A woman is being treated with clomiphene citrate for the treatment of infertility. She states to the nurse that she has seen an increase in vaginal discharge. The nurse knows that this effect is related to:

Correct Answer: C

Rationale: The correct answer is C: 'Increased production of vaginal secretions.' Clomiphene citrate affects cervical mucus production, leading to an increase in vaginal secretions. This effect is beneficial for fertility as it helps create a more hospitable environment for sperm transport. Choice A, 'Increased blood flow to the vaginal area,' is incorrect as the increase in vaginal discharge is primarily due to changes in cervical mucus. Choice B, 'Increased cervical mucus production,' is partially correct but does not fully explain the increase in vaginal secretions. Choice D, 'Increased lubrication in the vaginal canal,' is not directly related to the effect seen with clomiphene citrate treatment for infertility.

Correct Answer: B

Rationale: The correct answer is B. Alendronate should be taken in the morning with a full glass of water and the patient should remain upright for at least 30 minutes. This is important to prevent esophageal irritation and ensure proper absorption of the medication. Choice A is incorrect because alendronate should not be taken with food as it can decrease its absorption. Choice C is incorrect as taking the medication before bed increases the risk of esophageal irritation and reduces absorption due to lying down. Choice D is also incorrect because taking alendronate with milk or other calcium-rich foods can decrease its absorption.

Correct Answer: B

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, it is crucial for the nurse to consider the patient's adherence to the medication schedule. Breakthrough bleeding is often a sign of missed doses or inconsistent use, which can decrease the effectiveness of the oral contraceptive. Considering the possibility of pregnancy (Choice A) is important but secondary to assessing adherence. The need for an increased dosage (Choice C) is not typically the first consideration for breakthrough bleeding. Evaluating the effectiveness of the current oral contraceptive (Choice D) is relevant but should come after assessing adherence to the medication schedule.

Correct Answer: B

Rationale: The correct answer is B: Decreased prostate size. Finasteride is a medication used to reduce the size of the prostate gland in patients with BPH. By decreasing the size of the prostate, symptoms such as urinary frequency and urgency are improved. Choice A is incorrect as the medication aims to decrease, not increase, urinary symptoms. Choice C is incorrect because the goal of finasteride is to reduce, not increase, the prostate size. Choice D is also incorrect as finasteride is not indicated for lowering blood pressure.

Correct Answer: A

Rationale: The correct answer is to apply the testosterone gel to the chest or upper arms. This is recommended to minimize the risk of unintentional transfer of the medication to others, especially women and children, through skin contact. Applying the gel to the face, neck, or genitals is not advised as it can lead to unintended exposure to others. Additionally, applying the gel to the scalp or back is not appropriate as these areas are not indicated for absorption of testosterone.