Chapter 46 My Nursing Test Banks

 

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E
Chapter 46

Question 1

Type: MCSA

The nursing instructor teaches student nurses about male reproductive function and the role of follicle-stimulating hormone (FSH). The instructor evaluates learning has occurred when the students make which statement?

1. Follicle-stimulating hormone (FSH) regulates sperm production.

2. Follicle-stimulating hormone (FSH) regulates male androgen production.

3. Follicle-stimulating hormone (FSH) regulates production of testosterone.

4. Follicle-stimulating hormone (FSH) regulates male progesterone.

Correct Answer: 1

Rationale 1: Follicle-stimulating hormone (FSH) regulates sperm production in men.

Rationale 2: Androgens are male sex hormones not regulated by follicle-stimulating hormone (FSH).

Rationale 3: . Testosterone is regulated by luteinizing hormone (LH), not follicle-stimulating hormone (FSH).

Rationale 4: Follicle-stimulating hormone (FSH) does not regulate progesterone in men.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 46-1

Question 2

Type: MCSA

The student nurse is preparing to administer a high dose of androgen to the female client. The nursing instructor asks for the rationale. What is the best response by the student?

1. My client wants to improve athletic performance.

2. My client has breast cancer.

3. My client has brain cancer.

4. My client is planning on sexual reassignment surgery.

Correct Answer: 2

Rationale 1: Androgens will help with athletic performance, but this is not the reason the drug would be administered in a clinical setting.

Rationale 2: High doses of androgens are occasionally used as a palliative measure to treat certain types of breast cancer.

Rationale 3: Androgens would not have any effect on brain cancer.

Rationale 4: Sexual reassignment surgery would not be the reason for the drug to be administered in a clinical setting.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46-2

Question 3

Type: MCSA

A male client is considered infertile. He asks the nurse why drug companies arent developing drugs to treat this problem. What is the best response by the nurse?

1. Its difficult because the medications have many side effects that men do not like.

2. Its difficult because about 25% of infertile men also have erectile dysfunction.

3. Its difficult because only about 5% of infertile men have an endocrine problem.

4. Its difficult because many men do not want to even admit they have a problem.

Correct Answer: 3

Rationale 1: All medications have side effects, but if they were successful in treating infertility, men would use them.

Rationale 2: Erectile dysfunction is not considered a prominent problem in male infertility.

Rationale 3: Drug therapy for male infertility is not as successful as fertility pharmacotherapy for women, because only about 5% of infertile males have an endocrine disorder, which would be more treatable.

Rationale 4: Men are willing to admit to a problem, but male infertility is difficult to treat.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46-4

Question 4

Type: MCSA

The client receives androgen therapy and is concerned about recent body changes as a result of the therapy. He tells the nurse he is not sure if the treatment is worth it. What is the best therapeutic response by the nurse?

1. You sound concerned; Ill ask your doctor if anything can be done.

2. You sound concerned; lets talk about your body changes.

3. You sound concerned, but the effects on your body are only temporary.

4. You sound concerned, but you really do not look any different to me.

Correct Answer: 2

Rationale 1: Telling the client the nurse will speak to the physician is inappropriate, as there may be nothing that can be done to correct the results of the therapy.

Rationale 2: For the conversation to be therapeutic, the nurse must first assess the clients perception of the problem.

Rationale 3: The effects last throughout the course of therapy and are not temporary.

Rationale 4: Telling the client he does not look any different does not acknowledge his concerns and is non-therapeutic.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46-2

Question 5

Type: MCSA

A male client comes to the emergency department complaining of nocturia and nonspecific fullness in the lower pelvic region. What is the best assessment question for the nurse to ask the client?

1. Are you constipated?

2. Are you sexually active?

3. How old are you?

4. Do you take daily showers?

Correct Answer: 3

Rationale 1: Constipation could cause the feeling of fullness, but not the nocturia.

Rationale 2: The sexual activity of the client may be important, but this question would not be specific enough.

Rationale 3: The age of the client would help determine the etiology of the problem; these are common symptoms of benign prostatic hyperplasia (BPH).

Rationale 4: Asking about daily hygiene is not an issue at this time.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 46-6

Question 6

Type: MCSA

The nurse plans medication education for a client who receives a prescription for sildenafil (Viagra). What will the best plan by the nurse include?

1. Grapefruit juice will decrease the effects of sildenafil (Viagra).

2. You can take sildenafil (Viagra) anywhere from 1 to 6 hours before sex.

3. Be sure to take only one pill in a 24-hour period.

4. Sildenafil (Viagra) should be taken with food.

Correct Answer: 3

Rationale 1: Grapefruit juice can lead to increased, not decreased, levels of sildenafil (Viagra).

Rationale 2: The optimum time for administration is 1 hour before sex, but it can be taken up to 4 hours before sex.

Rationale 3: Taking only one pill in a 24-hour period is the recommended dosing for sildenafil (Viagra).

Rationale 4: Sildenafil (Viagra) should be taken on an empty stomach, not with food.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46-7

Question 7

Type: MCSA

A client has benign prostatic hyperplasia (BPH) and hypertension. Which medication could the client safely receive for hypertension?

1. Terazosin (Hytrin)

2. Sildenafil (Viagra)

3. Finasteride (Proscar)

4. Tamsulosin (Flomax)

Correct Answer: 1

Rationale 1: Terazosin (Hytrin) is an alpha1-adrenergic blocker that relaxes smooth muscle in the prostate, and can also reduce blood pressure.

Rationale 2: Sildenafil (Viagra) has no effect on benign prostatic hypertrophy.

Rationale 3: Finasteride (Proscar) has no effect on blood pressure.

Rationale 4: Tamsulosin (Flomax) can cause severe hypotension, but is not used for routine blood pressure management.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46-6

Question 8

Type: MCSA

The nurse is assessing a client and notes that he is receiving finasteride (Proscar). The client denies having any history of a significant prostate disorder. What is the best assessment question for the nurse to ask at this time?

1. Do you have male pattern baldness?

2. Do you have erectile dysfunction?

3. Do you have a stomach ulcer?

4. Do you have high blood pressure?

Correct Answer: 1

Rationale 1: Finasteride (Proscar) is also sold as Propecia, which is used to promote hair growth.

Rationale 2: Finasteride (Proscar) is not indicated for erectile dysfunction.

Rationale 3: Finasteride (Proscar) is not indicated for stomach ulcers.

Rationale 4: Finasteride (Proscar) is not indicated for high blood pressure.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 46-7

Question 9

Type: MCMA

The nurse plans to teach a class on anabolic steroids to a group of high school athletes. What will the best plan by the nurse include?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. The use of anabolic steroids can lead to infertility.

2. Your entire body is affected by anabolic steroids, especially your liver.

3. The use of anabolic steroids is the most effective way to increase muscle mass.

4. The use of anabolic steroids should be monitored by your doctor.

5. The use of anabolic steroids can lead to very aggressive behavior.

Correct Answer: 1,2,5

Rationale 1: The use of anabolic steroids can lead to infertility.

Rationale 2: The entire body is affected by anabolic steroids, and they can lead to liver damage.

Rationale 3: Weight training can effectively build muscle mass.

Rationale 4: Anabolic steroids are illegal, so their use would not be monitored by a physician.

Rationale 5: Behavioral changes, including aggression, are associated with anabolic steroids.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 46-3

Question 10

Type: MCMA

A male client has erectile dysfunction. Which systems should be assessed that could contribute to the erectile dysfunction?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Cardiovascular

2. Integumentary

3. Endocrine

4. Nervous

5. Renal

Correct Answer: 1,3,4,5

Rationale 1: Cardiovascular disorders can contribute to ED.

Rationale 2: Disorders of the integumentary system are unlikely to contribute to ED.

Rationale 3: Endocrine disorders contribute to ED.

Rationale 4: Penile erection has both neuromuscular and vascular components.

Rationale 5: Kidney disorders may contribute to ED.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 46-5

Question 11

Type: MCSA

The client has been prescribed doxazosin (Cardura). What teaching should the nurse provide?

1. Take your first dose as soon as you get your prescription at the pharmacy.

2. Do not drive for 12-24 hours after starting this medication.

3. You may experience sweating and a headache while taking this medication.

4. Increase fluids with this medication.

Correct Answer: 2

Rationale 1: The first dose should not be taken at the pharmacy.

Rationale 2: Doxazosin may cause first dose phenomenon which results in a greater initial drop in BP than with subsequent doses. The client should not drive for 12-24 hours until this effect has passed.

Rationale 3: Doxazosin (Cardura) does not cause diaphoresis or headache.

Rationale 4: There is no reason to encourage fluids.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46-8

Question 12

Type: MCSA

The client comes to the clinic and asks for a prescription for tadalafil (Cialis). What is a priority assessment question for the nurse to ask?

1. Do you have diabetes mellitus?

2. Do you have any sexually transmitted diseases?

3. Do you use nitroglycerine?

4. Do you take blood pressure medication?

Correct Answer: 3

Rationale 1: Having diabetes mellitus is not a contraindication to the use of tadalafil (Cialis).

Rationale 2: Having a sexually transmitted disease is not a contraindication to the use of tadalafil (Cialis).

Rationale 3: Combining tadalafil (Cialis) with nitroglycerine can lead to serious hypotension.

Rationale 4: Taking blood pressure medication is not a contraindication to the use of tadalafil (Cialis).

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 46-8

Question 13

Type: MCMA

The nurse has completed medication education for the client receiving danazol (Danocrine). The nurse evaluates learning has been effective when the client makes which statements?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. I may develop acne while on this medication.

2. I need to weigh myself twice weekly.

3. This medication may cause my hair to thin.

4. I need to have my serum cholesterol levels checked frequently.

5. I may notice that my breasts enlarge while taking this medication.

Correct Answer: 1,2,4,5

Rationale 1: Acne is a frequent adverse effect of androgens such as danazol.

Rationale 2: Testosterone can cause salt retention leading to water retention, so the client should weigh herself twice a week.

Rationale 3: An adverse effect of danazol and other androgen products is hirsutism.

Rationale 4: Testosterone therapy can increase cholesterol levels and lead to cardiovascular disease, so serum cholesterol levels must be monitored.

Rationale 5: Gynecomastia is an adverse effect of danazol and other androgens.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 46-8

Question 14

Type: MCSA

A male client has been prescribed finasteride (Proscar). Which medication education should the nurse provide?

1. Pregnant women should not touch this medication.

2. This drug has only very minor side effects.

3. You should experience effects of this drug within 1 week of starting treatment.

4. Swallow this medication whole with a full glass of water.

Correct Answer: 1

Rationale 1: Finasteride (Proscar) may be absorbed through the skin and cause damage to a male fetus.

Rationale 2: Finasteride (Proscar) may cause impotence, impaired fertility, diminished libido, and ejaculatory dysfunction. Other minor effects include headache, rash, dizziness, and asthenia.

Rationale 3: It may take 3-6 months for maximum effect of this medication.

Rationale 4: Finasteride (Proscar) may be crushed for oral administration.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46-7

Question 15

Type: MCSA

The client receives an androgen medication. What laboratory test does the nurse plan to assess?

1. Hemoglobin and hematocrit

2. Blood urea nitrogen levels

3. Serum magnesium

4. Cardiac enzymes

Correct Answer: 1

Rationale 1: An adverse effect of androgens is polycythemia, so hemoglobin and hematocrit should be monitored in this client.

Rationale 2: Androgens do not affect BUN.

Rationale 3: Androgens do not affect magnesium levels.

Rationale 4: Androgens do not cause myocardial infarction.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 46-2

Question 16

Type: MCSA

The primary function of follicle-stimulating hormone (FSH) in men is to

1. regulate sperm production.

2. regulate secondary sex characteristics.

3. regulate growth of male sex organs.

4. regulate testosterone.

Correct Answer: 1

Rationale 1: FSH regulates sperm.

Rationale 2: Testosterone regulates secondary sex characteristics.

Rationale 3: Androgen regulates growth of male sex organs.

Rationale 4: Luteinizing hormone regulates testosterone.

Global Rationale:

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 46-1

Question 17

Type: MCSA

Androgen is secreted by

1. follicle-stimulating hormone.

2. gonadotropin-releasing hormone.

3. the testes.

4. the pituitary gland.

Correct Answer: 3

Rationale 1: The pituitary releases follicle-stimulating hormone.

Rationale 2: Gonadotropin is released from the hypothalamus.

Rationale 3: Androgen is secreted by the testes.

Rationale 4: The pituitary releases follicle-stimulating hormone.

Global Rationale:

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 46-1

Question 18

Type: MCSA

The goal of androgen therapy in men is to

1. decrease the libido.

2. release follicle-stimulating hormone.

3. increase luteinizing hormone.

4. increase the libido.

Correct Answer: 4

Rationale 1: Androgens do not decrease the libido.

Rationale 2: Androgens do not release FSH.

Rationale 3: Androgens do not increase luteinizing hormone.

Rationale 4: Androgen therapy increases the libido and treats erectile dysfunction.

Global Rationale:

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 46-2

Question 19

Type: MCSA

The drug that will most likely be used for treatment of erectile dysfunction (ED) is

1. leuprolide (Lupron).

2. finasteride (Proscar).

3. tamsulosin (Flomax).

4. sildenafil (Viagra).

Correct Answer: 4

Rationale 1: Leuprolide is an androgen used in high doses for prostate cancer.

Rationale 2: Finasteride is used for benign prostatic hypertrophy.

Rationale 3: Tamsulosin is used for benign prostatic hypertrophy.

Rationale 4: Sildenafil is an agent for ED.

Global Rationale:

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 46-5

Question 20

Type: MCSA

A client with benign prostatic hyperplasia is to receive finasteride (Proscar). The nurse understands that this drugs works by

1. relaxing smooth muscle in the penis.

2. promoting shrinkage of an enlarged prostate gland.

3. increasing testosterone.

4. stimulating RNA synthesis.

Correct Answer: 2

Rationale 1: Agents for ED, such as phosphodiesterase-5 inhibitors, relax smooth muscle in the penis.

Rationale 2: 5-alpha reductase inhibitors promote shrinkage of the prostate gland.

Rationale 3: Androgens increase testosterone.

Rationale 4: Androgens stimulate RNA synthesis.

Global Rationale:

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46-7

Question 21

Type: MCSA

Which of the following is an adverse effect of 5-alpha reductase inhibitors?

1. Headache

2. Acne

3. Sexual dysfunction

4. Chest pain

Correct Answer: 3

Rationale 1: Headache is common with phosphodiesterase-5 inhibitors.

Rationale 2: Acne is an adverse effect of androgens.

Rationale 3: Sexual dysfunction is common with 5-alpha reductase inhibitors.

Rationale 4: Chest pain is an adverse effect of phosphodiesterase-5 inhibitors.

Global Rationale:

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts:

Learning Outcome: 46-7

Question 22

Type: MCMA

Which comments would the nurse interpret as indicating that a high school athlete understands the risks of using anabolic steroids?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. The only legal way I can take these drugs is if I inject them myself.

2. Once I stop taking these drugs, my body will return to normal.

3. As long as my coach says these drugs are okay, they wont hurt me.

4. I might become mentally dependent on these drugs.

5. If I take ibuprofen with these drugs it will protect me from bad side effects.

Correct Answer: 4

Rationale 1: Self-injection does not make the use of steroids legal.

Rationale 2: The effects of anabolic steroids often last long after the drug is discontinued.

Rationale 3: Coaches are not the experts on the use of anabolic steroids and their effects on the body. Reputable coaches should not tolerate the use of these drugs.

Rationale 4: Psychologic dependence is possible with use of anabolic steroids.

Rationale 5: Ibuprofen use could result in additive liver damage.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 46.3

Question 23

Type: MCMA

A clients sperm sample analysis reveals azoospermia. The nurse would ask about the presence of which diseases in the clients history?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Sexually transmitted infections

2. Erectile dysfunction

3. Mumps

4. Tuberculosis

5. Atherosclerosis

Correct Answer: 1,3,4

Rationale 1: STIs are a common cause of obstruction of the vas deferens which would result in sperm not passing into the ejaculate.

Rationale 2: ED would not result in azoospermia.

Rationale 3: Mumps and other infections may result in blockage of the vas deferens which would prevent the passage of sperm into the ejaculate.

Rationale 4: Infections such as chronic TB may result in obstruction of the vas deferens which could result in azoospermia.

Rationale 5: Atherosclerosis is more likely to be a reason for erectile dysfunction.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 46.4

Question 24

Type: MCMA

A client has been prescribed testosterone. Which medication education should the nurse provide?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Place the patch on a place that does not have hair.

2. Avoid placing the patch on active areas like the thigh or arm.

3. The patch should be changed every 7 days.

4. Observe for a rash at the patch site.

5. Keep these patches away from children.

Correct Answer: 1,4,5

Rationale 1: The patch should be placed on hair-free skin.

Rationale 2: As long as the skin is dry and hair-free the activity of the area is not an issue.

Rationale 3: The patch is changed daily.

Rationale 4: Skin irritation or rash may occur at the patch site.

Rationale 5: Children should not be exposed to these patches or the patch site.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46.7

Question 25

Type: MCMA

A client has been using sildenafil (Viagra) for several months. Which client reports would the nurse interpret as an adverse effect of this medication?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Nasal congestion

2. Earache

3. Blurry vision

4. Priapism

5. Photophobia

Correct Answer: 1,3,4,5

Rationale 1: Nasal congestion can occur as an adverse effect of sildenafil.

Rationale 2: Earache is not a known adverse effect of sildenafil.

Rationale 3: Blurry vision is a known adverse effect of sildenafil.

Rationale 4: Sustained erection is a known adverse effect of sildenafil.

Rationale 5: Increased sensitivity to light is a known adverse effect of sildenafil.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 46.7

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E

Copyright 2014 by Pearson Education, Inc.

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