Question 1

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?&#10;A) Annual x-rays of the hands and wrists are necessary to monitor epiphyseal closure.&#10;B) Gynecomastia may occur and is a common side effect.&#10;C) Injections are given every 2 to 4 weeks for 3 to 4 years.&#10;D) Use of this drug may lead to prostate cancer later in life.

Accepted Answer

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.

Question 2

A female patient who swims competitively admits to using anabolic steroids to increase her muscle mass and improve her performance. What will the nurse tell this patient?&#10;A) Anabolic steroids may actually regulate her periods.&#10;B) Breast size may increase as a result of this drug use.&#10;C) The risk of liver disease will increase.&#10;D) Voice changes and facial hair will reverse when she stops the drug.

Accepted Answer

Hepatotoxicity is an ever-present risk in athletes who abuse androgens. In female patients, androgens can cause menstrual irregularities. Breast size will decrease. Virilization effects may not be reversible after the drug is stopped.

Question 3

A nurse is providing education to a patient who is beginning therapy with AndroGel testosterone gel. What statement made by the patient demonstrates a need for further teaching?&#10;A) &#34;I should not shower or swim for at least 5 to 6 hours after application.&#34;&#10;B) &#34;I should avoid direct skin-to-skin contact with my spouse where the medication was applied.&#34;&#10;C) &#34;I should have my blood drawn for laboratory tests in 14 days.&#34;&#10;D) &#34;I should apply the medication to my genitals for best results.&#34;

Accepted Answer

The medication should be applied to the arms, shoulders, and abdomen, not to the genitalia; this statement indicates a need for further teaching. The patient should be instructed not to shower, bathe, or swim for 5 to 6 hours after applying the medication. The patient should be instructed to keep areas where the medication was applied covered to prevent direct skin-to-skin contact with others. The patient should be advised to return to the clinic within 2 weeks for blood tests.

Question 4

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?&#10;A) Acne and increased facial hair&#10;B) Breast enlargement&#10;C) Increased libido&#10;D) Nausea, anorexia, and fatigue

Accepted Answer

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.

Question 5

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?&#10;A) &#34;I should apply this to my forearms and neck after showering.&#34;&#10;B) &#34;I should keep treated areas exposed to the air so that they can dry.&#34;&#10;C) &#34;I should not let my child touch the gel to prevent behavioral problems.&#34;&#10;D) &#34;I should not swim or bathe for 3 to 4 hours after applying the gel.&#34;

Accepted Answer

Testosterone administered via gels can be transferred to others by skin-to-skin contact. In children, virilization can occur, as well 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.

Question 6

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) "A limited course of androgen therapy may be prescribed, but it is not necessary."
B) "He will eventually begin puberty, so this is nothing to worry about."
C) "He will probably have to receive injections of androgens for 3 to 4 years."
D) "The risk of accelerated growth plate closure is too great to warrant androgen therapy."

Accepted Answer

Although treatment is not required in this patient, the psychologic effects of delayed puberty indicate a limited course of androgen therapy. Telling the parents not to worry does not address their concerns. This patient will not be a candidate for long-term androgen replacement therapy. Limited treatment can minimize the risk of epiphyseal closure, especially with close monitoring and radiographs.

Question 7

A nurse is teaching a group of parents about the role of testosterone in puberty for boys. To evaluate the group's understanding, the nurse asks, "What physiologic effects related to testosterone can you expect to see in your sons?" Which responses indicate an understanding of the role of testosterone in male puberty?

A) "It promotes skeletal muscle growth."
B) "It increases height and weight."
C) "It delays epiphyseal closure."
D) "It causes a high-pitched voice."
E) "It causes acne."

Accepted Answer

The physiologic effects associated with androgen therapy are promotion of skeletal muscle growth, an increase in height and weight, acceleration of epiphyseal closure, deepening of the voice, oily skin, and acne. Androgen therapy accelerates epiphyseal closure; it does not delay it. Androgen therapy deepens the voice rather than raising the pitch.

Question 8

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?&#10;A) After 3 to 4 years of therapy&#10;B) If acne and facial hair develop&#10;C) When complete sexual maturation has occurred&#10;D) When testicular enlargement occurs

Accepted Answer

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.

Question 9

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?

A) Coagulation studies
B) Complete blood count (CBC) with differential
C) Liver function tests and serum cholesterol
D) Serum glucose and hemoglobin A1c

Accepted Answer

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. Blood coagulation is not affected. A CBC is not indicated. Serum glucose and hemoglobin A1c levels are not indicated.

Question 10

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) Five-pound weight gain
B) Increased growth of pubic hair
C) Rash at the site of the patch
D) Presence of acne

Accepted Answer

Patients receiving testosterone may experience edema secondary to sodium and water retention. Treatment involves discontinuing the drug and giving diuretics if needed. Masculinization of both females and males may occur and boys may experience growth of pubic hair, which is an expected effect. Patients may develop a sensitivity rash at the site of transdermal application. Acne is an expected effect.

Question 11

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) "Facial hair may develop with this drug but will go away over time."
B) "I may experience an increase in breast size while taking this drug."
C) "Testosterone may increase my high-density lipoprotein (HDL) cholesterol and reduce my low-density lipoprotein (LDL) cholesterol."
D) "Testosterone treats anemia by stimulating the synthesis of a renal hormone."

Accepted Answer

The answer of A nurse provides teaching for a female...

Question 12

An adult male patient will begin androgen therapy for testicular failure. Which statement by the patient indicates understanding of the treatment regimen?&#10;A) &#34;I will need to have x-rays of my hands and feet every 6 months.&#34;&#10;B) &#34;My libido may improve while I am taking this medication.&#34;&#10;C) &#34;Taking this drug may lead to the development of prostate cancer.&#34;&#10;D) &#34;This will restore fertility, so I can have a child.&#34;

Accepted Answer

The answer of An adult male patient will begin androgen...

Deck 65: Androgens