexual
dysfunction and deficient knowledge would be possible nursing diagnoses for this
patient, but the concerns expressed by the patient fail to support these diagnoses.
6. A child in renal failure is taking androgens to promote red blood cell production
and is seen in the clinic every other month. What adverse drug effect would the
nurse monitor for with this child?
a. Epiphyseal closure
b. Acne
c. Skin color
d. Weight gain
Ans: A
Feedback:
Because of the effects of androgens on epiphyseal closure, children should be closely
monitored with hand and wrist radiographs before treatment and every 6 months after
treatment. The other options are also adverse effects and require monitoring but are
not as serious as premature epiphyseal closure.
7. A patient has high blood pressure and penile erectile dysfunction. He asks the
nurse if he could try tadalafil (Cialis) after seeing an advertisement on television.
What medications, if taken by the patient, would the nurse recognize as increasing
the risk associated with taking tadalafil?
a. Beta-blockers
b. Angiotensin-converting enzyme (ACE) inhibitors
c. Alpha-adrenergic blockers
d. Calcium channel blockers
Ans: C
Feedback:
Serious drops in blood pressure, leading to potentially fatal myocardial infarction or
cerebrovascular event, have been reported when Cialis is combined with alpha-
adrenergic blockers. This reaction has not been reported with beta-blockers, calcium
channel blockers, or ACE inhibitors.
8. A patient will begin taking sildenafil (Viagra) for penile erectile dysfunction (ED).
What is the nurse’s priority teaching point about this drug?
a. He will have an erection exactly 1 hour after taking the drug.
b. The drug should not be taken with a penile implant or any anatomic penile
obstruction.
c. Avoid drinking grapefruit juice for 2 days before and after taking the drug.
, d. It is important to know the cause of ED because sildenafil does not treat all
causes.
Ans: C
Feedback:
Patients who are using sildenafil need to be advised to avoid drinking grapefruit juice
while using the drug. Grapefruit juice can cause a decrease in the metabolism of the
PDE5 inhibitor, leading to increased serum levels and a risk of toxicity. They need to
know that it takes 48 hours for grapefruit juice to be processed by the body, so they
need to avoid it for several days before and after taking the drug. The patient should
be screened for penile implants, anatomic penile obstruction, and the cause of ED
before the drug is prescribed. Sildenafil has a median onset of 27 minutes and
duration of 4 hours so the patient may have an erection as early as 27 minutes after
taking it.
9. A patient is prescribed oxymetholone (Anadrol-50) for treatment of angioedema.
The nurse knows the patient has type 2 diabetes and will instruct the patient that
the combination of oxymetholone with antidiabetic agents may lead to what?
a. Hyperglycemia
b. Hypoglycemia
c. Jaundice
d. Urinary retention
Ans: B
Feedback:
Because of its effects on the liver, oxymetholone (Anadrol-50) may interact with
antidiabetic agents to decrease their metabolism and increase their effectiveness,
leading to hypoglycemia. The dosage of the antidiabetic agents should be reduced and
the patient monitored closely. It would not lead to hyperglycemia, jaundice, and
urinary retention.
10. A student athlete presents at the clinic for his physical checkup. The athlete tells
the nurse that he is using large doses of creatine to increase muscle size and
strength. What should the nurse instruct the student to do while taking this
medication?
a. Take nonsteroidal anti-inflammatory drugs (NSAIDs) to stop pain from
expanding muscles.
b. Drink plenty of fluids while using this drug and watch for swelling.
c. Stop eating red meat or other animal products.
d. Take cimetidine (Tagamet) to relieve the stomach upset associated with the
use of this therapy.
Ans: B
Feedback:
1. A nurse is caring for an adolescent with hypogonadism who has been prescribed
fluoxymesterone (Androxy) for replacement. What adverse effect of this drug will
the nurse alert the patient to that could result in self-esteem concerns?
a. Acne
b. Dizziness
c. Insomnia
d. Fatigue
Ans: A
Feedback:
All these options are possible adverse effects of the drug. However, for the
adolescent, acne is the only one that could cause image concerns, which could lead to
low self-esteem. Dizziness, insomnia, and fatigue would not cause self-esteem
concerns.
2. A postmenopausal patient has been diagnosed with breast cancer. The patient is
being treated with methyltestosterone (Testred). What assessment finding would
the nurse suspect is a complication from the medication?
a. Increased blood pressure
b. Jaundice
c. Weight loss
d. High-pitched voice
Ans: B
Feedback:
, A potentially life-threatening effect of an androgen is hepatocellular cancer. Jaundice
would indicate that the liver function has been compromised. Usually weight gain and
deepening of the voice are adverse effects of this drug. An increase in blood pressure
is not associated with methyltestosterone.
3. The nurse administers an androgen and assesses the patient for what action caused
by this drug?
a. Decreased production of red blood cells
b. Decreased protein anabolism
c. Increased protein catabolism
d. Increased retention of nitrogen
Ans: D
Feedback:
Androgens act to increase the retention of nitrogen, sodium, potassium, and
phosphorous. They increase production of red blood cells and protein anabolism and
decrease protein catabolism.
4. An older male patient, who has difficulty swallowing pills and tablets, will begin
taking an androgen. What drug would the nurse identify as a good choice for this
patient?
a. Danazol (Danocrine)
b. Fluoxymesterone (Androxy)
c. Methyltestosterone (Testred)
d. Testosterone (Androderm)
Ans: D
Feedback:
A good choice for this patient would be testosterone because the drug can be
administered in long- acting depository forms and by dermatologic patch. These
forms would eliminate the need for the patient to swallow a pill or tablet. The other
options shown here are available only in oral form.
5. A 28-year-old female patient is taking danazol (Danocrine) as treatment for
endometriosis. The patient is upset about increased facial hair, a weight gain of 15
pounds, and a change in her voice; she discusses her concerns with the nurse. What
nursing diagnoses would be most appropriate for this patient?
a. Acute pain related to need for injections
b. Deficient knowledge regarding drug therapy
c. Disturbed body image related to drug therapy
d. Sexual dysfunction related to androgenic effects
Ans: C
Feedback:
, The patient is concerned about the way she looks and the sound of her voice. The
most appropriate nursing diagnosis would be disturbed body image. Danazol is not
administered by injections; therefore, acute pain would not be applicable. Sexual
dysfunction and deficient knowledge would be possible nursing diagnoses for this
patient, but the concerns expressed by the patient fail to support these diagnoses.
6. A child in renal failure is taking androgens to promote red blood cell production
and is seen in the clinic every other month. What adverse drug effect would the
nurse monitor for with this child?
a. Epiphyseal closure
b. Acne
c. Skin color
d. Weight gain
Ans: A
Feedback:
Because of the effects of androgens on epiphyseal closure, children should be closely
monitored with hand and wrist radiographs before treatment and every 6 months after
treatment. The other options are also adverse effects and require monitoring but are
not as serious as premature epiphyseal closure.
7. A patient has high blood pressure and penile erectile dysfunction. He asks the
nurse if he could try tadalafil (Cialis) after seeing an advertisement on television.
What medications, if taken by the patient, would the nurse recognize as increasing
the risk associated with taking tadalafil?
a. Beta-blockers
b. Angiotensin-converting enzyme (ACE) inhibitors
c. Alpha-adrenergic blockers
d. Calcium channel blockers
Ans: C
Feedback:
Serious drops in blood pressure, leading to potentially fatal myocardial infarction or
cerebrovascular event, have been reported when Cialis is combined with alpha-
adrenergic blockers. This reaction has not been reported with beta-blockers, calcium
channel blockers, or ACE inhibitors.
8. A patient will begin taking sildenafil (Viagra) for penile erectile dysfunction (ED).
What is the nurse’s priority teaching point about this drug?
a. He will have an erection exactly 1 hour after taking the drug.
b. The drug should not be taken with a penile implant or any anatomic penile
obstruction.
c. Avoid drinking grapefruit juice for 2 days before and after taking the drug.
, d. It is important to know the cause of ED because sildenafil does not treat all
causes.
Ans: C
Feedback:
Patients who are using sildenafil need to be advised to avoid drinking grapefruit juice
while using the drug. Grapefruit juice can cause a decrease in the metabolism of the
PDE5 inhibitor, leading to increased serum levels and a risk of toxicity. They need to
know that it takes 48 hours for grapefruit juice to be processed by the body, so they
need to avoid it for several days before and after taking the drug. The patient should
be screened for penile implants, anatomic penile obstruction, and the cause of ED
before the drug is prescribed. Sildenafil has a median onset of 27 minutes and
duration of 4 hours so the patient may have an erection as early as 27 minutes after
taking it.
9. A patient is prescribed oxymetholone (Anadrol-50) for treatment of angioedema.
The nurse knows the patient has type 2 diabetes and will instruct the patient that
the combination of oxymetholone with antidiabetic agents may lead to what?
a. Hyperglycemia
b. Hypoglycemia
c. Jaundice
d. Urinary retention
Ans: B
Feedback:
Because of its effects on the liver, oxymetholone (Anadrol-50) may interact with
antidiabetic agents to decrease their metabolism and increase their effectiveness,
leading to hypoglycemia. The dosage of the antidiabetic agents should be reduced and
the patient monitored closely. It would not lead to hyperglycemia, jaundice, and
urinary retention.
10. A student athlete presents at the clinic for his physical checkup. The athlete tells
the nurse that he is using large doses of creatine to increase muscle size and
strength. What should the nurse instruct the student to do while taking this
medication?
a. Take nonsteroidal anti-inflammatory drugs (NSAIDs) to stop pain from
expanding muscles.
b. Drink plenty of fluids while using this drug and watch for swelling.
c. Stop eating red meat or other animal products.
d. Take cimetidine (Tagamet) to relieve the stomach upset associated with the
use of this therapy.
Ans: B
Feedback:
