A nurse is teaching a male adult patient about the use of testosterone gel. Which statement by the patient indicates an understanding of the teaching?
B.
Testosterone administered via gels can be transferred to others by skin-to-skin contact. In children, virilization can occur, as well as aggressive behaviors. The gel should be applied to clean, dry skin on the upper arms, shoulders, or abdomen and should be covered with clothing. Swimming and bathing are allowed 5 to 6 hours after application
A 12-year-old male patient diagnosed with hypogonadism will begin testosterone injections. What will the nurse include when teaching the family about this therapy?
C. For the treatment of male hypogonadism, patients receive IM injections of testosterone every 2 to
4 weeks for 3 to 4 years. Evaluation for epiphyseal closure should be done with radiographs every 6 months, not annually. Gynecomastia is a rare side effect that usually occurs in patients taking testosterone in high doses. Testosterone only accelerates the growth of prostate cancer when it
occurs; it does not cause it.
An adolescent male patient is beginning androgen therapy for delayed puberty. His parents ask
the nurse when this treatment may be stopped. The nurse will offer which response?
B.
Testosterone therapy is used to treat delayed maturity, but only for a limited course. Testicular
enlargement is the first change associated with puberty and is a sign that puberty has begun. Males
with hypogonadism need treatment for 3 to 4 years. Acne and facial hair are common side effects.
Attaining complete sexual maturation is not necessary
A 14-year-old male patient has not begun puberty. His parents tell the nurse that their son does not want to go to school, because he gets teased. The nurse learns that the boy’s father did not begin puberty until age 16 years. Laboratory tests on this child do not reveal true hypogonadism. What will the nurse tell these parents when they ask what can be done for their son?
A.
Although treatment is not required in this patient, the psychological effects of delayed puberty
indicate a limited course of androgen therapy.
A nurse is providing education to a patient who is beginning therapy with AndroGel testosterone gel. Which statement made by the patient demonstrates a need for further teaching?
D.
The medication should be applied to the arms, shoulders, and abdomen, not to the genitalia;
A clinic nurse is assessing an adolescent male patient who has been receiving androgen therapy
for hypogonadism via a transdermal patch. The patient’s last clinic visit was 4 weeks earlier. Which part of the interval history is of most concern to the nurse?
A.
Patients receiving testosterone may experience edema secondary to sodium and water retention. Treatment involves discontinuing the drug and giving diuretics if needed.
A nurse provides teaching for a female patient with anemia who has had cancer chemotherapy and who will begin treatment with testosterone. Which statement by the patient indicates understanding of the teaching?
A.
Testosterone can be used to treat refractory anemias in men and women. It works by stimulating
the synthesis of erythropoietin, a renal hormone that stimulates the production of red blood cells.
Virilization effects can be permanent if the hormone is not withdrawn, so patients developing facial hair and other signs should be told to report this to the provider. Breast enlargement occurs in males taking this drug. Testosterone reduces HDL cholesterol and increases LDL cholesterol
A nurse is obtaining a history and reviewing the chart of an adult male patient who has been taking oral androgens. Which assessment would warrant notifying the provider?
D.
Nausea, anorexia, and fatigue can indicate hepatotoxicity and should be reported to the provider.
Virilization effects, gynecomastia, and an increase in libido are common, expected effects
An adult male patient will begin androgen therapy for testicular failure. Which statement by the patient indicates understanding of the treatment regimen?
D.
Treatment with androgen replacement therapy in patients with testicular failure helps to restore libido. A side effect of androgens is premature epiphyseal closure; this is not a concern in adults, so radiographs to evaluate this are not indicated. Androgens can promote the growth of prostate cancer when it occurs, but they do not cause it.
A 14-year-old male patient who plays football is admitted to the hospital. The nurse notes that the patient has short stature for his age according to a standard growth chart. The patient is muscular, has a deep voice, and needs to shave. The nurse notifies the provider of these findings. Which test will the nurse expect the provider to order?
C.
Adverse effects of androgen abuse can cause hepatotoxicity and an elevated serum cholesterol level, with a decrease in HDL cholesterol and an increase in LDL cholesterol.
A patient receiving transurethral alprostadil asks about intracavernous administration. Which information would be included in the explanation?
A.
Transurethral administration has fewer side effects than intracavernous administration of
alprostadil. Both intracavernous and transurethral administration lead to increased arterial blood
flow to the penis. The dosage of alprostadil ranges from 125 to 1000 mcg, which is higher than the
dose required for intracavernous administration (5 to 40 mcg)
A patient with erectile dysfunction is prescribed sildenafil (Viagra) 50 mg PRN. Which assessment finding would be most concerning?
C.
All the assessment findings are indicative ofpotential side effects of sildenafil. However, snoring
that has worsened indicates intensification of obstructive sleep apnea, which can lead to airway
obstruction.
A patient with erectile dysfunction is prescribed tadalafil (Cialis) 2.5 mg daily. Which medication history finding would indicate the need to discontinue this prescription?
B.
Use of PDE-5 inhibitors is contraindicated in patients receiving nitrate preparations due to the risk
of profound hypotension.
A patient prescribed dutasteride 2 weeks ago presents with continued complaints of urinary hesitancy. Which action is most appropriate?
D.
It may take up to 1 month for the effects of dutasteride to take effect. The patient should be educated about the time taken for positive effects to be achieved.
Which finding would indicate that terazosin has been effective for a patient with BPH?
C.
Terazosin is an alpha1-adrenergic antagonist. These medications relax the smooth muscles of the
bladder neck to improve urinary symptoms experienced with BPH.
A patient receiving doxazosin presents for a routine evaluation. Which assessment finding would be most concerning?
B.
Hypotension, dizziness, and nasal congestion are all adverse effects of doxazosin, an alpha1-adrenergic antagonist. However, hypotension would be the most concerning because it can lead to
inadequate peripheral tissue perfusion.
After educating a patient about administration of papaverine plus phentolamine for erectile dysfunction, which statement made by the patient indicates a need for further teaching?
A.
Papaverine plus phentolamine is administered as an intracavernous injection, not as an oral pill.
The patient should be educated about the correct route of administration. Desired effect may be
achieved quickly with administration. Adverse effects of administration include orthostatic
hypotension and fibrotic nodules in the corpus cavernosum from injection.
When prescribed off label, the goal is to mimic premenopausal levels of production—about 300 µg/day
B.
Testosterone Gel and Topical Solution
come with a black box warning due to what potential risk?
C.
Phosphodiesterase-5 Inhibitors (PDE-5) carry the following adverse reactions:
Select all that apply.
a. Grapefruit juice can elevate drug levels.
b. Use caution when combining with an α blocker; may cause serious drop in BP.
c. Concurrent use of nitrates is contraindicated.
d. High-fat foods delay absorption and can double the time to onset.
e. Contraindicated in patients with liver disease (e.g. hepatitis, cirrhosis)
a, b, c, d
A starting dose of 50 mg (the lowest strength available) is recommended if the drug is prescribed for patients taking antihypertensive drugs.
B.
(Fill in the blank) is teratogenic to the male fetus; therefore it is contraindicated for women who are pregnant or may become pregnant.
B.
The capsule contents can be irritating to the oropharyngeal mucosa; therefore the capsule must be swallowed whole with a full glass of water.
B.
Author
BodeS
ID
363876
Card Set
CH 52 & 53
Description
Chapter 52, “Androgens”
Chapter 53, “Male Sexual Dysfunction and Benign Prostatic Hyperplasia”
