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
Ethinyl estradiol and norethindrone, a common oral contraceptive combination, can sometimes lead to weight gain rather than weight loss. This is often attributed to fluid retention and changes in appetite or metabolism, rather than a catabolic effect causing weight reduction.
Choice B rationale
Easy bruising is not a typical manifestation of ethinyl estradiol and norethindrone use. While some hormonal contraceptives can affect coagulation factors, leading to an increased risk of thrombosis, they do not generally cause increased capillary fragility or platelet dysfunction manifesting as easy bruising.
Choice C rationale
Oral contraceptives containing estrogen, such as ethinyl estradiol, can actually cause a slight increase in blood pressure in some individuals due to their effects on the renin-angiotensin-aldosterone system, leading to sodium and water retention. Low blood pressure is not a common adverse effect.
Choice D rationale
Breakthrough bleeding, or irregular uterine bleeding that occurs during hormone therapy, is a common adverse effect of combined oral contraceptives like ethinyl estradiol and norethindrone, especially during the initial cycles of use. It results from an imbalance in the hormonal effects on the endometrium.
Correct Answer is ["A","C","D","E"]
Explanation
Choice A rationale
Furosemide, a loop diuretic, can cause ototoxicity, particularly with rapid IV administration or high doses. This adverse effect manifests as tinnitus, vertigo, or irreversible hearing loss due to its impact on the hair cells in the organ of Corti within the inner ear. Therefore, reporting any indications of hearing loss is crucial for client safety.
Choice B rationale
Taking the daily dose of furosemide at bedtime is generally not recommended. Furosemide has a rapid onset and relatively short duration of action, typically leading to increased urine production for several hours. Administering it at bedtime can disrupt sleep patterns due to frequent nocturia, making morning administration preferable to minimize nocturnal diuresis.
Choice C rationale
Daily weight monitoring is essential for clients taking furosemide for heart failure. Furosemide promotes diuresis, reducing fluid overload. Daily weight checks (normal variations are within 0.5-1 kg/day) allow for assessment of fluid balance and the effectiveness of the diuretic therapy, helping to identify both fluid excess and dehydration promptly.
Choice D rationale
Furosemide is a potassium-wasting diuretic, meaning it promotes the excretion of potassium from the body. Chronic use can lead to hypokalemia (normal range 3.5-5.0 mEq/L), which can cause muscle weakness, fatigue, and cardiac arrhythmias. Consuming foods high in potassium regularly helps mitigate this electrolyte imbalance and maintain physiological function.
Choice E rationale
Furosemide can cause orthostatic hypotension, a sudden drop in blood pressure upon standing. This occurs due to fluid volume depletion and vasodilation induced by the diuretic effect. Rising slowly from a sitting or lying position allows the cardiovascular system to compensate, reducing the risk of dizziness, syncope, and falls.
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