Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 45

Question 1 Type: MCMA The nurse teaches a class on pregnancy to clients in their first trimester. The nurse evaluates that learning has occurred when the clients make which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. "Ovulation occurs on appro imately !ay "# of the ovarian cycle." 2. "Ovulation is caused $y a surge of luteini%ing hormone." 3. "Ovulation is caused $y a surge of human chorionic gonadotropin." 4. "&ollicle'stimulating hormone causes ovarian follicles to develop." 5. "The pituitary gland secretes gonadotropin'releasing hormone." Corre t Ans!er: "() "ationa#e 1* Ovulation occurs on appro imately !ay #)( not !ay "#( of the ovarian cycle. "ationa#e 2* Ovulation is caused $y a surge of luteini%ing hormone. "ationa#e 3* +uman chorionic gonadotropin is produced during pregnancy, it is not involved with ovulation. "ationa#e 4* &ollicle'stimulating hormone causes ovarian follicles to develop. "ationa#e 5* The hypothalamus( not the pituitary gland( secretes gonadotropin'releasing hormone. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy%ing C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -hysiological Adaptation )ursin&/*nte&rated Con epts: /ursing -rocess* 0valuation (earnin& +ut ome: )1'# Question 2 Type: MCSA
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A client comes to the women4s center and tells the nurse she has had unprotected se . She asks for emergency contraception. 5hat is the $est assessment 6uestion for the nurse to ask? 1. "+ow long ago did you have unprotected se ?" 2. "!id you use a condom?" 3. "5hat kind of $irth control have you used in the past?" 4. "5here are you in your monthly cycle?" Corre t Ans!er: # "ationa#e 1* Choice of emergency contraceptive is guided in some ways $y the amount of time since unprotected se . "ationa#e 2* A condom is important to help prevent ST!s( $ut will not affect emergency contraception timeframes( and the client said she had unprotected se . "ationa#e 3* -rior methods of $irth control are not an issue here. "ationa#e 4* 5here the client is in her monthly cycle is not an issue here. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy%ing C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* Assessment (earnin& +ut ome: )1'7 Question 3 Type: MCSA The client receives estrogen for prostate cancer. +e asks the nurse why he is receiving a female hormone. 5hat is the $est response $y the nurse? 1. ".t shrinks your cancer $y making the cells die at a faster rate." 2. ".t eliminates the testosterone that feeds your cancer." 3. ".t suppresses secretion of the androgens that make your cancer grow." 4. ".t keeps nutrients from getting to( and feeding( your cancer." Corre t Ans!er: 7
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"ationa#e 1* Administration of estrogens will suppress androgen secretion( not kill the cells faster. "ationa#e 2* Administration of estrogens will suppress androgen secretion( $ut will not eliminate testosterone. "ationa#e 3* -rostate cancer is usually dependent on androgens for growth, administration of estrogens will suppress androgen secretion. "ationa#e 4* Administration of estrogens will suppress androgen secretion( not prevent nutrients from getting to( or feeding( the cancer. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* .mplementation (earnin& +ut ome: )1'1 Question 4 Type: MCSA The client is considered infertile. The physician orders clomiphene 8Clomid9. The nurse teaches the client a$out the medication and evaluates that learning has occurred when the client makes which statement? 1. "This medication increases my estrogen levels so . can ovulate." 2. "This medication stimulates :+ 8luteini%ing hormone9." 3. "This medication stimulates &S+ 8follicle'stimulating hormone9." 4. "This medication stimulates gonadotropin'releasing hormone." Corre t Ans!er: " "ationa#e 1* Clomiphene 8Clomid9 stimulates :+ 8luteini%ing hormone9, it does not increase estrogen levels. "ationa#e 2* Clomiphene 8Clomid9 stimulates :+ 8luteini%ing hormone9 resulting in the maturation of more ovarian follicles than would normally occur. "ationa#e 3* Clomiphene 8Clomid9 stimulates :+ 8luteini%ing hormone9, it does not stimulate &S+ 8follicle' stimulating hormone9. "ationa#e 4* Clomiphene 8Clomid9 stimulates :+ 8luteini%ing hormone9( not gonadotropin'releasing hormone. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy%ing
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C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* 0valuation (earnin& +ut ome: )1'; Question 5 Type: MCSA The nurse manages care for several clients receiving hormone replacement therapy 8+<T9. 5hat will the priority assessment $y the nurse include as related to side effects? 1. -ain in the calf 2. !ecreased li$ido 3. :ow'$ack pain 4. Chronic fatigue Corre t Ans!er: # "ationa#e 1* +ormone replacement therapy puts the client at risk for throm$ophle$itis. The nurse should always assess for calf pain and other symptoms of throm$ophle$itis. "ationa#e 2* !ecreased li$ido is a side effect of hormone replacement therapy 8+<T9( $ut is not as high a priority as assessing the pain in the calf. "ationa#e 3* :ow'$ack pain is nonspecific and does not apply to hormone replacement therapy 8+<T9. "ationa#e 4* Chronic fatigue could $e a side effect of hormone replacement therapy 8+<T9( $ut it is nonspecific and could result from many other causes. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy%ing C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* Assessment (earnin& +ut ome: )1') Question , Type: MCSA The client is receiving o ytocin 8-itocin9 for induction of la$or. 5hich assessment finding will most likely result in the nurse stopping the infusion? 1. The client tells the nurse she has a serious headache.
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2. The vaginal e am reveals that the client is entering transition. 3. The client reports that the uterine contractions are strong in intensity. 4. =terine contractions occur every " to 7 minutes and last )3 to >3 seconds. Corre t Ans!er: # "ationa#e 1* The headache could indicate hyponatremia 8water into ication9 due to the effects of o ytocin 8-itocin9, the client should $e assessed for fluid $alance. "ationa#e 2* The infusion should not $e stopped when the client enters transition. "ationa#e 3* Contractions that are strong in intensity are no reason to stop the infusion. "ationa#e 4* =terine contractions every " to 7 minutes and lasting )3 to >3 seconds are e pected with induction of la$or. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy%ing C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* Assessment (earnin& +ut ome: )1'? Question Type: MCSA A client calls the clinic and tells the nurse that she has missed taking several of her contraceptive pills during the current cycle. 5hat is the $est instruction for the nurse to give the client? 1. "-lease come into the clinic immediately to have a pregnancy test done." 2. "@ou might consider another form of $irth control if you keep missing your pills." 3. ".f you have missed less than three of your pills( you do not need to worry." 4. "@ou should use an alternative form of $irth control for the rest of this cycle." Corre t Ans!er: ) "ationa#e 1* There is no reason for the client to have a pregnancy test done at this time. "ationa#e 2* .f the client is una$le to remem$er to take her contraceptive pills( then the nurse should educate her on alternative forms of $irth control( $ut this is not the most immediate issue.
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"ationa#e 3* . The client could $ecome pregnant if she misses less than three of her pills( so this incorrect advice. "ationa#e 4* .f more than one pill is missed( the medication will not $e effective and conception could occur( so the client must use an alternative form of $irth control for the rest of her current cycle. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy%ing C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* .mplementation (earnin& +ut ome: )1'A Question . Type: MCSA The client takes Ortho'/ovum for 7 months and calls the clinic to report she is having vaginal $leeding. 5hat is the $est plan $y the nurse at this time? 1. Ask the client if she has $een having se ual intercourse recently. 2. Tell the client to go to the emergency department for medical treatment. 3. Ask the client if she is $leeding $etween cycles or if this is her regular period. 4. Tell the client not to worry if the $leeding resem$les her monthly flow. Corre t Ans!er: 7 "ationa#e 1* Se ual intercourse should not result in vaginal $leeding. "ationa#e 2* There is no need for the client to go to the emergency department at this time. "ationa#e 3* .t is important to determine the nature of the oral contraceptive 8OC9 cycle to determine what type of vaginal $leeding is occurring. "ationa#e 4* Telling the client not to worry is condescending, the nurse must collect more data. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* .mplementation (earnin& +ut ome: )1'#3 Question /
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Type: MCSA The nurse teaches the postpartum client a$out o ytocin 8-itocin9. The nurse evaluates that learning has occurred when the client makes which statement? 1. ".t will increase my uterine contractions." 2. ".t will increase my volume of fluid loss." 3. ".t will increase my vaginal muscle tone." 4. ".t will increase my milk production." Corre t Ans!er: # "ationa#e 1* O ytocin 8-itocin9( administered in the postpartum period( causes the smooth muscle of the uterus to contract. "ationa#e 2* O ytocin 8-itocin9 does not promote fluid loss. "ationa#e 3* O ytocin 8-itocin9 does not increase vaginal muscle tone. "ationa#e 4* O ytocin 8-itocin9 will not increase milk production. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy%ing C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* 0valuation (earnin& +ut ome: )1'? Question 10 Type: MCSA The client is pre'menopausal and asks the nurse if she should $e taking hormone replacement therapy 8+<T9. 5hat will the $est plan $y the nurse include? 1. !iscuss alternative methods of dealing with pre'menopausal symptoms. 2. Schedule an appointment with the physician to $egin hormone replacement therapy 8+<T9. 3. !etermine if the client has risk factors that would contraindicate hormone replacement therapy 8+<T9. 4. Tell the client to schedule an appointment when she is having menopause. Corre t Ans!er: #
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"ationa#e 1* +ormone replacement therapy 8+<T9 is an option( $ut the client should have all availa$le information in order to make an informed decision. The nurse should discuss alternate methods of dealing with pre'menopausal symptoms. "ationa#e 2* The client should have information a$out alternate methods availa$le prior to seeing the physician. "ationa#e 3* The nurse does not need to assess risk factors for hormone replacement therapy 8+<T9 until the client has made the decision to receive it. "ationa#e 4* The client is asking for assistance with pre' menopausal symptoms, she should not have to wait until menopause. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy%ing C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -hysiological Adaptation )ursin&/*nte&rated Con epts: /ursing -rocess* -lanning (earnin& +ut ome: )1') Question 11 Type: MCSA A client calls the clinic and tells the nurse she has nausea and $reast tenderness and is afraid she might $e pregnant. She is taking oral contraceptives and has taken them e actly as prescri$ed. 5hat is the $est response $y the nurse? 1. Tell the client to purchase an at'home pregnancy test to determine pregnancy. 2. Tell the client to come in for an evaluation and to discuss $irth control. 3. Tell the client that these symptoms are side effects of oral contraceptives. 4. Berify with the client that she has taken all her pills Cust as prescri$ed. Corre t Ans!er: 7 "ationa#e 1* Telling the client to purchase an at'home pregnancy test will only increase her an iety. "ationa#e 2* There is no reason for the client to come in for an evaluation at this time. "ationa#e 3* .t is important for the nurse to educate the client a$out the side effects of oral contraceptives. "ationa#e 4* Berifying how the pills were taken is unnecessary, the client said she took them as prescri$ed. $#o%a# "ationa#e:
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Co&niti'e (e'e#: Analy%ing C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* .mplementation (earnin& +ut ome: )1'## Question 12 Type: MCSA The client plans to use oral contraceptives for $irth control. 5hich client $ehavior would the nurse $e most concerned a$out? 1. The client has several se ual partners. 2. The client is $eing treated for $ipolar disorder. 3. The client smokes one'half pack of cigarettes per day. 4. The client drinks two glasses of wine a day. Corre t Ans!er: 7 "ationa#e 1* +aving several se ual partners is not a contraindication to the use of oral contraceptives. "ationa#e 2* Deing treated for $ipolar disorder is not a contraindication to the use of oral contraceptives. "ationa#e 3* Cigarette smoking increases the client4s risk for a throm$olytic disorder. "ationa#e 4* !rinking two glasses of wine per day is not a contraindication to the use of oral contraceptives. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy%ing C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* 0valuation (earnin& +ut ome: )1'#3 Question 13 Type: MCSA An adolescent client will receive !epo'-rovera as a method of $irth control. She asks the nurse how long the drug will $e effective. 5hat is the $est response $y the nurse? 1. Two months 2. Si months
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3. One year 4. Three months Corre t Ans!er: ) "ationa#e 1* !epo'-rovera is effective for three months. "ationa#e 2* !epo'-rovera is effective for three months( not si months. "ationa#e 3* !epo'-rovera is effective for three months( not one year. "ationa#e 4* !epo'-rovera is effective for three months. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* .mplementation (earnin& +ut ome: )1'#3 Question 14 Type: MCSA A female client has $een una$le to conceive a child for five years. She asks the nurse a$out medications to treat her infertility. 5hat is the $est response $y the nurse? 1. "+ave you considered adopting children? Many need a good home." 2. "That is a good 6uestion, . will refer you to a specialist in infertility." 3. "There are many new drugs availa$le, one should $e a$le to help you." 4. "Medications will only help if your infertility is related to an endocrine pro$lem." Corre t Ans!er: ) "ationa#e 1* This is not the time to address adoption issues. "ationa#e 2* The nurse can answer the 6uestion, there is no need to refer to a specialist at this time. "ationa#e 3* .t is not known whether the cause of this clientEs infertility can $e modified $y medication. "ationa#e 4* .t is $est to $e honest, medications will only help if the infertility is related to an endocrine pro$lem. $#o%a# "ationa#e:
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Co&niti'e (e'e#: Applying C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* .mplementation (earnin& +ut ome: )1'; Question 15 Type: MCSA 0strogens are secreted $y the 1. corpus luteum. 2. anterior pituitary. 3. ovarian follicles. 4. endometrium. Corre t Ans!er: 7 "ationa#e 1* -rogestin is secreted $y the corpus luteum. "ationa#e 2* Fonadotropin'releasing hormone is secreted $y the pituitary. "ationa#e 3* 0strogens are secreted $y the ovarian follicles. "ationa#e 4* The endometrium does not secrete( since it is a part of the uterus. $#o%a# "ationa#e: Co&niti'e (e'e#: <emem$ering C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -hysiological Adaptation )ursin&/*nte&rated Con epts: /ursing -rocess* Assessment (earnin& +ut ome: )1'# Question 1, Type: MCSA -rogestins are secreted $y the 1. anterior pituitary. 2. corpus luteum.
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3. ovarian follicles. 4. hypothalamus. Corre t Ans!er: " "ationa#e 1* Fonadotropin'releasing hormone is secreted $y the pituitary and the hypothalamus. "ationa#e 2* -rogestin is secreted $y the corpus luteum. "ationa#e 3* 0strogens are secreted $y the ovarian follicles. "ationa#e 4* Fonadotropin'releasing hormone is secreted $y the hypothalamus and the pituitary. $#o%a# "ationa#e: Co&niti'e (e'e#: <emem$ering C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -hysiological Adaptation )ursin&/*nte&rated Con epts: (earnin& +ut ome: )1'# Question 1Type: MCSA -rogestins are primarily used in the treatment of 1. $reast cancer. 2. amenorrhea. 3. dysfunctional uterine $leeding. 4. menopause. Corre t Ans!er: 7 "ationa#e 1* 0strogen in high doses is used for $reast cancer. "ationa#e 2* 0strogen or estrogen progestin is used for amenorrhea. "ationa#e 3* -rogestin is the main therapy for dysfunctional uterine $leeding. "ationa#e 4* 0strogen or estrogen progestin is used for menopausal symptoms. $#o%a# "ationa#e: Co&niti'e (e'e#: =nderstanding
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C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -hysiological Adaptation )ursin&/*nte&rated Con epts: (earnin& +ut ome: )1'> Question 1. Type: MCSA O ytocics are different from tocolytics in that o ytocics 1. slow uterine contractions. 2. raise the level of luteini%ing hormones. 3. increase ovarian secretion. 4. stimulate uterine contractions. Corre t Ans!er: ) "ationa#e 1* Tocolytics slow uterine contractions. "ationa#e 2* .nfertility drugs raise the level of luteini%ing hormone. "ationa#e 3* .nfertility drugs increase ovarian secretion. "ationa#e 4* O ytocics( such as o ytocin( stimulate uterine contractions to induce la$or. $#o%a# "ationa#e: Co&niti'e (e'e#: <emem$ering C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -hysiological Adaptation )ursin&/*nte&rated Con epts: (earnin& +ut ome: )1'? Question 1/ Type: MCSA The nurse e plains to a client who is taking oral contraceptives that these drugs can cause 1. throm$ophle$itis. 2. hypotension. 3. weight loss.
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4. pregnancy. Corre t Ans!er: # "ationa#e 1* Throm$ophle$itis can occur( especially in those who smoke. "ationa#e 2* +ypertension( not hypotension( can occur with oral contraceptives. "ationa#e 3* =sually( weight gain occurs with oral contraceptives. "ationa#e 4* Oral contraceptives do not cause pregnancy. $#o%a# "ationa#e: Co&niti'e (e'e#: =nderstanding C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -hysiological Adaptation )ursin&/*nte&rated Con epts: (earnin& +ut ome: )1'## Question 20 Type: MCMA A client has $een prescri$ed an estrogen'progestin com$ination oral contraceptive. +ow should the nurse e plain the mechanism of action of this pill? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. GThis pill will prevent you from ovulating.H 2. GThis pill makes it less likely that an em$ryo will implant.H 3. GThe spermicide in this pill will kill sperm $efore fertili%ation.H 4. GThe progestin in the pill will kill the egg $efore fertili%ation.H 5. The estrogen'progestin com$ination causes irrita$ility of the uterine lining so implanted em$ryos are e pelled. Corre t Ans!er: #(" "ationa#e 1* The estrogen'progestin com$ination contraceptive prevents ovulation. "ationa#e 2* The estrogen'progestin drugs make the uterine endometrium less favora$le to receive an em$ryo. "ationa#e 3* There is no spermicide in these pills.
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"ationa#e 4* The progestin does not kill the egg. "ationa#e 5* These drugs do not cause implanted em$ryos to $e e pelled. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* .mplementation (earnin& +ut ome: )1." Question 21 Type: MCMA A nurse uses the mnemonic AC+0S to remem$er the possi$le adverse effects of oral contraceptives. 5hich statements follow this mnemonic? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. G@ou may e perience increased acne while on oral contraceptives.H 2. G.f you e perience chest pain( call the clinic immediately.H 3. G.f you $egin to lose more hair than is normal your dose may need to $e adCusted.H 4. GAny $lurry vision or loss of vision should $e reported immediately.H 5. G.f you notice swelling in your feet( hands( or face( notify the clinic.H Corre t Ans!er: "()(1 "ationa#e 1* The GAH in AC+0S stands for a$dominal pain. "ationa#e 2* The GCH in AC+0S stands for chest pain. "ationa#e 3* The G+H in AC+0S stands for headache( not hair. "ationa#e 4* The G0H in AC+0S stands for eye pro$lems. "ationa#e 5* The GSH in AC+0S stands for swelling. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying
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C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: <eduction of <isk -otential )ursin&/*nte&rated Con epts: /ursing -rocess* .mplementation (earnin& +ut ome: )1'A Question 22 Type: MCMA A college student calls the family planning clinic and states( G. had unprotected se and now . am afraid . will get pregnant.H The nurse would provide which information a$out -lan D? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. G@ou can purchase -lan D without a prescription.H 2. G@ou will need to re6uest -lan D from the pharmacist.H 3. G@ou will take two separate doses of -lan D.H 4. G.f you are already pregnant( -lan D will end the pregnancy.H 5. G-lan D will prevent ovulation and implantation.H Corre t Ans!er: #("(7(1 "ationa#e 1* -lan D is availa$le without a prescription to women over the age of #?. "ationa#e 2* -lan D is kept $ehind the pharmacy counter so that the pharmacist can verify the clientEs age. "ationa#e 3* -lan D consists of two doses. -lan D One Step includes a single dose. "ationa#e 4* -lan D will not induce an a$ortion or terminate a pregnancy. "ationa#e 5* -lan D acts in a manner similar to oral contraceptives in that it prevents ovulation and implantation. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* .mplementation (earnin& +ut ome: )1.A Question 23 Type: MCMA
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A client has $een prescri$ed -remarin. 5hat medication information should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. G@ou may notice a decrease in your li$ido while on this medication.H 2. G.f you notice pain in your a$domen that goes through to your $ack( $e certain to notify the clinic.H 3. G!o not $ecome pregnant while on this drug.H 4. G.f you add the her$al $lack cohosh to this therapy the results will $e $etter.H 5. GThis medication will help prevent cardiovascular disease.H Corre t Ans!er: #("(7 "ationa#e 1* !ecreased li$ido is an adverse effect of this drug. "ationa#e 2* Acute pancreatitis( whose symptoms are acute epigastric pain going through to the $ack( is an adverse effect of this therapy. "ationa#e 3* ConCugated estrogens are contraindicated in pregnant clients. "ationa#e 4* Dlack cohosh may interfere with estrogen therapy. "ationa#e 5* .t was once $elieved that treatment with estrogen protected the client from cardiovascular disease( $ut this has not $een proven to $e correct. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* .mplementation (earnin& +ut ome: )1.#3 Question 24 Type: MCMA A client has $een prescri$ed /uva<ing. 5hat medication education should the nurse provide to this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, )20 Copyright "3#) $y -earson 0ducation( .nc.

1. GThis ring should $e inserted into your uterus.H 2. GOnce inserted( this ring will provide contraception for > months.H 3. G@ou should e pect to replace the ring every 7 weeks.H 4. Contraceptive protection is provided for 7 weeks. 5. The ring uses estrogen and progestin to provide contraception. Corre t Ans!er: )(1 "ationa#e 1* The ring is inserted into the vagina. "ationa#e 2* The ring provides 7 weeks of contraception. "ationa#e 3* The ring is worn for 7 weeks( removed for # week( and replaced at the $eginning of the )th week. "ationa#e 4* Contraceptive protection is provided for 7 weeks. "ationa#e 5* The active ingredients of /uva<ing are estrogen and progestin. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* .mplementation (earnin& +ut ome: )1.A Question 25 Type: MCMA A client has $een taking low'dose oral contraceptives. She calls the clinic and reports that she is mid'cycle and has noticed some slight spotting. 5hat information should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. GSlight spotting may occur( especially with low'dose oral contraceptives.H 2. G@ou may $e pregnant, please stop taking these pills and come to the clinic.H 3. GMonitor the $leeding and contact us again if it $ecomes continuous or heavy.H 4. GThis is an adverse reaction, stop using the pills.H
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, )20 Copyright "3#) $y -earson 0ducation( .nc.

5. G@ou must have gotten the wrong pills at the pharmacy.H Corre t Ans!er: #(7 "ationa#e 1* Mid'cycle spotting is common( especially with low'dose OC. "ationa#e 2* Contraceptive failure is always a possi$ility( $ut slight spotting is normal and does not indicate possi$le pregnancy. "ationa#e 3* The client should monitor the $leeding for changes such as $ecoming heavy or continuous. "ationa#e 4* There is no reason to discontinue the pills. "ationa#e 5* There is no indication that the wrong pills were o$tained. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: -hysiological .ntegrity C#ient )eed Su%: -harmacological and -arenteral Therapies )ursin&/*nte&rated Con epts: /ursing -rocess* .mplementation (earnin& +ut ome: )1.##

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, )20 Copyright "3#) $y -earson 0ducation( .nc.