PrepU Ch 7 Pharmacology in Women's Health
Regular monthly menstrual cycles cease at the time of: a. menopause. b. menorrhea. c. menses. d. menstruation. e. menarche.
a
The anatomy and physiology instructor is discussing the action of endogenous estrogen on the body. What effect would the instructor tell the students estrogen has on breast tissue in the body? a. Stimulates construction of milk ducts b. Restricts deposition of fat to abdomen and thighs c. Depresses formation of connective tissue during the 3rd decade of life d. Supports development of the placenta
a
The nurse's ongoing assessment of outpatient clients receiving estrogen, progestin, or combination products should include what assessments? (Select all that apply.) a. Respiratory rate b. Temperature c. Pulse d. Therapeutic effects e. Blood pressure
a, b, d, e
The health care provider has prescribed a combination of estrogen and progestin for a client. The nurse knows that this combination carries an increased risk of which conditions? (Select all that apply.) a. Dementia b. Myocardial infarction c. Multiple myeloma d. Blood clots e. Rheumatoid arthritis
a, b, d
The anatomy and physiology instructor is discussing the action of endogenous estrogen on the body. What effect would the instructor tell the students estrogen has on breast tissue in the body? a. Stimulates construction of milk ducts b. Supports development of the placenta c. Depresses formation of connective tissue during the 3rd decade of life d. Restricts deposition of fat to abdomen and thighs
a
The increase in thickness of the endometrial layer during the first half of the menstrual cycle is controlled by the: a. increasing level of estrogen. b. increasing level of HcG. c. level of FSH. d. dropping level of LH.
a
The nurse is discussing the use of Depo-Provera with a 17-year-old female who desires birth control. The nurse recognizes that this medication is used in this client for what reason? a. Birth control for 3 months b. No adverse effects usually associated with medroxyprogesterone c. No vaginal bleeding for 12 months d. Decreases chance of sexually transmitted infections
a
When caring for a patient receiving estrogen replacement therapy for postmenopausal symptoms, the nurse documents a diagnosis related to impaired tissue perfusion. Which condition is the nurse referring to in the diagnosis? a. Thromboembolism b. Chloasma c. Edema of the feet d. Gastrointestinal upset
a
Which client is least likely to benefit from treatment with megestrol (Megace)? a. A 23-year-old with endometrial cancer b. A 63-year-old with endometrial cancer with metastasis c. A 52-year-old with advanced breast cancer d. A 27-year-old female with dysmenorrhea
a
Which of the following medications, when administered concomitantly with oral contraceptives, can decrease the effect of the contraceptives? a. Anticonvulsants b. Antihypertensives c. Anticholinergics d. Anticoagulants
a
The nurse is caring for a client who has cancer and who until recently took estrogen. The nurse knows that estrogen may have increased the risk of development of which types of cancer? (Select all that apply.) a. Endometrial cancer b. Breast cancer c. Melanoma d. Brain cancer e. Lung cancer
a, b
The nurse performs which assessments when a female client comes to the clinic for a follow up visit while undergoing estrogen therapy? (Select all that apply.) a. Peripheral pulse b. Client weight c. Blood pressure check d. Peripheral oxygen saturation e. Temperature
a, b, c
A 20-year-old woman has been prescribed estrogen. As with all women taking estrogen, the nurse will carefully monitor the client for: a. cardiovascular complications. b. a decrease in secondary sexual characteristics. c. early epiphyseal closure. d. decreased libido.
a
A 20-year-old woman will soon begin taking oral contraceptives for the first time. What advice should the nurse provide to this client? a. "Make sure to seek care quickly if you experience bad headaches, calf pain, or changes in vision." b. "Some women get some pain in their chest or abdomen when they take oral contraceptives, but this will pass as your body gets used to them." c. "You need to carefully consider whether you might want to get pregnant later in your life." d. "It will take 10 to 12 weeks before the birth control pills will actually prevent pregnancy, so be vigilant with other contraceptives until then."
a
A 38-year-old female client has just visited the health care provider and has received a prescription for birth control pills. The client calls the nurse and states that she doesn't need birth control pills because she had voluntary sterilization after her third child. The nurse explains that birth control pills may be used for what other reason? a. Menstrual disorders b. Heart rhythm irregularities c. Breast lumps d. Thrombophlebitis
a
A client will begin estrogen therapy using the estradiol transdermal system. What statement by the client indicates a need for further instruction? a. "I will be able to hide the patch well under my belt." b. "I will apply it to clean, dry skin." c. "I can use my abdomen to place the patch." d. "I will remove one patch before I apply the new one."
a
A group of students are reviewing material in preparation for a test on the male and female breasts. The students demonstrate understanding of the material when they state: a. A primary function of the female breast is to produce milk. b. Progesterone is primarily responsible for the growth of breast tissue. c. The breasts contain a limited supply of blood vessels. d. Striated muscle in the nipples contract causing them to become erect.
a
A nurse caring for a 43-year-old client explains to the client that ovarian functions gradually decrease around this age. What is the implication of decreased ovarian function? a. Inability to become pregnant b. Susceptibility to fractures c. Changes in sexual response d. Increases the risk of heart disease
a
A nurse is caring for an adolescent girl experiencing menstruation for the first time. What are the changes that occur in the body at this stage that the nurse should share with the adolescent girl? a. Breast development b. Increased risk for bladder incontinence c. Menstrual related insomnia d. Loss of existing fat deposits
a
A nurse teaching a 57-year-old client about the factors that must be considered around the use of hormone replacement therapy (HRT) should discuss what increased risk associated with the therapy? a. venous thromboembolism b. bronchiectasis c. malignant hyperthermia d. Crohn's disease
a
A young mother is requesting oral contraceptives at her 6-week postnatal visit. Which of the following would be a contraindication for the use of progestin? a. Breastfeeding b. History of recent cholecystectomy c. Family history of cardiovascular disease d. History of pelvic inflammatory disease
a
During pregnancy, what becomes a massive endocrine gland? a. Placenta b. Umbilical cord c. Embryo d. Uterus
a
Estropipate is sometimes administered to postmenopausal women to prevent which condition? a. Osteoporosis b. Dysfunctional uterine bleeding c. Endometriosis d. Uterine cancer
a
In an ideal 28-day menstrual cycle, the secretory phase occurs during which days? a. 15 to 28 b. 1 to 5 c. 12 to 14 d. 5 to 11
a
On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which response by the nurse is most appropriate? a. "It's important to balance the possible benefits of HRT with the fact that it might increase your risk of heart disease and stroke" b. "We'll have to check your bone density first, because if it's too low then it's not safe to start HRT." c. "HRT might be quite beneficial to you, and it carries the additional benefit of modest protection against breast cancer." d. "Actually, most of the current research is suggesting that HRT may not be all that effective in treating the symptoms of menopause."
a
Oral contraceptive use would be contraindicated for which client? a. A 40-year-old client who smokes 1 to 1½ packs of cigarettes per day b. A 40-year-old client who has a family history of hypofunction of the pituitary gland c. A 45-year-old client who has a family history of pancreatic cancer d. A 50-year-old client who is taking a cholesterol-lowering medication
a
The nurse is discussing the use of estrogen with a woman who smokes cigarettes. The nurse informs the client that clients who take estrogen and continue to smoke are at a greater risk for thromboembolic disorder because of what reasons? (Select all that apply.) a. Increased platelet aggregation b. Decreased oxygen content to the lungs c. Vasoconstriction of small capillaries d. Increase in liver production of blood clotting factors e. Increased chance of thrombocytopenia
a, d
A 20-year-old woman has been prescribed estrogen. As with all women taking estrogen, the nurse will carefully monitor the client for: a. decreased libido. b. cardiovascular complications. c. a decrease in secondary sexual characteristics. d. early epiphyseal closure.
b
A 37-year-old woman recently underwent a bilateral salpingo-oophorectomy. During the assessment, which of the following situations should the nurse ask about to determine the client's surgical menopausal status? a. Decreased appetite b. Hot flashes c. Weight gain d. Headaches
b
A client has been prescribed transdermal estradiol. What important information does the nurse share with this client? a. The estrogen levels with this route of administration mimic menopause. b. Avoid prolonged sun exposure c. The client won't feel any effects of this medication for 2 weeks. d. There is more nausea with this type of administration than the oral route.
b
A client with a 28-day cycle reports that she ovulated on May 10. The nurse would expect the client's next menses to begin on: a. May 26 b. May 24 c. June 1 d. May 30
b
A menopausal client prescribed estrogen asks what the implications of taking the medication are. Which response by the nurse best demonstrates an understanding of the associated implications? a. "If estrogen and progesterone are taken together, there are no increased health risks." b. "Estrogen increases the risk of certain cancers, myocardial infarctions, and blood clots." c. "Estrogen has not been proven to increase the risk of any significant medical conditions." d. "Estrogen decreases the risk of dementia, myocardial infarctions, strokes, breast cancer, and blood clot."
b
A new client telephones the clinic requesting a renewal prescription for contraceptives she has been taking for 4 years. It has been more than a year since her last health care visit, but she is unable to come into the clinic until next month. She insists she is "doing fine" on this medication and must have her prescription now. Considering the circumstances and related safety issues, how should the clinic nurse respond? a. "Since you are doing well on this regimen, I'll arrange to get the prescription filled for a month to last until your clinic appointment." b. "Before the drugs are prescribed, a complete medical history, physical examination, Pap test, urinalysis, and weight and blood pressure measurements are recommended." c. "Before estrogen based drugs are prescribed, you must see the health care provider to get an order for a mammogram." d. "If you have a physical within 2 years, I can get your medication refilled."
b
A patient who is taking oral contraceptives develops an upper respiratory infection for which a tetracycline is ordered. Which instruction would be most important for the nurse to include? a. Reducing the oral contraceptive to every other day b. Using an alternative means of contraception while taking the tetracycline c. Taking the tetracycline 2 hours after taking the oral contraceptive d. Monitoring for increased adverse effects of the oral contraceptive
b
The nurse is caring for a woman who is receiving estrogen for treatment of amenorrhea. What evidence will the nurse use to indicate that the medication is working properly? a. Appearance of secondary sexual characteristics b. Occurrence of menstruation c. Decrease in hot flashes d. Lack of menstruation
b
The nurse is scheduled to administer an oral contraceptive to a client admitted with adult onset diabetes. What is the priority teaching that would be provided regarding this medication? a. Notify the primary care provider if your glucose is elevated because an adjustment in medication may be needed. b. Call the primary care provider for any sudden onset of chest pain, shortness of breath, or redness, swelling, and pain in a leg. c. If you skip a dose, use another form of contraception until the first week of the next cycle of the oral contraceptive. d. Take the medication the same time each day with food to decrease the development of nausea and vomiting.
b
The health care provider has ordered estrogen for a woman who is experiencing uterine bleeding resulting from a hormone imbalance. The nurse knows that this medication may be administered in what way? Select all that apply. a. Subcutaneously b. Intravenously c. Transdermally d. Intramuscularly e. Orally
b, d
Hormone replacement therapy comes in different types. Which of the following are estrogen-based drugs? Select all that apply. a. Activella b. Estring c. Aygestin d. Menest e. Vagifem f. Triphasil
b, d, e
A 20-year-old woman has been prescribed estrogen. As with all women taking estrogen, the nurse will carefully monitor the client for: a. early epiphyseal closure. b. a decrease in secondary sexual characteristics. c. cardiovascular complications. d. decreased libido.
c
A client alerts the nurse that they have been in menopause for a couple of months. The nurse teaches the client how menopause occurs. Which statement reflects the teaching has been effective? a. "There is an increase in the gonadotropins." b. "Hot flashes and night sweats are prominent." c. "Estrogen and progesterone diminish." d. "The menstrual cycle becomes irregular."
c
A nurse is obtaining a history from an older adult woman. During the interview, the woman states, "When I feel like I have to urinate, the urge is really strong and I go to the bathroom really frequently, often waking up several times during the night to go." The nurse would likely identify this as which condition? a. urge incontinence b. neurogenic bladder c. overactive bladder syndrome d. stress incontinence
c
After teaching a class on the female reproductive system, the nurse determines that the teaching was successful when the class identifies what as a primary function of the ovaries? a. Secretion of mucus that supplies lubrication for intercourse b. Carrying the ovum to the endometrium c. Secretion of estrogen and progesterone d. Location for implantation of a fertilized ovum
c
Hormones from various organs regulate the menstrual cycle. Which of the following hormones does not directly influence the cycle? a. Luteinizing hormone b. Gonadotropin-releasing hormone c. Testosterone d. Follicle-stimulating hormone
c
The U.S. Food and Drug Administration (FDA) has issued a Black Box Warning concerning estrogen's use and associated increased risk of which of the following? a. Pelvic inflammatory disease b. Lung disease c. Endometrial carcinoma d. Osteosarcoma
c
The nurse is caring for a woman who is receiving estrogen for treatment of amenorrhea. What evidence will the nurse use to indicate that the medication is working properly? a. Decrease in hot flashes b. Appearance of secondary sexual characteristics c. Occurrence of menstruation d. Lack of menstruation
c
The release of gonadotropin releasing hormone by the hypothalamus signals the onset of: a. menopause. b. menstruation. c. puberty. d. menarche
c
What additional warnings or risks should the nurse include in the teaching plan of a client receiving estrogen? a. Parkinson's disease b. cardiac valve dysfunction c. endometrial cancer d. diabetes mellitus
c
When caring for a patient receiving estrogen therapy, which action would be an appropriate part of the evaluation process? a. Directing the patient to weigh herself weekly and to report sudden weight gain b. Teaching the patient that combined estrogen-progestin therapy may increase blood sugar levels in women with diabetes c. Interviewing the patient and observing for therapeutic and adverse effects d. Teaching the patient to take estrogens and progestins with food or at bedtime to decrease nausea
c
Which hormone causes ovulation to occur? a. follicle-stimulating hormone (FSH) b. prolactin c. luteinizing hormone (LH) d. adrenocorticotropic hormone (ACTH)
c
Which would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a client taking estrogen? a. Amenorrhea b. Cholestatic jaundice c. Headaches d. Breast tenderness
c
A 21-year-old woman is prescribed an oral contraceptive pill to prevent pregnancy. The nurse should inform the client of which adverse effects of this medication? a. Cessation of bleeding and/or spotting b. Reduction of breast tissue c. Weight loss d. Nausea
d
A 27-year-old woman is concerned that she is pregnant even though she has been using oral contraceptives. During the assessment, the nurse discovers the client has been using various herbs. Which of the following herbs is contraindicated for use with oral contraceptives? a. Chamomile b. Pennyroyal c. Valerian d. St. John's wort
d
A 49-year-old female client is asking the nurse about how her changing hormones relate to menopause. The nurse explains that atrophic vaginitis is a common problem during menopause. The treatment for atrophic vaginitis requires replacing: a. human chorionic gonadotropin. b. progesterone. c. testosterone. d. estrogen.
d
A client is receiving a medroxyprogesterone contraceptive injection. The nurse would instruct the client to return for the next dose at which time? a. 1 year b. 6 months c. 3 years d. 3 months
d
A client is receiving conjugated estrogens. The nurse would anticipate administering this drug by which route? a. Intravaginal b. Intravenous c. Subcutaneous d. Oral
d
A female client asks the nurse about the use of progestins. The nurse shares with the client that clients who take this medication are at an increased risk for what serious adverse effect? a. Seizures b. Respiratory difficulties c. Renal failure d. Cardiovascular complications
d
A monophasic oral contraceptives composition is described as having which characteristic? a. primarily follicle-stimulating hormone b. fixed amounts of estrogen and varied amounts of progestin c. three different doses of estrogen and progestin d. fixed amounts of both estrogen and progestin components
d
A nurse is caring for a 25-year-old clinic client who is starting on birth control pills. What statement by the client indicates that she needs further teaching? a. "I may gain or lose weight while I am taking these pills." b. "I will monitor my weight and have my blood pressure checked in 3 months." c. "I know my nausea is common, but it should subside in a few weeks." d. "I will exercise more if I experience chest or leg pain."
d
After teaching a group of students about female reproductive hormones, the instructor determines that the teaching was successful when the students identify which hormone as being primarily responsible for maintaining pregnancy? a. Estrogen b. Luteinizing hormone c. Follicle-stimulating hormone d. Progesterone
d
After teaching a group of students about the events that occur with fertilization and implantation of an ovum, the instructor determines that the teaching has been effective when the students identify what as an endocrine structure? a. Umbilical cord b. Fetus c. Uterus d. Placenta
d
Estropipate is sometimes administered to postmenopausal women to prevent which condition? a. Endometriosis b. Dysfunctional uterine bleeding c. Uterine cancer d. Osteoporosis
d
Kalie, age 18, is prescribed progesterone for the treatment of primary amenorrhea. Which adverse effect would need to be reported immediately to the health care provider? a. Weight gain b. Abnormal menstrual bleeding c. Breast tenderness d. Pain in one leg
d
The health care provider has ordered a variety of laboratory assessments on a client who will need estrogen replacement. The follow labs are ordered: blood urea nitrogen (BUN), creatinine, and liver function tests (LFTs). What is the nurse's best statement explaining to a client the need to draw the labs? a. "Additional labs will be ordered if these values indicate problems with your body." b. "I will get the prescriber to talk to you about the laboratory assessments ordered." c. "Medication adjustments are based on baseline laboratory values." d. "The labs will identify your body's ability to filter and excrete medications."
d
The nurse is caring for a client who would like to start taking oral contraceptives. What aspect of this client's health history should the nurse prioritize for follow-up? a. The client takes NSAIDs for the treatment of headaches and joint pain. b. The client's body mass index (BMI) is 18.0 (underweight). c. The client uses marijuana one to two times per week. d. The client was treated for deep vein thrombosis following surgery.
d
The nurse is caring for a woman with a new prescription for oral contraceptives. What outcome would be most important for the nurse to evaluate? a. The client describes a positive attitude toward sexual behavior. b. The client makes the necessary appointments for follow-up care. c. The client can explain how medication cannot prevent most sexually transmitted infections. d. The client can verbalize how and when to take medication even if a pill is missed.
d
The production of estrogen during pregnancy would be negatively affected if which structure was not functioning effectively? a. amniotic sac b. fallopian tube c. uterus d. placenta
d
Which hormone is responsible for ovulation? a. Estrogen b. Progesterone c. Follicle-stimulating hormone d. Luteinizing hormone
d
Why does the presence of estrogen in oral contraceptives increase the risk for developing blood clots? a. The estrogen stimulates skeletal growth, causing increased production of red blood cells. b. The estrogen increases serum triglyceride, cholesterol, and glucose levels. c. The estrogen causes peripheral vasoconstriction. d. The estrogen increases production of factors II, VII, IX, and X.
d
