A nurse is assessing a client who is receiving androgen therapy to treat endometriosis.
For which of the following adverse effects should the nurse monitor?
Weight loss.
Hypotension.
Muscle hypertrophy.
Edema.
The Correct Answer is D
Choice A rationale
Androgen therapy can lead to fluid retention, which would typically cause weight gain rather than weight loss. Androgens promote anabolism and can increase muscle mass and erythrocyte production, but they also influence fluid balance by affecting renal sodium and water reabsorption.
Choice B rationale
Androgen therapy generally does not cause hypotension. In some cases, it may lead to a slight increase in blood pressure due to fluid retention and effects on the renin-angiotensin-aldosterone system. Hypotension is not a recognized common adverse effect of androgen therapy.
Choice C rationale
Androgen therapy does promote muscle hypertrophy due to its anabolic effects, increasing protein synthesis and muscle mass. However, this is generally a desired therapeutic effect, not an adverse effect requiring monitoring for cessation, especially when used for conditions like muscle wasting.
Choice D rationale
Androgens can cause fluid retention, leading to edema. This occurs due to their influence on mineralocorticoid receptors in the renal tubules, which promotes sodium and water reabsorption. Nurses should monitor for signs of fluid overload, such as peripheral or pulmonary edema, and changes in body weight.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Calcium levels are primarily regulated by parathyroid hormone and calcitonin and are essential for bone health and muscle function. Neither lovastatin nor ezetimibe directly impacts calcium metabolism to a degree that requires routine monitoring of serum calcium levels. Calcium monitoring is not a primary concern for these lipid-lowering medications.
Choice B rationale
Creatinine clearance is a measure of renal function, reflecting the kidney's ability to filter waste products from the blood. While some medications can affect kidney function, lovastatin and ezetimibe do not typically have significant nephrotoxic effects that necessitate routine monitoring of creatinine clearance unless pre-existing renal impairment is present.
Choice C rationale
Thyroid stimulating hormone (TSH) is produced by the pituitary gland and regulates thyroid hormone production. There is no direct pharmacological mechanism by which lovastatin or ezetimibe would significantly alter thyroid function or TSH levels. Therefore, TSH monitoring is not a standard requirement for these lipid-lowering therapies.
Choice D rationale
Both lovastatin (a statin) and ezetimibe can, albeit rarely, cause liver dysfunction, including elevated liver enzymes. Alanine aminotransferase (ALT) is a specific indicator of hepatocellular injury. Monitoring ALT is crucial to detect potential drug-induced hepatotoxicity, particularly with combination therapy, ensuring early intervention if liver damage occurs. Normal ALT is typically 7-55 U/L.
Correct Answer is C
Explanation
Choice A rationale
Urinary retention is a potential adverse effect of opioid analgesics like meperidine due to their anticholinergic effects, which can relax the detrusor muscle and increase bladder sphincter tone. While important to monitor, it is not the most immediate life-threatening concern compared to respiratory depression.
Choice B rationale
Vomiting is a common gastrointestinal adverse effect of opioid analgesics, often due to stimulation of the chemoreceptor trigger zone in the brainstem. While distressing for the client and requiring intervention, it does not pose the immediate life-threatening risk that respiratory depression does.
Choice C rationale
Meperidine is an opioid agonist that acts on mu-opioid receptors in the central nervous system, including the brainstem respiratory centers. This can lead to dose-dependent respiratory depression by decreasing the sensitivity of these centers to carbon dioxide, making a depressed respiratory rate (normal range 12-20 breaths/min) the priority assessment for client safety.
Choice D rationale
Altered level of consciousness, such as drowsiness or sedation, is a common central nervous system effect of meperidine. While a significant finding indicating opioid effect, it is secondary in priority to respiratory depression, which directly impacts vital gas exchange and can quickly become life-threatening.
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