Nokea
A nurse is caring for a client receiving goserelin acetate for prostate cancer. The nurse would monitor the client for which of the following adverse reactions?
- A. Breast atrophy, sexual dysfunction
- B. Pharyngitis, asthenia
- C. Breast tenderness, edema
- D. Hyperglycemia, leukocytosis
Correct Answer: A
Rationale: Breast atrophy and sexual dysfunction may be seen as adverse reactions of goserelin acetate therapy. Pharyngitis and asthenia are seen with the use of anastrozole, Breast tenderness and edema are seen with drugs such as estramustine. Hyperglycemia and leukocytosis are seen as adverse reactions of mitotane.
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A client with benign hypertrophy of the prostate has heard claims that the herb sawM palmetto can help relieve his symptoms. The client is eager to know more about this herb. Which of the following pieces of information should the nurse provide the client regarding the use of the herb?
- A. Take the herb as tea, prepared in hot water.
- B. Improvement can be seen within 2 to 3 weeks.
- C. It may delay the need for prostatic surgery.
- D. Stop the herb after 3 months of intake.
Correct Answer: C
Rationale: The nurse should inform the client that saw palmetto might help delay the need for prostatic surgery. The active components are not water soluble and should not be taken as a tea. Improvement can be seen after 1 to 3 months of taking the herb, and not within 2 to 3 weeks. The herb intake should not be stopped after 3 months but should be continued for 6 months, followed by evaluation by the health care provider.
A client is receiving oxybutynin for treatment of overactive bladder. The client also takes haloperidol (Haldol) as an antipsychotic agent. What effect of the interaction of these two drugs should the nurse observe for in the client?
- A. Decreased effect of the antipsychotic drug
- B. Increased risk for bleeding
- C. Lowered plasma concentrations
- D. Increased effect of the antispasmodic drug
Correct Answer: A
Rationale: The nurse should observe for decreased effectiveness of the antipsychotic drug in the client as the effect of the interaction of the antispasmodic drug and haloperidol. Increased risk for bleeding results from the interaction of oral anticoagulants with anti-infective drugs. Increased effect of the antispasmodic drug occurs with the interaction of an antispasmodic drug with a tricyclic antidepressant. Plasma concentrations are lowered due to the interaction of fosfomycin, which is an anti-infective, with metoclopramide, which is used to relieve gastric upset.
A client is receiving estrogen therapy. When teaching the client about this therapy, the nurse would inform the client about which of the following as a possible adverse reaction? Select all that apply.
- A. Migraines
- B. Breakthrough bleeding
- C. Changes in libido
- D. Weight gain
- E. Breast tenderness
Correct Answer: A,B,C,D,E
Rationale: Adverse reactions associated with estrogens include headache, including migraines, breakthrough bleeding, spotting, or changes in menstrual flow; changes in libido; weight gain or loss; and breast pain, enlargement, and tenderness.
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.
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.