Nokea
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.
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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.
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.
Hormones may be used in cancer therapy, especially for advanced disease. Which of the following are hormones used as antineoplastic drugs? Select all that apply.
- A. Testolactone (Teslac)
- B. Leuprolide (Lupron)
- C. Megestrol (Megace)
- D. Bicalutamide (Casodex)
- E. Goserelin (Zoladex)
Correct Answer: A,B,C,E
Rationale: Testolactone (Teslac), leuprolide (Lupron), megestrol (Megace), and goserelin (Zoladex) are hormones used as antineoplastic drugs. Bicalutamide (Casodex) is an antiandrogen, not a hormone.
A client is prescribed finasteride to treat his symptoms of BPH. When teaching the client about this drug, the nurse would most likely include a discussion about the possibility of which of the following?
- A. Erectile dysfunction
- B. Dry mouth
- C. Constipation
- D. Decreased libido
- E. Weight gain
Correct Answer: A,D
Rationale: Androgen hormone inhibitors such as finasteride have been associated with the adverse reaction of erectile dysfunction and decreased libido. Dry mouth and constipation are associated with antispasmodics. Weight gain is associated with alpha-adrenergic blockers.
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.