Women's Health

B

A 21-year-old woman is prescribed an oral contraceptive pill to prevent pregnancy. What is the mechanism of action of oral contraceptive pills? A) Increase production of FSH and LH B) Suppress ovulation C) Thin the cervical mucosa D) Thicken the endometrial lining

A

A 36-year-old client has been a long-time user of oral contraceptives. She calls the office to request a visit because of sudden and severe leg pain. Why is this concerning? A) She has an increased risk of thrombophlebitis. B) She has an increased risk of stress fractures. C) She has an increased risk of cellulitis. D) She has an increased risk of lymphedema.

C

A client is menopausal and has been given a prescription for estrogen. She asks the nurse what some of the risks are in taking this medication. The nurse's best response is: A) Estrogen decreases the risk of dementia, myocardial infarctions, strokes, breast cancer, and blood clot. B) Estrogen has not been proven to increase any medical conditions. C) Estrogen increases the risk of certain cancers, myocardial infarctions, and blood clots. D) As long as estrogen and progesterone are taken together, there are no increased health risks.

C

A client who has been on estrogen therapy for two months calls the clinic and tells the nurse that she has developed increased pigmentation to her facial skin. What is the nurse's best response to this client? A) "This will go away as soon as you stop the therapy." B) "If you wash your face in hot, soapy water three times a day, it will go away." C) "Changes to the skin may not go away even after the medication is discontinued." D) "This must be a reaction to some makeup you are using. It is not related to the estrogen."

A, B, C, D

A nurse can advise clients that transdermal delivery of estrogens has been found to be safer especially for women with which of the following conditions? Select all that apply: A) Hypertriglyceridemia B) Type 2 diabetes C) Migraine headaches D) Hypertension E) Rheumatoid arthritis

D, E

A nurse educating a client on the use of estradiol (Estrace) should warn the client of which of the following dermatologic reactions that may continue after drug discontinuation? Select all that apply: A) Dermatitis B) Stevens Johnson syndrome C) Pruritis D) Chloasma E) Melasma

A, C, D

A nurse may administer norethindrone (Aygestin) to a female client for which reason? (Select all that apply.) A) Treatment of amenorrhea B) Treatment of edema C) Treatment of endometriosis D) Prevention of pregnancy E) Prevention of estrogen-dependent breast carcinoma

C

A patient has been prescribed the drug finasteride for the treatment of benign hypertrophy of the prostate. Which of the following adverse effects of the drug should the nurse caution the patient about? A) Hypertension B) Increased libido C) Impotence D) Hyperglycemia

A

A patient is in the clinic for a follow-up visit after having been on hormone replacement therapy for 3 months. Which report by the patient would immediately concern the nurse? A) Smoking a pack of cigarettes a day B) Gaining ten pounds in the last 3 months C) A craving for sugar D) A decrease in weight bearing exercise

A

A patient is receiving conjugated estrogens. The nurse would anticipate administering this drug by which route? A) Oral B) Subcutaneous C) Intravaginal D) Intravenous

A

A patient is receiving menotropins. The nurse would anticipate administering this drug by which route? A) Intramuscular B) Oral C) Subcutaneous D) Intradermal

A

A patient suffers from dysmenorrhea. Which oral medication will be prescribed that has the ability to provide physiological actions on the neuroendocrine control of ovarian function? A) Estrogen B) Progestins C) Naprosyn (Naproxen) D) Ibuprofen (Motrin)

B

A patient taking hormonal contraceptives turns 35 years of age and has smoked for 15 years. What action is most important? A) Begin an exercise regime. B) Begin smoking cessation. C) Begin daily aspirin therapy. D) Begin taking NicoDerm.

A

A woman has been prescribed Climara, a transdermal estradiol patch. Which of the following should she be instructed regarding the administration? A) Avoid prolonged sun exposure at the patch site due to increased plasma concentrations. B) The application of heat at the patch site will decrease effectiveness and result in pregnancy. C) The medication, when exposed to sunlight, can increase the risk of breast cancer development. D) Exposure of the medication to cold will increase effectiveness with application once a month.

C

A woman is prescribed hormonal contraceptives. What places her at risk for the development of blood clots? A) Hormonal contraceptives increase serum triglyceride and cholesterol. B) Hormonal contraceptives stimulate skeletal growth and RBC production. C) Hormonal contraceptives increase blood levels of clotting factors. D) Hormonal contraceptives will cause peripheral vasoconstriction.

A)

After teaching a new client about her new prescription for an estrogen-based contraceptive, the nurse realizes that she needs more teaching when she says which of the following? A) "I can keep smoking." B) "I should check my weight weekly." C) "I should call my physician if I have any unusual vaginal bleeding." D) "I will need an annual examination to be sure there are no problems."

A

After teaching a patient who is prescribed estradiol vaginal cream, the nurse determines that the patient has understood the instructions when she states that she will administer the medication at which frequency? A) Once a day B) Once every other day C) Once a week D) Once a month

D

An adolescent patient asks the nurse, "What should I do if I forget to take my birth control pill?" What should the nurse reply? A) "Abstain from intercourse for 7 days." B) "It's okay to miss a day or two, as long as you don't go over 5 days." C) "Just wait until your next dose, then take double the dose." D) "Take the dose as soon as you discover your oversight."

D

During patient teaching, a young woman asks the nurse the following question: "If I get pregnant on the 'pill' should I continue to take it?" What is the nurse's best response? A) "The pill has no effect on pregnancy." B) "The pill will cause miscarriage." C) "The pill is not harmful to the male fetus." D) "The pill can be harmful to the female fetus."

C

Estradiol is sometimes administered to postmenopausal women to prevent which condition? A) Endometriosis B) Dysfunctional uterine bleeding C) Osteoporosis D) Uterine cancer

A

Medroxyprogesterone is an effective form of birth control. Long-term use can cause what serious adverse effect? A) Osteoporosis B) Menstrual irregularities C) Headaches D) Nervousness

D

Mr. Franklin, 68 years old, is treated for benign prostatic hypertrophy. Which male hormone is responsible for the growth of the prostate? A) Testosterone B) Androgen C) Interstitial cell-stimulating hormone D) Dihydrotestosterone

A

Patient education is necessary to ensure proper use of exogenous estrogen and to enable the patient to recognize adverse effects. Which of the following should a nurse teach the patient? A) Self-breast examination B) Basal body temperature evaluation C) Maintenance of proper records D) Proper use of barriers to prevent STDs

A

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) Endometrial carcinoma B) Lung disease C) Pelvic inflammatory disease D) Osteosarcoma

C

The client informs the nurse that she had unprotected intercourse last night. The client is considering requesting emergency postcoital contraception. The nurse's best response is: A) Emergency contraception is not effective if started later than 12 hours after exposure. B) Emergency contraception is most effective if started 72 hours after exposure. C) Emergency contraception is most effective if started within 24 hours and no later than 72 hours after exposure. D) Emergency contraception is most effective if started within 8 hours and no later than 24 hours after exposure.

C, D

The client is about to begin therapy for erectile dysfunction and asks the nurse about the likelihood of priapism occurring with these medications. The nurse knows that priapism is most likely to occur in clients with which condition? Select all that apply. A) Iron deficiency anemia B) Multiple myeloma C) Leukemia D) Testicular torsion E) Raynaud's disease

A, C

The health care provider has ordered estrogen for a woman who is experiencing uterine bleeding that results from a hormone imbalance. The nurse knows that this medication may be administered in what way? Select all that apply. A) Intravenously B) Transdermally C) Intramuscularly D) Orally E) Subcutaneously

B,C,D

The nurse expects the health care provider to perform which client examinations prior to the start of estrogen therapy? (Select all that apply.) A) Chest X-ray B) Papanicolaou (Pap) test C) Breast exam D) Rectal exam E) Eye exam

A, D, E

The nurse is aware that progestins will be prescribed with great caution in a client with which condition? (Select all that apply.) A) Renal disase B) Tension headaches C) Arthritis D) Epilepsy E) Asthma

B

The nurse is discussing estrogen therapy with a woman age 52 years. What information will the nurse share with this client regarding estrogen's benefit to the cardiac system? A) "High-dose estrogen in women under the age of 60 will reverse the effects of aging in the heart." B) "Low-dose estrogen in women under the age of 60 may be beneficial to the cardiac system." C) "Estrogen therapy is only beneficial to the cardiac system if it is started before age 50." D) "Estrogen therapy has shown no benefit to the cardiac system."

C

The nurse is discussing proper use of oral contraceptives with a patient. The nurse should instruct the patient to immediately contact a health care provider if she: A) experiences breast tenderness. B) misses a dose of the medication. C) misses a menstrual period. D) experiences nausea.

B, E

The nurse is providing information to a female client who is starting estrogen therapy. What adverse effect must the client report to the health care provider immediately? Select all that apply. A) Nausea and vomiting B) Shortness of breath C) Breast tenderness D) Amenorrhea E) Sudden, severe headache

B, C, D

The nurse is taking a history of a female client who is scheduled to begin estrogen therapy. It is most important to the drug therapy for the nurse to determine if the client has a history of what condition? Select all that apply. A) Osteomyelitis B) Thrombophlebitis C) Liver disease D) Smokes 1.5 packs of cigarettes/day E) Drinks one glass of white wine/day

A

The nurse is teaching a patient about etonogestrel, which the patient is receiving as a subdermal implant. The nurse informs the patient that the implant will need to be removed at which time? A) In 3 years B) In a year C) In 2 years D) In 4 years

A

Which is an example of a progestin? A) Norethindrone (Aygestin) B) Estradiol (Estrace) C) Raloxifene (Evista) D) Bicalutamide (Casodex)

B, D

Which of the following drugs inhibit the conversion of testosterone into 5-alpha-dihydrotestosterone (DHT) which results in a decrease in prostate gland size and are useful in the treatment of benign prostatic hypertrophy? Select all that apply: A) Terazosin (Hytrin) B) Finasteride (Proscar) C) Methyltestosterone (Testred) D) Dutasteride (Avodart) E) Doxazosin (Cardura)

C

Which of the following statements best describes the rationale for using a 28-day oral contraceptive pack? A) This will allow for a longer period of time between periods. B) This is a less expensive form of birth control method. Because some of them have dispensers with 26 tablets containing several inactive or placebo tablets of a third color. C) This will assist clients to comply with their medication regimen, making it less likely to forget taking their pill every day. This cycle allows the medication regimen to mimic normal variations of hormone secretions. D) This cycle allows the medication regimen to mimic normal variations of hormone secretions. This allows for a rest of ovarian function between periods.

C

Why does the presence of estrogen in oral contraceptives increase the risk for developing blood clots? A) The estrogen increases serum triglyceride, cholesterol, and glucose levels. B) The estrogen stimulates skeletal growth, causing increased production of red blood cells. C) The estrogen increases production of clotting factors. D) The estrogen causes peripheral vasoconstriction.