Nursing Elites

1. A male patient is receiving androgen therapy for the treatment of hypogonadism. What adverse effect should the nurse monitor for during this treatment?

• A. Liver dysfunction
• B. Kidney dysfunction
• C. Heart failure
• D. Pulmonary embolism

Correct answer: A

Rationale: The correct adverse effect to monitor for during androgen therapy for hypogonadism is liver dysfunction. Androgen therapy can lead to hepatotoxicity, so monitoring liver function tests is crucial during treatment. Kidney dysfunction (Choice B), heart failure (Choice C), and pulmonary embolism (Choice D) are not commonly associated with androgen therapy and are less likely adverse effects compared to liver dysfunction.

2. A nurse is administering testosterone to a patient with hypogonadism. What outcome indicates that the treatment is having the desired effect?

• A. Increased libido
• B. Increased muscle mass
• C. Improved secondary sexual characteristics
• D. Decreased sperm count

Correct answer: C

Rationale: The correct answer is C: 'Improved secondary sexual characteristics.' Testosterone therapy in patients with hypogonadism typically leads to improved secondary sexual characteristics, which include increased muscle mass and libido. While increased libido (choice A) and increased muscle mass (choice B) are effects of testosterone therapy, they are more specific outcomes related to secondary sexual characteristics. Decreased sperm count (choice D) would not be an expected outcome of testosterone therapy for hypogonadism, as testosterone is essential for sperm production.

3. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What important contraindication should the nurse emphasize during patient education?

• A. Use of nitrates
• B. History of hypertension
• C. History of peptic ulcer disease
• D. Use of antihypertensive medications

Correct answer: A

Rationale: The correct answer is A: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients using nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices B, C, and D are incorrect because they are not direct contraindications for sildenafil use. While a history of hypertension or peptic ulcer disease may require caution, they are not absolute contraindications like the concomitant use of nitrates.

4. When teaching a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?

• A. Oral contraceptives are 100% effective when taken correctly.
• B. Oral contraceptives are effective immediately after starting.
• C. Oral contraceptives are less effective if taken with certain antibiotics.
• D. Oral contraceptives are less effective if taken with food.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the effectiveness of the contraceptive. It is important for patients to be aware of this interaction to consider additional contraceptive methods during antibiotic therapy. Choices A and B are incorrect as no contraceptive method is 100% effective, and oral contraceptives typically require a period of time to reach full effectiveness. Choice D is incorrect as taking oral contraceptives with food does not significantly impact their effectiveness.

5. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What should the nurse emphasize during patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be aware of the signs and symptoms of blood clots.
• B. Tamoxifen may cause weight gain, so patients should monitor their diet.
• C. Tamoxifen may cause hot flashes and other menopausal symptoms.
• D. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, a serious side effect. Therefore, patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, and redness in the legs, and advised to seek immediate medical attention if they occur. Choice B is incorrect because weight gain is not a significant side effect of tamoxifen. Choice C is incorrect because hot flashes and menopausal symptoms are common side effects of tamoxifen but are not as critical to address as venous thromboembolism. Choice D is incorrect because tamoxifen does not decrease the risk of osteoporosis; in fact, it may increase the risk of bone loss in premenopausal women.

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