Download Pharmacology Quiz: Androgens, Estrogens, and Contraceptives and more Exams Nursing in PDF only on Docsity!
NU 641 QUIZ 4 UPDATED EXAM WITH
VERIFIED SOLUTIONS.
Men who use transdermal testosterone gel (AndroGel) should be advised to avoid:
- Washing their hands after applying the gel
- Wearing occlusive clothing while using the gel
- Exposure to estrogens while using the gel
- Skin-to-skin contact with pregnant women while using the gel - correct answer - 4 Education when prescribing androgens to male patients includes advising that:
- Short-term use places the patient at risk for hepatocellular carcinoma.
- Cholestatic hepatitis and jaundice may occur with low doses of androgens.
- Gynecomastia is a rare occurrence with the use of androgens.
- Low sperm levels only occur with long-term use of androgens. - correct answer - 2 Patients who are prescribed exogenous androgens need to be warned that decreased libido:
- Is an unusual side effect of androgens and should be reported to the provider
- Is treated with increased doses of androgens, so the patient should let the provider know if he is having problems
- May be a sign of early prostate cancer and he should make an appointment for a prostate screening exam
- May occur with androgen therapy - correct answer - 4 The U.S. Food and Drug Administration warns that androgens may cause:
- Peliosis hepatis
- Orthostatic hypotension
- Menstrual irregularities
- Acne - correct answer - 1 Monitoring for a patient who is using androgens includes evaluation of:
- Complete blood count and C-reactive protein levels
- Lipid levels and liver function tests
- Serum potassium and magnesium levels
- Urine protein and potassium levels - correct answer - 2
Women who have migraines with an aura should not be prescribed estrogen because of:
- The interaction between triptans and estrogen, limiting migraine therapy choices
- An increased incidence of migraines with the use of estrogen
- An increased risk of stroke occurring with estrogen use
- Patients with migraines may be prescribed estrogen without any concerns - correct answer - 3 A 22-year-old woman receives a prescription for oral contraceptives. Education for this patient includes:
- Counseling regarding decreasing or not smoking while taking oral contraceptives
- Advising a monthly pregnancy test for the first 3 months she is taking the contraceptive
- Advising that she may miss two pills in a row and not be concerned about pregnancy
- Recommending that her next follow-up visit is in 1 year for a refill and annual exam - correct answer - 1 A 19-year-old female is a nasal Staph aureus carrier and is placed on 5 days of rifampin for treatment. Her only other medication is combined oral contraceptives. What education should she receive regarding her medications?
- Separate the oral ingestion of the rifampin and oral contraceptive by at least an hour.
- Both medications are best tolerated if taken on an empty stomach.
- She should use a back-up method of birth control such as condoms for the rest of the current pill pack.
- If she gets nauseated with the medications she should call the office for an antiemetic prescription. - correct answer - 3 A 56-year-old woman is complaining of vaginal dryness and dyspareunia. To treat her symptoms with the lowest adverse effects she should be prescribed:
- Low-dose oral estrogen
- A low-dose estrogen/progesterone combination
- A vaginal estradiol ring
- Vaginal progesterone cream - correct answer - 3 Shana is receiving her first medroxyprogesterone (Depo Provera) injection. Shana will need to be monitored for:
- Depression
- Hypertension
- Weight loss
- Cataracts - correct answer - 1
- Reassurance that some spotting is normal the first few months of Depo and it should improve.
- Schedule an appointment for an exam as this is not normal.
- Prescribe 4 weeks of estrogen to treat the abnormal vaginal bleeding.
- Order a pregnancy test and suggest she use a back-up method of contraception until she has her next shot. - correct answer - 1 William is a 62-year-old male who is requesting a prescription for sildenafil (Viagra). He should be screened for ________________ before prescribing sildenafil.
- Renal dysfunction
- Unstable coronary artery disease
- Benign prostatic hypertrophy
- History of priapism - correct answer - 2 Men who are prescribed sildenafil (Viagra) need ongoing monitoring for:
- Development of chest pain or dizziness
- Weight gain
- Priapism
- Renal function - correct answer - 1
Men who are prescribed an erectile dysfunction drug such as sildenafil (Viagra) should be warned about the risk for:
- Impotence when combined with antihypertensives
- Fatal hypotension if combined with nitrates
- Weight gain if combined with antidepressants
- All of the above - correct answer - 2 Androgens are indicated for:
- Symptomatic treatment for male deficiency
- Female libido, endometriosis, and postmenopausal symptoms
- Increased muscle mass
- Symptomatic treatment in both sexes for cancer and HIV
- 1, 2, and 4
- All of the above - correct answer - 5 Long-term use of androgens requires specific laboratory monitoring of:
- Glucose, calcium, testosterone, and thyroid function
- Calcium, testosterone, PSA, and liver function
- Calcium, testosterone, PSA, liver function, glucose, and lipids
- CBC, testosterone, PSA, and thyroid level - correct answer - 3
- Breakthrough bleeding
- Breast tenderness
- Pregnancy - correct answer - 2 Women who are taking an oral contraceptive containing the progesterone drospirenone may require monitoring of: 1.Hemoglobin 2.Serum calcium 3.White blood count 4.Serum potassium - correct answer - 4 The mechanism of action of oral combined contraceptives that prevents pregnancy is: 1.Estrogen prevents the luteinizing hormone surge necessary for ovulation. 2.Progestins thicken cervical mucus and slow tubal motility. 3.Estrogen thins the endometrium making implantation difficult. 4.Progestin suppresses follicle stimulating hormone release. - correct answer - 2
To improve actual effectiveness of oral contraceptives women should be educated regarding: 1.Use of a back-up method if they have vomiting or diarrhea during a pill packet 2.Doubling pills if they have diarrhea during the middle of a pill pack 3.The fact that they will have a normal menstrual cycle if they miss two pills 4.The fact that mid-cycle spotting is not normal and the provider should be contacted immediately - correct answer - 1 A contraindication to the use of combined contraceptives is: 1.Adolescence (not approved for this age) 2.A history of clotting disorder 3.Recent pregnancy 4.Being overweight - correct answer - 2 Obese women may have increased risk of failure with which contraceptive method? 1.Combined oral contraceptives 2.Progestin-only oral contraceptive pill 3.Injectable progestin 4.Combined topical patch - correct answer - 4
The topical patch combined contraceptive (Ortho Evra) is:
- Started on the first day of the menstrual cycle
- Recommended for women over 200 pounds
- Not as effective as oral combined contraceptives
- Known to have more adverse effects, such as nausea, than the oral combined contraceptives - correct answer - 1 Progesterone-only pills are recommended for women who:
- Are breastfeeding
- Have a history of migraine
- Have a medical history that contradicts the use of estrogen
- All of the above - correct answer - 4 Women who are prescribed progestin-only contraception need education regarding which common adverse drug effects?
- Increased migraine headaches
- Increased risk of developing blood clots
- Irregular vaginal bleeding for the first few months
- Increased risk for hypercalcemia - correct answer - 3
An advantage of using the NuvaRing vaginal ring for contraception is:
- It does not require fitting and is easy to insert.
- It is inserted once a week, eliminating the need to remember to take a daily pill.
- Patients get a level of estrogen and progestin equal to combined oral contraceptives.
- It also provides protection against vaginal infections. - correct answer - 1 Oral emergency contraception (Plan B) is contraindicated in women who:
- Had intercourse within the past 72 hours
- May be pregnant
- Are taking combined oral contraceptives
- Are using a diaphragm - correct answer - 2 The goals of therapy when prescribing HRT include reducing:
- Cardiovascular risk
- risk of stroke or other thromboembolic event
- breast cancer
- all of the above - correct answer - 3 Women with an intact uterus should be treated with both estrogen and progestin due to:
- increased risk for endometrial cancer if estrogen is used alone
- combination therapy provides the best relief of menopausal vasomotor symptoms
- reduced risk for colon cancer with combined therapy
- lower risk of developing blood clots with combined therapy - correct answer - 1 Ongoing monitoring for women on ERT includes:
- lipid levels, repeated annually if normal
- annual health history and review of risk profile
- annual mammogram
- all of the above - correct answer - 4 Kristine would like to start HRT to treat the significant vasomotor symptoms she is experiencing during menopause. Education for a woman considering hormone replacement would include: A. Explaining that HRT is totally safe if used for a short term
B. Telling her to ignore media hype regarding HRT C. Discussing the advantages and risks of HRT D. Encouraging the patient to use phytoestrogens with the HRT - correct answer - C Angela is a black women who has heard that women of African descent do not need to worry about osteoporosis. What education would you give her?
- She is correct, black women do not have much risk of developing osteoporosis due to their dark skin
- black women are at risk of developing osteoporosis due to their lower calcium intake as a group
- if she doesn't drink alcohol, her risk is low
- if has has not lost more than 10% of her body weight recently, her risk is low - correct answer - 2 Drugs that increase the risk of osteoporosis developing include:
- Oral combined contraceptives
- carbamazepine
- calcium channel blockers
- high doses of vitamin D - correct answer - 2
Why are SERMS generally not ordered in women in early menopause?
- the rapid onset of severe hot flashes can be unbearable
- the bone remodeling effect results in osteoporosis
- they tend to induce intermittent spotting
- they create more risk with breast cancer than they are worth - correct answer - 1 The treatment goals when treating urinary tract infection (UTI) include: 1.Eradication of infecting organism 2.Relief of symptoms 3.Prevention of recurrence of the UTI 4.All of the above - correct answer - 4 Sally is a 16-year-old female with a urinary tract infection. She is healthy, afebrile, with no use of antibiotics in the previous 6 months and no drug allergies. An appropriate first-line antibiotic choice for her would be: 1.Azithromycin 2.Trimethoprim/sulfamethoxazole
3.Ceftriaxone 4.Levofloxacin - correct answer - 2 Jamie is a 24-year-old female with a urinary tract infection. She is healthy, afebrile, and her only drug allergy is sulfa, which gives her a rash. An appropriate first-line antibiotic choice for herwouldbe: 1.Azithromycin 2.Trimethoprim/sulfamethoxazole 3.Ceftriaxone 4.Ciprofloxacin - correct answer - 4 Juanita is a 28-year-old pregnant woman at 38 weeks gestation who is diagnosed with a lower urinary tract infection (UTI). She is healthy with no drug allergies. Appropriate first-line therapy for her UTI would be: 1.Azithromycin 2.Trimethoprim/sulfamethoxazole 3.Amoxicillin 4.Ciprofloxacin - correct answer - 3
