Chapter 57: Drugs for Mens Health and Reproductive Disorders Nursing School Test Banks

Chapter 57: Drugs for Mens Health and Reproductive Disorders
Test Bank

MULTIPLE CHOICE

1. A 50-year-old male patient reports having decreased libido and testicular atrophy. The nurse will anticipate that the provider may order which medication to treat these symptoms?
a. Testosterone (Androderm)
b. Finasteride (Proscar)
c. Gonadotropin-releasing hormone (Gn-RH)
d. Sildenafil (Viagra)
ANS: A
Testosterone is given patients who have low testosterone, evidenced by decreased libido and testicular atrophy in adult men. Finasteride is given to treat benign prostatic hypertrophy. Gn-RH is used to inhibit testosterone production. Sildenafil is used to treat erectile dysfunction.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Pages 875-876
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

2. The nurse is teaching the parents of a boy who has inadequate pituitary function and delayed puberty about testosterone enanthate injections. Which statement by the parents indicates a need for further teaching?
a. He will need x-rays of his hands every 6 months.
b. Injections will be given deep into his gluteal muscles.
c. Sexual development will occur in 1 to 2 years.
d. We should report urinary tract problems immediately.
ANS: C
It takes 3 to 4 years for sexual development to occur with androgen therapy for hypogonadism, so parents should be reminded of this. X-rays are needed every 6 months to assess bone age. Injections are given deep intramuscularly into gluteal muscles. Urinary tract problems can occur and should be reported.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 876
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

3. The nurse is instructing a patient about the buccal muco-adhesive testosterone system (Striant) to treat low testosterone. What information will the nurse include when teaching this patient about this drug?
a. If the product slides out of position more than 4 hours before the next dose, replace it with a new system.
b. Place the flattened surface against the gum and hold it firmly in place for 30 seconds.
c. The product may be swallowed after it has been in place for at least 4 hours.
d. To remove the product, slide it upwards away from the tooth until it releases.
ANS: A
If the product falls off within the 12-hour dosing interval or falls out of position within 4 hours of the next dose, it should be discarded and a new product applied. The rounded surface should be placed against the gum. The product should not be swallowed. The product should be removed by sliding downwards toward the tooth.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 876
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

4. The nurse provides teaching to a man who will begin using an Androderm testosterone patch. Which statement by the patient indicates understanding of the teaching?
a. I may stop using Androderm when my serum testosterone is normal.
b. I should apply this to any skin other than the scrotum or bony areas.
c. I will apply two skin patches every morning after a shower.
d. My serum testosterone will continue to rise with each day of use.
ANS: B
Androderm should be applied to any intact skin other than the scrotum or over a bony area. When the medication is withdrawn, testosterone levels will drop. The patient should apply two patches every day at 10 PM. The first day of use results in serum testosterone levels in the normal range, and serum levels do not accumulate with continued use.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 876
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

5. A man who has been using androgen therapy tells the nurse that he and his wife wish to conceive a pregnancy. The nurse will tell this patient that
a. androgen therapy will not harm the fetus.
b. he will need to increase his dose of testosterone to increase his sperm count.
c. it may take 3 months after cessation of androgen therapy to conceive.
d. there should be no problems conceiving while using androgen therapy.
ANS: C
Androgens cause decreased sperm counts and usually takes 3 months after cessation of therapy to return sperm counts to normal. During pregnancy, androgens can cross the placenta and cause masculinization of the fetus. Virilization can occur in those secondarily exposed to testosterone gel and may cause teratogenic effects in fetuses. Increasing the testosterone will not increase the sperm count.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 876
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

6. The nurse is teaching an adult male patient about the use of testosterone gel. Which statement by the patient indicates understanding of the teaching?
a. A decreased urinary stream is an expected side effect.
b. I should apply the gel to my forearms every day.
c. I will have hand and wrist x-rays every 6 months.
d. I will need regular evaluation of serum lipid levels.
ANS: D
Testosterone can increase lipid levels so these should be monitored regularly. A decreased urinary stream can indicate prostatic hypertrophy and should be reported. Patients should apply the gel where it is least likely to come in contact with other people. Only prepubertal males require bone age evaluation.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 877
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

7. The oral antiandrogen drug flutamide (Eulexin) is used to treat which condition?
a. Benign prostatic hypertrophy (BPH)
b. Breast cancer
c. Male-pattern baldness
d. Metastatic prostate cancer
ANS: D
This antiandrogen drug is used to treat metastatic prostate cancer. It is not effective to treat other hormonally dependent diseases such as breast cancer, male-pattern baldness, or BPH.

DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: Page 879
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

8. A patient will begin taking finasteride (Propecia) to treat benign prostatic hypertrophy (BPH) and asks the nurse how long the medication will be necessary. The nurse will tell the patient that he will need to take this medication for how long?
a. 6 months
b. 12 months
c. Indefinitely
d. Until symptoms resolve
ANS: C
Continued treatment with finasteride is recommended in order to sustain results since reversal of effect usually occurs within 1 year after cessation of the drug.

DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: Page 879
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

9. A 14-year-old male is being evaluated for delayed puberty. Which finding indicates delayed puberty in this child?
a. Androgen deficiency
b. Growth hormone deficiency
c. Height of 2.5 standard deviations below the mean
d. Lack of epiphyseal closure
ANS: A
Low androgen levels indicate delayed puberty. Patients who are short and who have not developed secondary sexual characteristics may have growth hormone deficiency, normal variations in development, or delayed puberty. Growth hormone deficiency may cause short stature.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 879
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

10. A male patient wants to begin taking tadalifil (Cialis) to treat erectile dysfunction. Which aspect of this patients history would be of concern?
a. Angina pectoris
b. Asthma
c. Benign prostatic hypertrophy
d. Color blindness
ANS: A
Patient with angina usually are treated with nitrates; phosphodiesterase inhibitors such as tadalifil are contraindicated in patients taking nitrates.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Pages 880-881
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

11. A patient will begin using sildenafil citrate (Viagra) to treat erectile dysfunction. The nurse will instruct the patient to take the medication
a. daily in the morning.
b. just prior to sexual activity.
c. 30 minutes to 4 hours before sexual activity.
d. twice daily.
ANS: C
Sildenafil should be taken at least 30 minutes and less than 4 hours prior to sexual activity. It is not taken daily or twice daily. If taken just prior to sexual activity, it does not have time to take effect.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 881
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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