A nurse is teaching a client who is to begin taking tamoxifen to treat breast cancer. The nurse should instruct the client to expect which of the following findings as an adverse effect of the medication?

Choice A reason: This is incorrect because orally administered decongestants do not have an immediate onset. They take longer to act than nasal sprays because they have to be absorbed through the gastrointestinal tract. Nasal sprays act directly on the nasal mucosa and have a faster onset.

Choice B reason: This is correct because orally administered decongestants do not cause rebound congestion. Rebound congestion is a condition in which the nasal passages become more swollen and congested after the effect of the nasal spray wears off. This can lead to overuse and dependence on the nasal spray. Orally administered decongestants do not have this effect because they act systemically and not locally.

Choice C reason: This is incorrect because orally administered decongestants do not have a shorter duration. They have a longer duration than nasal sprays because they are metabolized more slowly by the liver. Nasal sprays have a shorter duration because they are eliminated more quickly by the nasal mucosa.

Choice D reason: This is incorrect because orally administered decongestants are not more potent than nasal sprays. They have a similar potency, but they have a different mechanism of action. Orally administered decongestants act on the alpha-adrenergic receptors in the blood vessels, causing vasoconstriction and reducing congestion. Nasal sprays act on the beta-adrenergic receptors in the bronchial smooth muscle, causing bronchodilation and improving airflow.

Choice A reason: Constipation is not an adverse effect of tamoxifen. Tamoxifen does not affect the gastrointestinal motility or function. Constipation may be caused by other factors such as dehydration, low-fiber diet, or lack of exercise.

Choice B reason: Clotting is an adverse effect of tamoxifen. Tamoxifen can increase the risk of thromboembolic events such as deep vein thrombosis, pulmonary embolism, or stroke. Clotting can cause serious complications such as pain, swelling, shortness of breath, chest pain, or neurological deficits.

Choice C reason: Tinnitus is not an adverse effect of tamoxifen. Tamoxifen does not affect the auditory system or cause hearing loss. Tinnitus may be caused by other factors such as noise exposure, ear infection, or medication toxicity.

Choice D reason: Urinary retention is not an adverse effect of tamoxifen. Tamoxifen does not affect the urinary system or cause bladder dysfunction. Urinary retention may be caused by other factors such as prostate enlargement, nerve damage, or medication side effects.