Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. The nurse is caring for a female patient who would like to start taking oral
contraceptives. What assessment finding may indicate the patient is not a good
candidate for these drugs?
a. Decreased appetite
b. Dehydration
c. Occasional headaches
d. History of deep vein thrombosis
Ans: D
Feedback:
Estrogens are contraindicated in the presence of a history of thromboembolic
disorders because of the increased risk of thrombus and embolus development. A loss
of appetite would not contraindicate oral contraceptives but would require further
assessment to determine the cause. Dehydration would require fluid administration to
correct but is not a contraindication to oral contraceptives. Occasional headaches are
not uncommon and would not contraindicate contraceptive use.
2. The nurse is caring for a patient with an intact uterus who requests hormone
replacement for short-term use to reduce menopausal symptoms. What
combination drug would be appropriate for this patient?
a. Estrace
b. Premphase
c. Premarin
d. Estratab
Ans: B
Feedback:
The patient would be given Premphase because it is a combination of estrogen and
progesterone. The combination is important to help avoid risk of endometrial
hyperplasia. Estrace, Premarin, and Estratab contain only estrogen so they are not
combination drugs.
3. The nurse is caring for a patient who just had subdermal implantation of
NuvaRing. As part of drug teaching, the nurse will tell the patient this implant
needs to be removed when?
a. 3 months
b. 6 months
, c. 1 year
d. 3 years
Ans: D
Feedback:
Etonogestrel, in addition to being available as a vaginal ring, NuvaRing, is available
as a subdermal implant that may be left in place for up to 3 years and then must be
removed. Another implant could be placed at that time.
4. A patient tells the nurse she is taking soy, calcium, and a multivitamin as an
alternative to taking hormone replacement pills. What is the nurse’s priority
response?
a. Increase her iron supplement.
b. Discontinue her calcium supplement.
c. Decrease the amount of carbohydrates in her diet.
d. Increase calcium supplementation.
Ans: B
Feedback:
The nurse may advise the patient to stop using a calcium supplement because soy is
not to be taken with calcium, iron, or zinc. However, the patient may have to decide
whether it would be more beneficial for her to continue the calcium and discontinue
the soy if osteoporosis is a concern. Decreasing carbohydrates is a healthy choice,
especially for a menopausal woman, but would not be the priority concern.
5. A patient with a seizure disorder taking phenytoin (Dilantin) requests a
prescription for an oral contraceptive. What is the nurse’s priority response?
a. The effect of oral contraceptives containing progestin is reduced by
phenytoin.
b. The effect of oral contraceptives containing progestin and estrogen is
reduced by phenytoin.
c. The effect of oral contraceptives containing estrogen is reduced by
phenytoin.
d. You will need to increase the dosage of your phenytoin once you start
contraceptives.
Ans: B
Feedback:
The effectiveness of oral contraceptives containing estrogen, progestin, or both will
be reduced by phenytoin, so contraceptives will not be adequate to prevent pregnancy.
There is no reason to change the dosage of phenytoin.
6. A patient is using a progestin vaginal gel. What possible adverse effects should the
nurse tell the patient about?
1. The nurse is caring for a female patient who would like to start taking oral
contraceptives. What assessment finding may indicate the patient is not a good
candidate for these drugs?
a. Decreased appetite
b. Dehydration
c. Occasional headaches
d. History of deep vein thrombosis
Ans: D
Feedback:
Estrogens are contraindicated in the presence of a history of thromboembolic
disorders because of the increased risk of thrombus and embolus development. A loss
of appetite would not contraindicate oral contraceptives but would require further
assessment to determine the cause. Dehydration would require fluid administration to
correct but is not a contraindication to oral contraceptives. Occasional headaches are
not uncommon and would not contraindicate contraceptive use.
2. The nurse is caring for a patient with an intact uterus who requests hormone
replacement for short-term use to reduce menopausal symptoms. What
combination drug would be appropriate for this patient?
a. Estrace
b. Premphase
c. Premarin
d. Estratab
Ans: B
Feedback:
The patient would be given Premphase because it is a combination of estrogen and
progesterone. The combination is important to help avoid risk of endometrial
hyperplasia. Estrace, Premarin, and Estratab contain only estrogen so they are not
combination drugs.
3. The nurse is caring for a patient who just had subdermal implantation of
NuvaRing. As part of drug teaching, the nurse will tell the patient this implant
needs to be removed when?
a. 3 months
b. 6 months
, c. 1 year
d. 3 years
Ans: D
Feedback:
Etonogestrel, in addition to being available as a vaginal ring, NuvaRing, is available
as a subdermal implant that may be left in place for up to 3 years and then must be
removed. Another implant could be placed at that time.
4. A patient tells the nurse she is taking soy, calcium, and a multivitamin as an
alternative to taking hormone replacement pills. What is the nurse’s priority
response?
a. Increase her iron supplement.
b. Discontinue her calcium supplement.
c. Decrease the amount of carbohydrates in her diet.
d. Increase calcium supplementation.
Ans: B
Feedback:
The nurse may advise the patient to stop using a calcium supplement because soy is
not to be taken with calcium, iron, or zinc. However, the patient may have to decide
whether it would be more beneficial for her to continue the calcium and discontinue
the soy if osteoporosis is a concern. Decreasing carbohydrates is a healthy choice,
especially for a menopausal woman, but would not be the priority concern.
5. A patient with a seizure disorder taking phenytoin (Dilantin) requests a
prescription for an oral contraceptive. What is the nurse’s priority response?
a. The effect of oral contraceptives containing progestin is reduced by
phenytoin.
b. The effect of oral contraceptives containing progestin and estrogen is
reduced by phenytoin.
c. The effect of oral contraceptives containing estrogen is reduced by
phenytoin.
d. You will need to increase the dosage of your phenytoin once you start
contraceptives.
Ans: B
Feedback:
The effectiveness of oral contraceptives containing estrogen, progestin, or both will
be reduced by phenytoin, so contraceptives will not be adequate to prevent pregnancy.
There is no reason to change the dosage of phenytoin.
6. A patient is using a progestin vaginal gel. What possible adverse effects should the
nurse tell the patient about?
