Download NAMS Menopause Certification Exam Practice Questions with correct Answers Latest 2025 and more Exams Nursing in PDF only on Docsity!
NAMS Menopause Certification Exam
Practice Questions with correct Answers
Latest 2025
What is the 1st line treatment to help with VMS of menopause after trying nonpharmacologic therapies? --- correct answer --- Systemic hormone therapy (HT), since it provides optimal relief of hot flushes What symptoms should be present for a woman to be on HT? --- correct answer --- VMS If patients have vaginal symptoms only, only use what kind of products? --- correct answer --- Vaginal products What are the 2 most common estrogens used in HT? --- correct answer --- Estradiol and Conjugated equine estrogens (CEE) What are the 2 most common progestogens used in HT? --- correct answer --- Medroxyprogesterone acetate (MPA) and Micronized progesterone (MP)
Which hormone should be used with caution in patients with a peanut allergy? --- correct answer --- Micronized Progesterone (MP) What are all of the contraindications to MHT? --- correct answer --- - History/concern for breast cancer
- Estrogen-sensitive malignancies
- Undiagnosed genital bleeding
- Untreated endometrial hyperplasia
- Past idiopathic or current DVT/PE
- Active or recent arterial thrombolic disease (stroke or MI)
- Uncontrolled hypertension >140/
- Active liver disease
- Porphyria cutanea tarda (skin condition more sensitive to bruising) What are the nonhormonal medications that can be used to treat VMS? --- correct answer --- SSRIs, SNRIs, Clonidine, Gabapentin, Pregabalin What SSRI should be used if the patient is taking Tamoxifen for breast cancer? --- correct answer --- Escitalopram
What is the name of the 1st line therapy vaginal moisturizer/lubricant? --- correct answer --- Replens What other medications are also used to treat vaginal symptoms of menopause? --- correct answer --- Low dose vaginal estrogen Prasterone Ospemifene Can also use a water-based lubricant like GoodCleanLove or Yes! Has better osmolality for the vagina Do you need a progestogen for vaginal estrogens? --- correct answer - -
- Not needed if it has a localized effect on the vagina Brand name of conjugated equine estrogen (CEE) --- correct answer - - - Premarin Indication of Premarin --- correct answer --- Vulvar and vaginal atrophy with menopause Dosing of Premarin --- correct answer --- 0.3-1.25 mg daily
Brand name of Estradiol tablet --- correct answer --- Estrace Estrace indication --- correct answer --- VMS associated with menopause, vulvar and vaginal atrophy associated with menopause, osteoporosis prevention Dosing of Estrace --- correct answer --- 0.5- 2 mg daily What are the brand names of the Estradiol transdermal systems? --- correct answer --- Climara, Minivelle Indication of estradiol patches Climara and Minivelle --- correct answer --- VMS associated with menopause Dosing of Minivelle --- correct answer --- 0.025-0.1 mg twice a week Brand names of estradiol vaginal rings --- correct answer --- Estring, Femring Indication of estradiol vaginal rings --- correct answer --- VMS symptoms of menopause
If patient does NOT have a uterus, you can give them --- correct answer --- estrogen alone What are the 3 main differences in estrogen of transdermal estrogens? --- correct answer --- Lower VTE risk No impact on triglycerides Potential lower stroke risk, so lower blood clot risk What are the 2 main differences in estrogen of oral estrogens? --- correct answer --- Increases triglycerides Potential for decreased libido What is the Women's Health Initiative (WHI)? --- correct answer --- Clinical study started in 1991. Studied the use of conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA) in women with and without a uterus What was the most important "shocking" result from the WHI? --- correct answer --- Estrogen + progestin combo resulted in an increased risk of breast cancer
What was the problem with how the WHI ended? --- correct answer - -
- There was some bias in the study, since it stopped early. Upon further investigation 18 years later, increased mortality was not associated with hormone therapy. Women would have less side effects over time When is it considered safe to start menopause hormone therapy (MHT) in women? --- correct answer --- Likely safe to start in patients with no contraindications who are within 10 years of menopause, and/or <60 years old according to NAMS (North American Menopause Society) Is tobacco use a contraindication to MHT? --- correct answer --- Tobacco use is NOT a contraindication to hormone therapy, but transdermal therapy may be preferred Dosing of Estring and Femring --- correct answer --- 12.4 mg or 24. mg (released as 0.05mg/day or 0.1mg/day) Indication of MPA --- correct answer --- Contraception, endometriosis, combined with estrogen to treat VMS of menopause
Adverse effects of Duavee --- correct answer --- May increase risk of stroke and DVT Duavee could also be more useful in women that are also at risk of what disease? --- correct answer --- Breast cancer Indication of Replens --- correct answer --- Treats vulvovaginal atrophy, dyspareunia How much does Replens cost? --- correct answer --- $ Brand name of Prasterone --- correct answer --- Intrarosa Indication of Prasterone --- correct answer --- Treats vaginal symptoms of GMS; treats dyspareunia MOA of Prasterone --- correct answer --- Is made up of DHEA, which is metabolized to Estradiol and androgens; restores vaginal tissue Dosing of Prasterone --- correct answer --- 1 vaginal insert contains 6.5mg of Prasterone
Contraindications of Prasterone --- correct answer --- Undiagnosed genital bleeding, suspected or known breast cancer Indication of Venlafaxine --- correct answer --- VMS of menopause MOA of Venlafaxine --- correct answer --- Inhibits CNS serotonin and NE reuptake Side effects of Venlafaxine --- correct answer --- GI upset, sleep disturbances (insomnia or fatigue), blood pressure may increase Counseling points with Venlafaxine --- correct answer --- Recommend to take in the morning with breakfast. Blood pressure increase usually occurs on higher doses Brand name of Paroxetine mesylate --- correct answer --- Brisdelle Indication of Brisdelle --- correct answer --- Moderate-severe VMS >7- 8 times a day
MOA of Ospemifene --- correct answer --- SERM Dosing of Ospemifene --- correct answer --- 60 mg once daily orally with food Side effects of Ospemifene --- correct answer --- Hot flush, vaginal discharge, muscle spasms, genital discharge, hyperhidrosis Drug interactions with Ospemifene --- correct answer --- Rifampin, Fluconazole, estrogen agonist/antagonist Contraindications of Ospemifene --- correct answer --- Undiagnosed genital bleeding, history of VTE, arterial thrombotic disease, estrogen- dependent neoplasia
