Unit4: Ch 41- Drugs Affecting the Male Reproductive System (Karch 7th Ed)

Question 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

Answer 1

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

Question 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

Answer 2

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.

Question 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

Answer 3

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.

Question 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)

Answer 4

Ans: D
Feedback:
A good choice for this patient would be testosterone because the drug can be administered in longacting
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.

Question 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

Answer 5

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.

Question 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

Answer 6

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.

Question 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

Answer 7

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.

Question 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.

Answer 8

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.

Question 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

Answer 9

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.

Question 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.

Answer 10

Ans: B
Feedback:
Creatine is a protein by-product that has to be processed through the kidneys. If an athlete is using it to
try to increase muscle size, he should be advised to drink plenty of fluids to help flush it through the
kidney and to watch for any swelling that could indicate change in renal function. NSAIDs could
aggravate renal problems and cause more swelling. Getting protein from food sources is a natural way
to provide the body with proteins. If stomach upset occurs, the athlete should stop using the herbal
therapy and not add another drug to his regimen, especially cimetidine that can increase risk of kidney
damage.

Question 11

A 9-year-old boy is taking testosterone injections for treatment of hypogonadism. What should be
measured every 6 months on this child?
A) Liver function test (LFT)
B) Cholesterol level
C) Vision
D) Hand and wrist radiographs

Answer 11

Ans: D
Feedback:
Because of the effects of these hormones on epiphyseal closure, children should be closely monitored
with hand and wrist radiographs before treatment and every 6 months after treatment. It would not be
necessary to measure LFTs, cholesterol levels, or the child’s vision.

Question 12

The nurse assesses the patient taking anabolic steroids for what serious adverse effects?
A) Elevated blood urea nitrogen (BUN)
B) Elevated blood glucose level
C) Bradycardia
D) Jaundice

Answer 12

Ans: D
Feedback:
Anabolic steroids all have black box warnings as alerts to the potentially serious effects of liver tumors,
hepatitis, and blood lipid level changes that might be associated with increased risk of coronary artery
disease. As a result, the nurse should assess for jaundice that could be an early indication of liver
dysfunction. Elevated BUN, blood glucose levels, and bradycardia are not commonly reported adverse
effects.

Question 13

What therapeutic effect will the nurse assess for in the male patient taking anabolic steroids?
A) Thinning of the skin
B) Body hair loss
C) Increase in red blood cells (RBCs) and hemoglobin
D) Gynecomastia

Answer 13

Ans: C
Feedback:
Therapeutic effects include promotion of body tissue-building processes, reverse catabolic or tissuedestroying
processes, and increased hemoglobin and red blood cell mass. Thinning of the skin and body
hair loss are not associated effects of anabolic steroids. Gynecomastia is an adverse effect and would
not be a therapeutic effect for which the drug was administered

Question 14

An woman is prescribed androgens. The nurse teaches the patient to anticipate what effect from the
drug?
A) Atrophy of breasts
B) Rapid bone growth
C) Loss of pubic hair
D) Nervousness

Answer 14

Ans: D
Feedback:
Antiestrogen effects flushing, sweating, vaginitis, nervousness, and emotional lability can be anticipated
when these drugs are used in women. When androgens are administered to women you would not
expect the results to include atrophy of the breasts, rapid bone growth, or loss of pubic hair.

Question 15

The nurse is caring for a patient who has been taking androgens and has been admitted to the ICU
following a car accident. What lab results will the nurse interpret as more indicative of androgen
therapy than actual disease states? (Select all that apply.)
A) Decreased thyroid function
B) Increased creatinine levels
C) Increased creatinine clearance
D) Elevated liver enzymes
E) Increased white blood cell (WBC) count

Answer 15

Ans: A, B, C
Feedback:
While a patient is taking androgens, thyroid function may be decreased, as well as increased creatinine
and creatinine clearance, results that are not associated with disease states. These effects can last up to
2 weeks after the discontinuation of therapy. Elevated liver enzymes may indicate a potentially lifethreatening
effect that has been documented is hepatocellular cancer. Increased WBC count would
indicate an infection. Increased liver enzymes and WBC are not associated with androgen therapy but
instead indicate a disease state

Question 16

The 63-year-old male patient receives a prescription for androgens. The nurse evaluates that the patient
understood drug teaching when he makes what statement?
A) If I experience acne, I will contact my physician immediately.
B) If I experience flushing, sweating, nervousness, or emotional lability I’ll know it’s the drug.
C) I will report any difficulty urinating such as trouble starting my flow.
D) These pills may make my skin turn yellow but it will go away when the drug is stopped.

Answer 16

Ans: B
Feedback:
Benign prostatic hypertrophy, a common problem in older men, may be aggravated by androgenic
effects that may enlarge the prostate further, leading to urinary difficulties and increased risk of
prostate cancer. Nurses should teach these men the signs and symptoms of prostatic enlargement and
the importance of reporting these manifestations immediately to prevent worsening of symptoms. Acne
need not be reported immediately. Flushing, sweating, nervousness, and emotional lability are more
usually experienced by women. Yellowing of the skin may be an indication of liver disease, which
should be reported immediately.

Question 17

A female athlete is using high doses of anabolic steroids to enhance her performance. The nurse warns
this patient that such use of anabolic steroids is likely to result in what?
A) Masculinization
B) Immobility of joints
C) Obesity
D) Hypotension

Answer 17

Ans: A
Feedback:
Adverse effects in women include masculinization effects, hirsutism, and deepening of the voice. A
woman using anabolic steroids would not expect it to result in joint immobility, obesity, or
hypotension.

Question 18

The nurse attributes what assessment finding to the use of androgens by the male patient?
A) Testicular atrophy
B) Increased fertility
C) Increased urination
D) Hoarseness

Answer 18

Ans: A
Feedback:
In adult men, adverse effects include inhibition of testicular function, gynecomastia, testicular atrophy,
priapism, baldness, and change in libido. Increased fertility, increased urination, and hoarseness would
not be expected assessment findings.

Question 19

The nurse administers danazol (Danocrine) be a woman for what purpose?
A) Reverse folic acid deficiencies
B) Increase hair growth
C) Decrease symptoms of endometriosis
D) Prevent toxic shock syndrome.

Answer 19

Ans: C
Feedback:
Danazol may be used in women to prevent or treat endometriosis or fibrocystic breast disease. Danazol
is not prescribed for increased hair growth, to reverse folic acid deficiencies, or to prevent toxic shock
syndrome.

Question 20

The nurse assesses the young adult athlete who has been taking anabolic steroids to enhance his
performance. What findings would the nurse associate with this practice? (Select all that apply.)
A) Personality changes
B) Sexual dysfunction
C) Increased serum lipid levels
D) Cardiomyopathy
E) Weight loss

Answer 20

Ans: A, B, C, D
Feedback:
Cardiomyopathy, hepatic carcinoma, personality changes, and sexual dysfunction are all associated with the excessive and off-label use of anabolic steroids for athletic performance enhancement.
Adverse effects associated with prescription use include inhibition of testicular function, gynecomastia,
testicular atrophy, priapism, baldness, change in libido, serum electrolyte changes, liver dysfunction,
insomnia, and weight gain, not weight loss.

Question 21

The nurse learns a patient receiving a new prescription for oxandrolone takes a lipid-lowering
medication daily. What will the nurse tell the patient about this drug interaction?
A) Lipid-lowering drug becomes much less effective.
B) Increased risk of oxandrolone toxicity with this combination of drugs
C) Increased risk of liver damage with this combination of drugs
D) Oxandrolone becomes less effective with this combination of drugs.

Answer 21

Ans: A
Feedback:
Anabolic steroids may alter lipid metabolism and cause a lack of effectiveness for lipid-lowering
agents. Lipid-lowering medications do not impact anabolic steroids and there is no increased risk for
toxicity of either drug.

Question 22

What supplement would be safest for a diabetic female athlete wishing to improve athletic
performance?
A) Bee pollen
B) Damiana
C) Wild yam
D) Spirulina

Answer 22

Ans: C
Feedback:
Wild yam is an estrogen-like herb used to increase athletic performance, slow the aging process, and
improve energy and stamina. It can be toxic to the liver and may cause breast pain but is the safest of
these supplements. Bee pollen is associated with serious allergic reactions and random studies have
found wide variety of ingredients in each product. Damiana interferes with antidiabetic agents so it
would not be appropriate for this patient. Spirulina may contain toxic metals and can cause serious
reactions in children and pets. It interferes with vitamin B12absorption and there are no studies to prove
it is effective in the claims it makes.

Question 23

When a 5-year-old patient is prescribed oxandrolone (Oxandrin) to promote weight gain, how would
the nurse expect the drug to be administered?
A) Long-term
B) Short-term
C) Continuous
D) Intermittent

Answer 23

Ans: D
Feedback:
Oxandrin is given intermittently to pediatric patients and should not be used on a daily basis for short,
long, or continuous therapy.

Question 24

The nurse gives a class at the local high school on the use of anabolic steroids. The nurse explains that
one of the most serious and all too common side effects of using these drugs without a prescription and
medical follow-up is what?
A) Renal stones
B) Death
C) Cirrhosis
D) Malignant hyperthermia

Answer 24

Ans: B
Feedback:
Prolonged use of high doses may cause potentially life-threatening conditions, placing the patient at
risk of death. Conditions such as peliosis hepatis, hepatic neoplasms, and hepatocellular carcinoma are
often seen with high-dose street use of these drugs. Renal stones, cirrhosis, and malignant hyperthermia
are not associated with the use of anabolic steroids.

Question 25

When fluoxymesterone (Androxy) is administered to a 14-year-old boy for hypogonadism, what is the
expected result?
A) Enlarged sex organs
B) Decreased skin thickness
C) Increased protein metabolism
D) Increased sperm production

Answer 25

Ans: A
Feedback:
In prepubertal boys, administration of male sex hormone-like drugs will stimulate development of
masculine characteristics and cause development of the male sexual organs. Production of sperm will
occur when the boy enters puberty. These drugs are not administered to decrease skin thickness or
increase protein metabolism.

Question 26

A 69-year-old man is prescribed testosterone. The patient is found to have hypertension and a history of
congestive failure after assessment by the nurse. What is this patient at increased risk for?
A) Fluid retention
B) Impotence
C) Liver failure
D) Kidney failure

Answer 26

Ans: A
Feedback:
Older adults often have hypertension and other cardiovascular disorders that may be aggravated by
sodium and water retention associated with androgens and anabolic steroids. Testosterone would not
increase the risk of impotence. Liver and kidney failure could be exacerbated by the drug if they were
preexisting conditions but since that is not indicated by the question, this would be a lower risk than
fluid retention

Question 27

The nurse is caring for a patient with cryptorchidism who is 28 years old and taking testosterone to treat
his condition. What statement by this patient would lead the nurse to believe that he has understood the
teaching provided about the drug?
A) “My body hair may increase.”
B) “My sexual desire may increase.”
C) “My voice may become higher.”
D) “My skin may become clear and soft.”

Answer 27

Ans: A
Feedback:
Androgenic effects include acne, edema, hirsutism (increased hair distribution), deepening of the voice,
oily skin and hair, weight gain, decrease in breast size, and testicular atrophy. Testosterone does not
make the skin clear and soft, it does not make the voice higher, and the testicular atrophy is more likely
to decrease rather than increase libido.

Question 28

A 16-year-old boy is diagnosed with delayed onset of puberty and the physician has ordered
testosterone, intramuscular (IM), once every 2 weeks. What nursing intervention would be important to
the patient?
A) Discuss changes that will occur in his body.
B) Have patient fast before injection.
C) Have patient reduce protein intake.
D) Decrease exercise while on this hormonal treatment.

Answer 28

Ans: A
Feedback:
It is important for this patient to understand what will happen and the changes he will see to reduce the
anxiety that could occur if he didn’t understand. Discuss the development of masculine characteristics
as well as common adverse effects such as acne. Having the patient fast before the injection would not
be necessary, nor would decreasing exercise or reducing protein intake.

Question 29

A patient has been prescribed sildenafil citrate. What should the nurse teach the patient about this
medication?
A) Take the medication with a glass of grapefruit juice.
B) The drug should be taken 1 hour before attempting intercourse.
C) Facial flushing or headache should be reported to the physician immediately.
D) A dose exceeding 80 mg will result in a change of vision, making everything appear blue.

Answer 29

Ans: B
Feedback:
The drug should be taken approximately 1 hour before intercourse to allow adequate time for
absorption and therapeutic effects to occur. Facial flushing, mild headache, indigestion, and running
nose are common side effects of sildenafil citrate and do not need to be reported unless they become
acute. The blue haze that occurs with the 100-mg dosage is transient (it lasts about 1 hour). Grapefruit
juice should be avoided 2 days before until 2 days after taking the medication because it prolongs the
drugs metabolism and excretion.

Question 30

A 55-year-old man presents at the clinic complaining of erectile dysfunction. The patient has a history
of diabetes mellitus. The physician orders tadalafil (Cialis) to be taken 1 hour before sexual intercourse.
The nurse reviews the patient’s history before instructing the patient on the use of this medication.
What disorder (or condition) would contraindicate the use of tadalafil (Cialis)?
A) Cataracts
B) Penile implant
C) Hypotension
D) Lung cancer

Answer 30

Ans: B
Feedback:
Patients with a penile implant should not take tadalafil. Patients with cataracts, hypotension, or lung
cancer may take tadalafil if needed but should do so with caution and should be carefully monitored for
adverse effects.

Question 31

For what reason might the nurse administer sildenafil to a woman?
A) Pulmonary arterial hypertension
B) Sexual dysfunction
C) Breast cancer
D) Endometriosis

Answer 31

Ans: A
Feedback:
Sildenafil is used to treat erectile dysfunction in the presence of sexual stimulation in men and to treat
pulmonary arterial hypertension in women. It is not used for sexual dysfunction, breast cancer, or endometriosis in women

Question 32

A 68-year-old male patient tells the nurse that he has been unable to get an erection for the past 6
months and he guesses his sex life is over. The provider orders diagnostic testing to determine whether
sildenafil (Viagra) is appropriate for the patient. What is the most correct nursing diagnosis for this
patient?
A) Sexual dysfunction
B) Disturbed body image
C) Ineffective sexuality pattern
D) Disturbed tactile sensory perception

Answer 32

Ans: A
Feedback:
The patient is experiencing sexual dysfunction so that would be the most appropriate nursing diagnosis.
The patient did not discuss feeling let down by or unhappy with his body so disturbed body image is
incorrect. The effectiveness of sexual pattern is not known. No problem with sensory perception is
indicated by this question.

Question 33

The 22-year-old patient tells the nurse he doesn’t have trouble obtaining and maintaining an erection
but wonders if taking Viagra would improve the sexual experience anyway. What is the nurse’s best
response?
A) The only thing Viagra does is improve blood flow to the penis to make it erect.
B) Viagra improves stamina and sensation, making the sexual experience better.
C) Viagra has its greatest effect if both the man and woman take it at the same time.
D) Viagra does nothing to improve the sexual experience.

Answer 33

Ans: A
Feedback:
Viagra improves blood flow into the penis and that is its only effect. It does not improve stamina or
sensation. Research has indicated it has no effect on women’s sexual response. To say only that Viagra
does nothing would not provide adequate information for the patient.

Question 34

The patient is prescribed oxandrolone 2.5 mg twice a day and is told to increase the dosage to gain
weight to a maximum of 20 mg/d. If each tablet contains 2.5 mg, how many tablets would the nurse tell the patient he may take per day to avoid exceeding the 20 mg/d maximum?
A) 4
B) 6
C) 8
D) 10

Answer 34

Ans: C
Feedback:
Calculate the number of tablets required to administer 20 mg by dividing 20 mg by 2.5 mg. 20/2.5 = 8
tablets

Question 35

The patient is prescribed sildenafil 25 mg PO one hour before sexual intercourse is planned. The patient
returns for follow-up care and says that 25 mg did not produce an erection so he increased the dosage.
How much of an increase would be enough to concern a nurse?
A) 50 mg
B) 75 mg
C) 100 mg
D) 25 mg

Answer 35

Ans: C
Feedback:
Normal dosage range is 25 to 100 mg so the nurse should not be concerned unless the dosage exceeded
100 mg.