NURS 317 Unit 4 Chapter 41 Pharm Point Questions Flashcards
The client asks the nurse if there is a medication that can be taken to treat erectile dysfunction that would last longer than 4 hours. What drug is the nurse aware of that the client could take after work that would still have an effect late that night?
A) Sildenafil
B) Alprostadil
C) Tadalafil
D) Vardenafil
C) Tadalafil
Rationale:Tadalafil is approved for daily use in men who are very active sexually. This drug may be selected if the timing of sexual stimulation is not known and may be more than 4 hours away. Vardenafil must be taken approximately 1 hour before sexual stimulation. Sildenafil must be taken approximately 1 hour before sexual stimulation. Alprostadil is injected directly into the cavernosum.
The nurse is caring for a client who has experienced significant muscle wasting secondary to cancer. What medication is most likely to benefit this client?
A) Danazol
B) Alprostadil
C) Oxandrolone
D) Tadalafil
C) Oxandrolone
Rationale:Oxandrolone is an anabolic steroid, which promotes muscle development. Danazol is an androgen. Alprostadil is a prostaglandin. Tadalafil is a phosphodiesterase type 5 receptor inhibitor.
Testosterone is injected directly into the corpus spongiosum.
A) FALSE
B) TRUE
A) FALSE
Rationale:Alprostadil is injected directly into the corpus cavernosum.
Androgens are used as replacement therapy for hypergonadism.
A) TRUE
B) FALSE
B) FALSE
Rationale:Hypogonadism is an indication for use of androgens as replacement therapy.
A client with erectile dysfunction has been prescribed alprostadil. What nursing action is most appropriate?
A) Caution the client against drinking grapefruit juice for the duration of treatment.
B) Educate the client about correct placement of the transdermal patch and the schedule for replacement.
C) Ensure the client is comfortable with having an injection in his penis.
D) Assess the integrity of the client’s testicles.
C) Ensure the client is comfortable with having an injection in his penis.
Rationale:Alprostadil is injected directly into the corpus cavernosum. It is not available as a patch. Testicular examination is not necessary, and the client does not have to avoid grapefruit juice.
After teaching a client who is prescribed sildenafil about using the drug, the nurse determines that the teaching was successful when the client makes what statement?
A) “I need to take the pill about an hour before any sexual stimulation.”
B) “I can take the pill in the morning before I engage in sex later in the day.”
C) “I should take the pill after dinner if I’m planning to have sex later that night.”
D) “I should take the medication just before I start having sex.”
A) “I need to take the pill about an hour before any sexual stimulation.”
Rationale:Sildenafil should be taken approximately 1 hour before sexual stimulation. The duration of effect is only 4 hours, so taking it more than 4 hours before having sexual intercourse would be incorrect.
What would the nurse expect to administer as a depot injection?
A) Danazol
B) Testosterone
C) Fluoxymesterone
D) Methyltestosterone
B) Testosterone
Rationale:Testosterone is administered IM, transdermally, and in long-acting depository (depot injection) forms. The others are administered orally.
What actions does the nurse anticipate after administering testosterone?
A) Decreased production of red blood cells
B) Decreased retention of nitrogen
C) Decreased protein catabolism
D) Decreased retention of sodium
C) Decreased protein catabolism
Rationale:Protein catabolism increases with testosterone use, while red blood cell production, retention of nitrogen, and retention of sodium increase.
A 30-year-old male is receiving oxymetholone as treatment for anemia. The nurse alerts the client to what possible adverse effects? Select all that apply.
A) Testicular atrophy
B) Gynecomastia
C) Priapism
D) Hirsutism
E) Baldness
A) Testicular atrophy
B) Gynecomastia
C) Priapism
Rationale:In postpubertal males, oxymetholone can cause gynecomastia, priapism, and testicular atrophy. Hirsutism and baldness may occur in women.
The nurse is taking the health history of a client who is requesting a prescription for sildenafil. What aspect of the client’s health history should the nurse prioritize?
A) The client is allergic to tree nuts and shellfish
B) The client has type 2 diabetes, controlled with diet
C) The client experienced ototoxicity from gentamicin several years ago
D) The client has a history of angina
D) The client has a history of angina
Rationale:Sildenafil is contraindicated in men who take nitrates for ischemic heart disease; the nurse should assess the client’s medication regimen related to angina. Allergies, type 2 diabetes, and ototoxicity do not contraindicate the use of sildenafil.
A client with erectile dysfunction has been prescribed a PDE5 inhibitor. What dietary modification should the nurse emphasize?
A) Limiting intake of shellfish
B) Limiting high-potassium foods and salt substitutes
C) Avoidance of aged cheese and red wine
D) Avoidance of grapefruit juice
D) Avoidance of grapefruit juice
Rationale:Clients who are using PDE5 inhibitors 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. There are not contraindications against the other listed foods.
What drug could the nurse administer to a client requiring androgen therapy who is incapable of swallowing pills or tablets?
A) Danazol
B) Methyltestosterone
C) Testosterone
D) Fluoxymesterone
C) Testosterone
Rationale:Testosterone is available in many different forms including oral, injectable, topical, transdermal patches, and sprays. All of the other options are available only as a PO medication.
Anabolic steroids are analogues of testosterone with increased protein-building effects.
A) FALSE
B) TRUE
B) TRUE
Rationale:The anabolic steroids are analogues of testosterone that have been developed to produce the tissue-building effects of testosterone with less androgenic effect. Anabolic steroids include oxandrolone and oxymetholone.
Which client would be most likely to benefit from testosterone injections?
A) 16-year-old boy who has not yet begun puberty
B) An adult client with testicular cancer
C) A 13-year-old client with orchitis
D) An older adult client with benign prostatic hyperplasia
A) 16-year-old boy who has not yet begun puberty
Rationale:Delayed male puberty is an indication for exogenous testosterone. It is not used to treat BPH, orchitis, or testicular cancer.
The nurse is explaining the negative effects of anabolic steroids for enhancing athletic performance to the adolescent female client experiencing negative effects. The client asks the nurse if there is research to prove herbal and alternative therapies can improve performance. What is the nurse’s best response?
A) “Creatine is all natural, effective as a performance enhancer, and can be used long term.”
B) “Bee pollen has been proven to be very effective.”
C) “Spirulina is completely safe and has studies to prove its effectiveness.”
D) “Wild yam has been found to have many estrogen-like effects and is used to increase athletic performance.”
D) “Wild yam has been found to have many estrogen-like effects and is used to increase athletic performance.”
Rationale:Wild yam has been found to have many estrogen-like effects. This herb is used to increase athletic performance because it may contain a constituent of dehydroepiandrosterone (DHEA) used to slow the aging process and improve energy and stamina. There have been no studies to prove the claim of improved athletic performance with bee pollen. There is no scientific data available for creatine effects, and it should only be used short term because of risk to kidney function. Spirulina has no scientific studies to validate its effectiveness and could contain toxic metals.
