A nurse is teaching a male adult patient about the use of ...

[ENagel]

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?
 
  a. I should apply this to my forearms and neck after showering.
  b. I should keep treated areas exposed to the air so that they can dry.
  c. I should not let my child touch the gel to prevent behavioral problems.
  d. I should not swim or bathe for 3 to 4 hours after applying the gel.

Question 2

A patient who is taking oral contraceptives begins taking valproic acid Depakote for seizures. After a week of therapy with valproic acid, the patient tells the nurse that she is experiencing nausea. What will the nurse do?
 
  a. Ask the patient if she is taking the valproic acid with food, because taking the drug on an empty stomach can cause ga-strointestinal side effects.
  b. Contact the provider to request an order for a blood ammonia level, because hyperammonemia can occur with valproic acid therapy.
  c. Suggest that the patient perform a home pregnancy test, because valproic acid can reduce the efficacy of oral contraceptives.
  d. Suspect that hepatotoxicity has occurred, because this is a common adverse effect of valproic acid.

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Answer to Question 1

C
Testosterone administered via gels can be transferred to others by skin-to-skin contact. In child-ren, 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.

Answer to Question 2

A
Gastrointestinal effects, including nausea, vomiting, and indigestion, are common with valproic acid and can be minimized by taking the drug with food or using an enteric-coated product. Hyperammonemia can occur when valproic acid is combined with topiramate. Signs of pregnancy usually do not occur within a week, so this is less likely. Hepatotoxicity is a rare adverse effect.

[ENagel]

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