Chapter 61: Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications

Chapter 61: Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A 50-year-old postmenopausal patient who has had a hysterectomy has moderate to severe vasomotor symptoms and is discussing estrogen therapy (ET) with the nurse. The patient is concerned about adverse effects of ET. The nurse will tell her that:

ANS:  D

Transdermal preparations of estrogen have fewer adverse effects, use lower doses of estrogen, and have less fluctuation of estrogen levels than do oral preparations. Progesterone is contraindicated in women who have undergone hysterectomy. Intravaginal preparations are most useful for treating local estrogen deficiency such as vaginal and vulvar atrophy. Side effects of ET are the same at the patient’s age as for other women using ET.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 736

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

2. A patient who is at risk for osteoporosis will begin taking the selective estrogen receptor modulator raloxifene [Evista]. Which statement will the nurse include when teaching this patient about the medication?

ANS:  D

Raloxifene can induce hot flashes in patients taking the drug. It increases the risk for thromboembolism. It protects against breast cancer and does not pose a risk of uterine cancer.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 736-737

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

3. A nurse provides teaching to a patient who has had a hysterectomy and is about to begin hormone therapy to manage menopausal symptoms. Which statement by the patient indicates understanding of the teaching?

ANS:  C

For patients who have undergone hysterectomy, progestin is unnecessary; estrogen-only preparations still carry increased risk of breast cancer and should be taken in the lowest effective dose for the shortest time possible. Even though uterine cancer is no longer a possibility, breast cancer is still a risk. Studies have shown no protection against coronary heart disease but increased risk of stroke and breast cancer with estrogens.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 741

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

4. A nurse provides teaching to a group of nursing students about the risks and benefits of hormone therapy (HT), including estrogen therapy (ET) and combination estrogen/progestin therapy (EPT). Which statement by a student indicates understanding of the teaching?

ANS:  D

ET can be used to suppress menopausal symptoms and to prevent osteoporosis, but it carries risks of breast cancer and stroke, while conferring no preventive benefit for coronary heart disease. ET does not reverse osteoporosis but may help prevent it. EPT is not safer than ET; progestins appear to increase the risk of breast cancer. EPT does not prevent myocardial infarction in patients with coronary heart disease.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 741

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies