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Review Questions

a. The most important action for a nurse caring for transgender and nonbinary clients is to self-assess their own personal attitudes, beliefs, and feelings regarding these clients.
c. This is an intended effect of hormonal therapy for individuals undergoing MTF transition.
b. This is the only condition listed that is not a contraindication for testosterone therapy.
c. Hypertension is often treated with ACE inhibitors or angiotensin receptor blockers, which could cause hyperkalemia when given concomitantly with spironolactone.
b. Hyperkalemia is the most common and most serious adverse effect of spironolactone. Cardiac dysrhythmias and muscle cramps are indications of hyperkalemia and should be reported.
a. Finasteride is highly toxic to a fetus. Any female who is pregnant or of childbearing age should avoid contact with this medication, especially if the tablet is broken or crushed.
a. Testosterone therapy cannot be started in a pregnant client because of the dangers to the fetus.
b. A client transitioning from female to male who has not had gender-affirming surgery still has female organs and still needs regular screenings for cervical and breast cancer.
d. Spironolactone is an androgen blocker but does not block testosterone. Because the client is unsure about whether to transition, spironolactone is an appropriate choice because changes in sexual characteristics with spironolactone are reversible.
b. Androgens may decrease blood glucose levels; therefore, any hypoglycemic medication is likely to need a dosage adjustment.

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