Nokea
A client comes to the emergency department and reports that he is in extreme pain. Physical assessment reveals priapism. When obtaining the client's medication history, which of the following would the nurse expect the client to report using?
- A. Tamsulosin
- B. Terazosin
- C. Tadalafil
- D. Tolterodine
Correct Answer: C
Rationale: Priapism occurs with the use of phosphodiesterase type 5 inhibitors, such as tadalafil. It is not associated with use of antiadrenergic drugs or antispasmodics.
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After reviewing information about estrogens and their use, the instructor determines that the teaching was successful when the students identify which of the following as true? Select all that apply.
- A. Changes in lipids levels occur with the use of estrogens.
- B. Progestin use is recommended when estrogen is used after a hysterectomy.
- C. Estrogen replacement therapy (ERT) helps to lessen the changes to the aging tissues.
- D. Estrogens increase a woman's risk for gallbladder disease.
- E. The use of estrogens is associated with relatively few adverse reactions.
Correct Answer: A,C,D
Rationale: Estrogens can relieve symptoms of menopause but can lead to blood pressure and lipid changes. ERT can help lessen the changes to aging tissues, but the estrogen does increase a woman's risk for gallbladder disease. The addition of progestin is recommended when estrogen is used to treat menopausal symptoms in a woman with an intact uterus. Estrogen alone may be used for estrogen replacement therapy after a hysterectomy. The administration of estrogen by any route may result in many adverse reactions, although these reactions vary in incidence and intensity.
A client is receiving estrogen therapy but also takes phenytoin for seizure control. The nurse would alert the client to the possibility of which of the following?
- A. Potential for blood clots
- B. Increased risk for infection
- C. Possibility of breakthrough bleeding
- D. Increased risk for seizures
Correct Answer: C
Rationale: When estrogen is given with phenytoin, a hydantoin, the client is at increased risk for breakthrough bleeding. Blood clots can be an adverse reaction with estrogen therapy alone. There is no increased risk for infection. When given together, these drugs do not increase the risk for seizures.
A client is prescribed flavoxate. When reviewing the client's history, the nurse would expect to find which of the following complaints? Select all that apply.
- A. Dysuria
- B. Nocturia
- C. Leakage
- D. Suprapubic pain
- E. Inability to void
Correct Answer: A,B,D
Rationale: Flavoxate, an antispasmodic, is used to relieve symptoms of dysuria, urinary urgency, nocturia, suprapubic pain, and frequency and urge incontinence. Other antispasmodics are used to treat bladder instability, such as leakage caused by a neurogenic bladder. The drug is not used to treat an inability to void.
A client is beginning therapy with prescribed terazosin for treatment of BPH. Based on the nurse's understanding of the action of this drug, the nurse would identify which nursing diagnosis as most likely?
- A. Acute Pain
- B. Risk for Injury
- C. Impaired Mucous Membranes
- D. Deficient Knowledge
Correct Answer: B
Rationale: Terazosin, an antiadrenergic drug, can cause a hypotensive reaction. Thus, the client may experience an immediate lowering of blood pressure when first starting this drug and be at risk for injury. Acute Pain would be more appropriate for a client experiencing priapism from erectile dysfunction drugs. Impaired Mucous Membranes would be appropriate for the client receiving antispasmodics. Deficient Knowledge could apply to any client receiving medication.
After teaching a group of nursing students about drugs used to treat genitourinary problems in the older adult, the instructor determines that the teaching was successful when the students identify which of the following as an alpha-adrenergic blocker used to treat BPH? Select all that apply.
- A. Darifenacin
- B. Oxybutynin
- C. Alfuzosin
- D. Tamsulosin
- E. Raloxifene
Correct Answer: C,D
Rationale: Alpha-adrenergic drugs used to treat BPH include alfuzosin and tamsulosin. Darifenacin and oxybutynin are antispasmodics. Raloxifene is a miscellaneous agent used to prevent and treat osteoporosis.