Nokea
A nurse is reviewing the medical history report of a client who is to receive gonadotropins. In which of the following conditions would the use of gonadotropins be contraindicated?
- A. Sensitivity to benzyl alcohol
- B. Epiphyseal closure
- C. Adrenal dysfunction
- D. Epilepsy
Correct Answer: C
Rationale: While reviewing the medical history of the client, the nurse should identify that gonadotropins are contraindicated in clients with adrenal dysfunction, high gonadotropin levels, thyroid dysfunction, liver disease, abnormal bleeding, ovarian cysts, sex-hormone-dependent tumors, or organic intracranial lesions (pituitary tumors). Gonadotropins should be used cautiously in clients with epilepsy. Somatropin growth hormones are contraindicated in clients with sensitivity to benzyl alcohol, epiphyseal closure, and underlying cranial lesions.
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A client is receiving corticosteroids at a health care facility. The client is also receiving digoxin as treatment for heart failure. The nurse understands that which of the following is a possibility due to the interaction of these two drugs?
- A. Increased risk for toxicity
- B. Decreased muscle function
- C. Increased risk of hyperkalemia
- D. Decreased serum corticosteroid levels
Correct Answer: A
Rationale: The nurse should observe for an increased risk for digoxin toxicity when corticosteroids are given with digoxin. Decreased muscle function, hyperkalemia, and decreased serum corticosteroid levels are not associated with the interaction.
The nurse should discontinue therapy and notify the physician if which of the following adverse reactions occurs in a client taking gonadotropin (Menopur).
- A. Abdominal pain
- B. Visual disturbances
- C. Auditory disturbances
- D. Ascites
Correct Answer: B
Rationale: If the patient complains of visual disturbances, the drug therapy is discontinued and the primary health care provider notified. An examination by an ophthalmologist is usually indicated. Abdominal pain and ascites are adverse reactions that may or may not require discontinuation of the drug. Auditory disturbances are not associated with this drug.
Which of the following should be included in the nurse's preadministration assessment of a client receiving desmopressin (DDAVP) for relief of abdominal distention? Select all that apply.
- A. Abdominal girth
- B. Weight
- C. Pulse
- D. Respiratory rate
- E. Blood glucose
Correct Answer: A,C,D
Rationale: Blood pressure, pulse, respiratory rate, and abdominal girth should be included in the nurse's preadministration assessment of a client receiving desmopressin (DDAVP) for relief of abdominal distention.
A client with diabetes insipidus has been prescribed vasopressin. The client's ambulatory status is limited. Which of the following would be most important for this client?
- A. Measuring the amount of fluid loss every 24 hours
- B. Refilling the water container at frequent intervals
- C. Giving four glasses of water immediately after the client takes the drug
- D. Examining the client's abdomen every 15 to 30 minutes
Correct Answer: B
Rationale: Clients with diabetes insipidus are continually thirsty, and in this case, the client also has limited ambulatory activities. Therefore, the nurse should be careful to refill the water container at frequent intervals to ensure the availability of enough drinking water at hand for the client. The nurse need not be careful to measure the amount of fluid loss every 24 hours, give four glasses of water immediately after the client takes the drug, or examine the client's abdomen every 15 to 30 minutes. The nurse instructs the client to measure the amount of urine excreted at each voiding and then total the amount for each 24-hour period. The nurse should instruct the client to drink one or two glasses of water immediately before taking the drug. The nurse need not auscultate the abdomen every 15 to 30 minutes in a client with diabetes insipidus. The nurse auscultates the abdomen every 15 to 30 minutes in a client with abdominal distention.
Which of the following drugs might a nurse administer to a female client with fertility problems to help increase her chances of becoming pregnant? Select all that apply.
- A. Vasopressin (Pressyn)
- B. Clomiphene (Clomid)
- C. Octreotide (Sandostatin)
- D. Cetrorelix (Cetrotide)
- E. Gonadotropin (Menopur)
Correct Answer: B,D,E
Rationale: A nurse might administer clomiphene (Clomid), cetrorelix (Cetrotide), or gonadotropin (Menopur) to a female client with fertility problems to help increase her chances of becoming pregnant.