Nokea
While conducting a health promotion presentation for a local group of women who are in their 30s and 40s, one of the women asks the nurse, 'I've heard horror stories about menopause. Are there any herbal products that can help?' Which of the following would the nurse include in the response? Select all that apply.
- A. Black cohosh
- B. Sage
- C. Calendula
- D. Saw palmetto
- E. Dandelion
Correct Answer: A,B,C,E
Rationale: Black cohosh, sage, dandelion, and calendula are herbs that may be used to address menopausal symptoms. Saw palmetto is used to relieve the symptoms of benign prostatic hypertrophy.
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Nurses who are pregnant or may become pregnant should not handle which drugs if they are crushed or broken due to the drugs' substantial risk of abnormal growth to a male fetus? Select all that apply.
- A. Methyltestosterone (Testred)
- B. Finasteride (Proscar)
- C. Testosterone (Striant)
- D. Dutasteride (Avodart)
- E. Oxandrolone (Oxandrin)
Correct Answer: B,D
Rationale: Women of childbearing age should not handle androgen hormone inhibitors, such as finasteride (Proscar) or dutasteride (Avodart) tablets, if they are crushed or broken due to the drugs' substantial risk of abnormal growth to a male fetus.
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.
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 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 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.