Chapter 41: Drugs Used in Mens and Womens Health My Nursing Test Banks

Chapter 41: Drugs Used in Mens and Womens Health

Test Bank

MULTIPLE CHOICE

1. A female patient has developed leukorrhea since being on oral broad spectrum antibiotics for the past week for a lower respiratory infection. Which organism causes leukorrhea?

a.

Herpes simplex

b.

Mycoplasma hominis

c.

Human papillomavirus (HPV)

d.

Candida albicans

ANS: D

Candida albicans infections of the mouth, gastrointestinal tract, or vagina may develop as secondary infections during the use of broad spectrum antibiotics, such as penicillins, tetracyclines, and cephalosporins. Herpes simplex, Mycoplasma hominis, and HPV do not cause leukorrhea.

DIF: Cognitive Level: Comprehension REF: p. 642 OBJ: 1

TOP: Nursing Process Step: Assessment

MSC: NCLEX Client Needs Category: Physiological Integrity

2. A patient states that she has a difficult time remembering when to resume her triphasic contraceptive pills following her menses. Which alternative plan will the nurse suggest that she discuss with her health care provider?

a.

Changing to the 28-day packet

b.

Using the inert pills every other month

c.

Changing her prescription to the mini pill

d.

Calling the health care provider whenever she forgets to get appropriate instruction

ANS: A

Using the 28-day packet would allow her to continue with the same type of combination oral contraception. The 28-day packet would allow her to continue daily pills and eliminate the need to recall. Using the inert pills on alternate months will alter her menstrual schedule. Changing to the mini pill might not meet her contraceptive needs. It is unnecessary and inappropriate to contact the provider for missed doses.

DIF: Cognitive Level: Application REF: pp. 652-653 | p. 647

OBJ: 3 | 4 TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

3. Which is more likely to be experienced by women taking the mini pill as an oral contraceptive?

a.

Ovulation, dysmenorrhea, and break-through bleeding

b.

Excessive weight gain and breast tenderness

c.

Increased estrogen related adverse effects

d.

Difficulty breastfeeding after pregnancy

ANS: A

The mini pill is made up of progestin, which inhibits ovulation. This form of contraception is an alternative for women particularly susceptible to adverse effects caused by estrogen therapy. Between 30% and 40% of women continue to ovulate with this form of contraception, however, and there is a slightly higher incidence of uterine and tubal pregnancies. Dysmenorrhea, manifested by irregular or infrequent menses and spotting between cycles, is common in women taking the mini pill. The mini pill has a reduced chance for weight gain and breast tenderness, does not contain estrogen, and does not cause difficulty with breastfeeding.

DIF: Cognitive Level: Comprehension REF: p. 653 OBJ: 4

TOP: Nursing Process Step: Evaluation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

4. The nurse is obtaining a history on a patient who is seeking oral contraceptives. Which condition would contraindicate the use of oral contraceptives?

a.

Sexually transmitted diseases (STDs)

b.

Hypothyroidism

c.

Varicose veins

d.

Thromboembolic disease

ANS: D

Women who have a history of thromboembolic disease must consult with a health care provider before obtaining a prescription for an oral contraceptive. Serious adverse effects include embolisms and thrombus formation, cardiac abnormalities, seizures, and severe depression. STDs, hypothyroidism, and varicose veins do not pose a problem with contraceptive therapy.

DIF: Cognitive Level: Comprehension REF: p. 652 OBJ: 4

TOP: Nursing Process Step: Evaluation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

5. A patient diagnosed with benign prostatic hypertrophy asks why tamsulosin (Flomax), an alpha1 adrenergic blocking agent, has been prescribed. Which explanation by the nurse is most accurate?

a.

It inhibits the action of testosterone.

b.

It improves sexual function.

c.

It reduces the size of the prostate.

d.

It increases urinary flow.

ANS: D

Alpha 1 adrenergic blocking agents are used to relax the smooth muscle of the bladder and prostate. Tamsulosin specifically blocks alpha1 receptors on the prostate gland and certain areas of the bladder neck, causing muscle relaxation and increased urine flow in men with enlarged prostate glands. Adrenergic blocking agents do not affect hormone production, directly affect sexual function, or affect prostate size.

DIF: Cognitive Level: Comprehension REF: pp. 659-660 OBJ: 6

TOP: Nursing Process Step: Evaluation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

6. Which type of drug is most effective in the treatment of erectile dysfunction (ED)?

a.

Phosphodiesterase inhibitors

b.

Antiandrogen agents

c.

Sympathomimetic agents

d.

Alpha 1 adrenergic blocking agents

ANS: A

Sildenafil (Viagra), a phosphodiesterase inhibitor, increases cyclic guanosine monophosphate concentrations in the corpus cavernosum, which results in smooth muscle relaxation and greater blood flow into the corpus cavernosum, producing an erection. Antiandrogen agents, sympathomimetic agents, and adrenergic blocking agents are not effective in treating ED.

DIF: Cognitive Level: Comprehension REF: p. 662 OBJ: 7

TOP: Nursing Process Step: Evaluation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

7. The nurse is teaching a patient beginning therapy with dutasteride (Avodart). How long will it take before the patient can expect results?

a.

24 hours

b.

2 weeks

c.

1 month

d.

6 months

ANS: D

Longer than 6 to 12 months of treatment may be necessary to assess whether a therapeutic response has been achieved.

DIF: Cognitive Level: Comprehension REF: p. 660 OBJ: 6

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

8. Why must caution be used when taking a phosphodiesterase inhibitor to enhance male sexual function?

a.

It can become habit forming.

b.

Life-threatening consequences can occur with cardiovascular disorders.

c.

It is an ineffective treatment.

d.

It is expensive and available only by special prescription.

ANS: B

The patient must consult with a health care provider before using a phosphodiesterase inhibitor. People with cardiovascular disorders are particularly susceptible to life-threatening consequences with its use. It is unlikely that a patient will develop physiologic dependence on the medication, although psychological dependence may occur. Phosphodiesterase inhibitors can be a very effective treatment for ED. Phosphodiesterase inhibitors are readily available online and are not expensive.

DIF: Cognitive Level: Comprehension REF: p. 663 OBJ: 7

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

9. What is the mechanism whereby estrogen functions as a contraceptive?

a.

Inhibiting luteinizing hormone (LH), blocking release of ovum from a follicle

b.

Thinning cervical mucus, which inhibits sperm migration

c.

Trapping the ovum in the endometrial wall, preventing its growth

d.

Blocking follicle-stimulating hormone (FSH), thereby preventing release of ovum

ANS: D

Estrogens block pituitary release of FSH, preventing the ovaries from developing a follicle from which the ovum is released. Progestins inhibit pituitary release of LH, the hormone responsible for releasing an ovum from a follicle. Estrogens and progestins alter cervical mucus by making it thick and viscous, inhibiting sperm migration. Hormones also change the endometrial wall, impairing implantation of the fertilized ovum.

DIF: Cognitive Level: Comprehension REF: p. 647 OBJ: N/A

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

10. The nurse is instructing a patient on use of a transdermal contraceptive. When evaluating the patients understanding of the information provided, the nurse identifies a need for further education when the patient states:

a.

Apply the first patch during the first 24 hours of the menstrual period.

b.

Use a backup contraceptive concurrently for the first 7 days of the first cycle.

c.

Fold the used patch over on itself before discarding.

d.

Trim the patch carefully prior to application.

ANS: D

Patches should not be cut. The first patch should be applied during the first 24 hours of the menstrual period. A backup contraceptive should be used concurrently for the first 7 days of the first cycle. When removing the patch, it should be folded over on itself and placed in a sturdy container.

DIF: Cognitive Level: Analysis REF: p. 655 OBJ: 5

TOP: Nursing Process Step: Evaluation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance; Physiological Integrity

11. A woman using the NuvaRing vaginal ring informs the nurse that the ring was accidentally expelled a day ago. The nurse will instruct this patient to:

a.

rinse the ring in cool water and reinsert as soon as possible.

b.

rinse the ring in hot water and reinsert as soon as possible.

c.

rinse the ring in lukewarm water, reinsert, and use a nonhormonal back up contraceptive.

d.

insert a new ring.

ANS: C

If the ring is expelled for longer than 3 hours, the patient should be instructed to rinse it in cool or lukewarm water, reinsert, and use a nonhormonal back up contraceptive for the next 7 consecutive days of continuous ring use. It is not necessary to insert a new ring after a day.

DIF: Cognitive Level: Application REF: p. 657 OBJ: 5

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance; Physiological Integrity

MULTIPLE RESPONSE

12. The health care provider has instructed a patient to use over the counter miconazole (Monistat) cream to treat her vaginal yeast infection. What information is important to include in patient education? (Select all that apply.)

a.

Wash the genital area thoroughly before inserting the vaginal cream.

b.

Wash the applicator before usage.

c.

Wear a minipad to catch remaining discharge following vaginal administration.

d.

Wash hands before and after administration.

e.

The sexual partner may require treatment as well.

ANS: A, C, D, E

It is imperative that proper cleansing of the genital area be done regularly using soap and water; rinse and dry well. A minipad should be worn to catch remaining discharge. Hands should be washed before and after medication insertion and before and after toileting. Both partners in a sexual relationship require treatment. The male partner may require oral anti infectives. The vaginal applicator should be thoroughly washed with soap and water after each use and then dried.

DIF: Cognitive Level: Application REF: pp. 645-646 OBJ: 2

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

13. A nurse working at the community health clinic receives a call from a teen patient who reports that she has missed one of her birth control pills. Which response by the nurse is accurate? (Select all that apply.)

a.

Take the missed pill now.

b.

Take the next pill at the regularly scheduled time.

c.

Come into the clinic for a pregnancy test.

d.

Start with the next months pill packet at day 1.

e.

Take the missed pill and the next pill together at the next regularly scheduled time.

ANS: A, B

If a patient misses one pill, she should take the missed pill immediately. Even if a patient misses one pill, she should take the next pill for that day on time after taking the missed pill immediately. A pregnancy test is not necessary. Starting the next months pill packet at day 1 is not the appropriate action to take. Taking both the missed pill and the next pill at the next scheduled time is not the appropriate action to take.

DIF: Cognitive Level: Application REF: pp. 652-653 OBJ: 3 | 4

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

14. The nurse is completing a female reproductive history on a 16 year old. What important assessment(s) should be included? (Select all that apply.)

a.

Breast self-examination (BSE) routine

b.

Age of menarche and pattern of menses

c.

Smoking and blood pressure history when seeking a prescription for oral contraceptive pills (OCPs)

d.

Sexual orientation and number of partners

e.

Number of pregnancies, live births, miscarriages, and abortions

f.

Nutritional intake of carbohydrates

ANS: A, B, C, D, E

All women of reproductive age should perform regular BSEs. Onset and pattern of menses provide baseline assessments for future comparison. OCPs are contraindicated in women who smoke or have hypertension. Sexual orientation and number of partners provide a baseline assessment for future STD assessments. Gestational history provides baseline information for future pregnancies. Nutritional intake of carbohydrates is not included when obtaining a female reproductive history.

DIF: Cognitive Level: Application REF: pp. 642-643 | p. 645

OBJ: 2 TOP: Nursing Process Step: Assessment

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

15. The nurse is giving instructions to a young female at an outpatient clinic regarding combination OCP therapy. What information will the nurse include? (Select all that apply.)

a.

Medication should be taken at approximately the same time daily.

b.

A back up birth control method should be used for the first 6 months.

c.

Medication should be discontinued 1 year before attempting pregnancy.

d.

Headaches, dizziness, and chest or abdominal pain should be reported immediately.

e.

If a pill is missed, take it immediately and remain on schedule for the next dosage.

ANS: A, D, E

Medications should be taken at approximately the same time daily. Headaches, dizziness, and chest or abdominal pain should be reported immediately to the health care provider because these may be symptoms of a serious adverse effect. If one pill is missed, patients are directed to take it as soon as possible and continue with their normal schedule. If more than one pill is missed and a period is skipped, patients should return to their health care provider for a pregnancy test before restarting contraception. A back up contraceptive method is recommended at any point with OCP therapy. Because of a possibility of birth defects, the pill should be discontinued 3 months before attempting pregnancy.

DIF: Cognitive Level: Application REF: pp. 652-653 OBJ: 3 | 4

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

16. The nurse will teach the patient beginning therapy with alfuzosin, an alpha 1 adrenergic blocking agent, to expect which common (and usually self limiting) adverse effect(s)? (Select all that apply.)

a.

Nausea

b.

Insomnia

c.

Dizziness

d.

Headache

e.

Lethargy

f.

Anorexia

ANS: C, D, E

Dizziness, headache, and lethargy are adverse effects of treatment with alfuzosin. Nausea, insomnia, and anorexia are not adverse effects of treatment with alfuzosin.

DIF: Cognitive Level: Comprehension REF: pp. 659-660 OBJ: 6

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

17. The nurse at an outpatient clinic is educating a group of young adults regarding prevention of the spread of sexually transmitted infections. Information will include: (Select all that apply.)

a.

the use of hormonal contraceptives.

b.

the use of latex condoms when infection is present.

c.

abstinence.

d.

frequent use of nonoxynol 9.

e.

the importance of partner services.

ANS: C, E

Abstinence will prevent sexually transmitted infections, and use of sexual abstinence during the communicable phase of any disease will prevent reinfection. All sexual partners need to understand the importance of partner services, the documentation of all sexual partners for the purpose of providing evaluation and treatment. Hormonal contraceptives do not prevent sexually transmitted infections. When infections are present, abstain from sexual intercourse. A recent study indicates that frequent use of nonoxynol 9 may actually increase the risk of HIV infection during vaginal intercourse because of irritation of vaginal tissues.

DIF: Cognitive Level: Application REF: pp. 645-647 OBJ: 2

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance; Physiological Integrity

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