Nokea
Prior to administering oxybutynin (Ditropan) to a client, the nurse should get a full medical history because the use of oxybutynin (Ditropan) is contraindicated in clients with which of the following? Select all that apply.
- A. Myasthenia gravis
- B. Urinary tract blockage
- C. Diabetes
- D. Intestinal blockage
- E. Hypertriglyceridemia
Correct Answer: A,B,D
Rationale: The use of oxybutynin (Ditropan) is contraindicated in clients with the following: known hypersensitivity, glaucoma, myasthenia gravis, abdominal bleeding, and intestinal, gastric, or urinary tract blockages.
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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 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 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.
A client is receiving tamsulosin for treatment of BPH. The client also has hypertension, for which he takes atenolol. Which assessment would be most important for the nurse to obtain?
- A. Temperature
- B. Pulse rate
- C. Respiratory rate
- D. Blood pressure
Correct Answer: D
Rationale: Tamsulosin, an alpha-adrenergic blocker, when given with a beta blocker such as atenolol can cause an increase in hypotension. Therefore, assessment of the client's blood pressure would be most important.
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.