Nokea
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.
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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 nurse is conducting a presentation for a group of middle-aged women about menopause and the changes that occur to the female genitourinary system. Which of the following would the nurse include in the discussion? Select all that apply.
- A. Lengthening of the vaginal wall
- B. Slowed rate of lubrication during sexual arousal
- C. Decreased risk of yeast infection from pH changes
- D. Weakening of the pelvic floor muscles
- E. Thinning of the vaginal walls
Correct Answer: B,D,E
Rationale: Genitourinary changes associated with aging include thinning of the vaginal walls with shortening and loss of elasticity; decreased lubrication with a slowing of the rate during sexual arousal; increased risk of yeast infections due to changes in the pH of the environment; and weakening of the pelvic floor muscles, which can lead to stress incontinence.
After teaching a client how to use an estradiol transdermal system, the nurse determines that the teaching was successful when the client states which of the following? Select all that apply.
- A. I can put the patch on my breasts.
- B. I should rotate the sites, staying away from the same site for about a week.
- C. When I apply it, I should rub the patch vigorously for about 10 seconds.
- D. I apply the patch immediately after I open the pouch.
- E. If the area is oily or irritated, I need to avoid that area.
Correct Answer: B,D
Rationale: When using a transdermal system, the client should apply the system immediately after opening the pouch with the adhesive side down, applying it to the clean dry skin of the buttocks, trunk, abdomen, upper inner thigh, or upper arm. The system should not be applied to the breasts, waistline, or a site exposed to sunlight. The area should not be oily or irritated. Once the patch is applied, the client should press on it firmly with the palm of the hand for about 10 seconds. The application site is rotated with at least 1-week intervals between applications to a particular site.
A nurse educating a client receiving tolterodine (Detrol) should warn the client about which of the following common adverse reactions? Select all that apply.
- A. Anorexia
- B. Xerostomia
- C. Decreased lacrimation
- D. Blurred vision
- E. Diarrhea
Correct Answer: B,C,E
Rationale: Common adverse reactions seen with the use of tolterodine (Detrol) include xerostomia, drowsiness, constipation, headache, decreased lacrimation, decreased sweating, GI disturbances, blurred vision, and urinary hesitancy.
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.