Deck 20: Drugs Affecting the Reproductive System

Question 1

Postmenopausal women with an intact uterus should not be prescribed:

A)An estrogen/progesterone combination
B)Intramuscular (IM) medroxyprogesterone (Depo-Provera)
C)Estrogen alone
D)Androgens

Answer 1

Estrogen alone

Question 2

Men who use transdermal testosterone gel (AndroGel) should be advised to avoid:

A)Washing their hands after applying the gel
B)Wearing occlusive clothing while using the gel
C)Exposure to estrogens while using the gel
D)Skin-to-skin contact with pregnant women while using the gel

Answer 2

Skin-to-skin contact with pregnant women while using the gel

Question 3

Men who are prescribed sildenafil (Viagra) need ongoing monitoring for:

A)Development of chest pain or dizziness
B)Weight gain
C)Priapism
D)Renal function

Answer 3

Development of chest pain or dizziness

Question 4

William is a 62-year-old male who is requesting a prescription for sildenafil (Viagra). He should be screened for ________________ before receiving a prescription for sildenafil.

A)Renal dysfunction
B)Unstable coronary artery disease
C)Benign prostatic hypertrophy
D)History of priapism

Question 5

Male patients require ______________________ before and during androgen therapy.

A)A digital prostate exam
B)A Doppler exam of testicular blood flow
C)Urine analysis for proteinuria
D)Serial orthostatic blood pressures

Question 6

Androgens are indicated for:

A)Symptomatic treatment for male deficiency
B)Female libido, endometriosis, and postmenopausal symptoms treatment
C)Increased muscle mass in frail women
D)Symptomatic treatment in both sexes for cancer and human immunodeficiency virus (HIV)

Question 7

A 22-year-old woman receives a prescription for oral contraceptives. Education for this patient includes:

A)Counseling regarding decreasing or not smoking while taking oral contraceptives
B)Advising a monthly pregnancy test for the first three months she is taking the contraceptive
C)Advising that she may miss two pills in a row and not be concerned about pregnancy
D)Recommending that her next follow-up visit is in one year for a refill and annual exam

Question 8

Men who are prescribed an erectile dysfunction drug such as sildenafil (Viagra) should be warned about the risk for:

A)Impotence when combined with antihypertensives
B)Fatal hypotension if combined with nitrates
C)Weight gain if combined with antidepressants
D)All of the above

Question 9

Women who have migraines with an aura should not be prescribed estrogen because of:

A)The interaction between triptans and estrogen, limiting migraine therapy choices
B)An increased incidence of migraines with the use of estrogen
C)An increased risk of stroke occurring with estrogen use
D)Patients with migraines may be prescribed estrogen without any concerns.

Question 10

Monitoring for a patient who is using androgens includes evaluation of:

A)Complete blood count (CBC) and C-reactive protein levels
B)Lipid levels and liver function tests
C)Serum potassium and magnesium levels
D)Urine protein and potassium levels

Question 11

Shana received her first medroxyprogesterone (Depo-Provera) injection six weeks ago and calls the clinic, concerned that she has been having a light period off and on since receiving her Depo shot. What should the provider do?

A)Reassure her that some spotting is normal the first few months of Depo and it should improve.
B)Schedule an appointment for an exam as this is not normal.
C)Prescribe four weeks of estrogen to treat the abnormal vaginal bleeding.
D)Order a pregnancy test and suggest she use a back-up method of contraception until she has her next shot.

Question 12

A 19-year-old female is a nasal Staph aureus carrier and is placed on five days of rifampin for treatment. Her only other medication is combined oral contraceptives. What education should she receive regarding her medications?

A)Separate the oral ingestion of the rifampin and oral contraceptive by at least an hour.
B)Both medications are best tolerated if taken on an empty stomach.
C)She should use a back-up method of birth control such as condoms for the rest of the current pill pack to avoid the low possibility of birth control pill (BCP) ineffectiveness.
D)If she gets nauseated with the medications she should call the office for an antiemetic prescription.

Question 13

The U.S. Food and Drug Administration warns that androgens may cause:

A)Peliosis hepatis
B)Orthostatic hypotension
C)Menstrual irregularities
D)Acne

Question 14

The medroxyprogesterone (Depo-Provera) injection has a black box warning due to:

A)The potential development of significant hypertension
B)Increased risk of strokes
C)Decreased bone density
D)The risk of a life-threatening rash such as Stevens-Johnson syndrome

Question 15

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:

A)Low-dose oral estrogen
B)A low-dose estrogen/progesterone combination
C)A vaginal estradiol ring
D)Vaginal progesterone cream

Question 16

Patients who are prescribed exogenous androgens need to be warned that decreased libido:

A)Is an unusual side effect of androgens and should be reported to the provider
B)Is treated with increased doses of androgens, so the patient should let the provider know if he is having problems
C)May be a sign of early prostate cancer, so he should make an appointment for a prostate screening exam
D)May occur with androgen therapy

Question 17

Absolute contraindications to estrogen therapy include:

A)History of any type of cancer
B)Clotting disorders
C)History of tension headaches
D)Orthostatic hypotension

Question 18

When prescribing medroxyprogesterone (Depo-Provera) injections, essential education would include advising of the following potential adverse drug effects:

A)Hypertension and dysuria
B)Depression and weight gain
C)Abdominal pain and constipation
D)Orthostatic hypotension and dermatitis

Question 19

Shana is receiving her first medroxyprogesterone (Depo-Provera) injection. Shana will need to be monitored for:

A)Depression
B)Hypertension
C)Weight loss
D)Cataracts

Question 20

Education when prescribing androgens to male patients includes advising that:

A)Short-term use places the patient at risk for hepatocellular carcinoma.
B)Cholestatic hepatitis and jaundice may occur with low doses of androgens.
C)Gynecomastia is a rare occurrence with the use of androgens.
D)Low sperm levels only occur with long-term use of androgens.

Question 21

Your female patient is requesting "Viagra for women" to help with her depressed libido. What can you share with her?

A)This drug does not have the same rapid onset as a phosphodiesterase type 5 (PDE5) for men.
B)The "pink Viagra" is focused on a proposed neurotransmitter dysfunction.
C)It takes about three months for full effect and many patients do not see a major clinical effect.
D)All of the above.

Question 22

Absolute contraindications that clinicians must consider when initiating estrogen therapy include:

A)Undiagnosed dysfunctional uterine bleeding
B)Deep vein or arterial thromboemboli within the prior year
C)Endometriosis
D)1 and 2

Question 23

The newer dyspareunia drugs are required by the U.S. Food and Drug Administration (FDA) to carry the same risk warnings as:

A)Progestins
B)Estrogens
C)Testosterone
D)Androgen antagonists

Question 24

Long-term use of androgens requires specific laboratory monitoring of:

A)Glucose, calcium, testosterone, and thyroid function
B)Calcium, testosterone, prostate-specific antigen (PSA), and liver function
C)Calcium, testosterone, PSA, liver function, glucose, and lipids
D)CBC, testosterone, PSA, and thyroid level

Question 25

What medication can be used to help treat hyperprolactinemia?

A)Addyi
B)A PDE-5
C)Bromocriptine
D)Progesterone

Question 26

"Fertility drugs" linked with female infertility treatments can also be used for:

A)Male spermatogenesis issues
B)Lactation suppression
C)Pituitary tumor suppression
D)An abortifacient

Question 27

Reexamination of the women's health study has modified guidelines for the use of estrogen in menopause. Which of the following is true?

A)Supplementation for the first five years is considered to have a reasonable risk/benefit profile for selected groups of women.
B)Estrogen can once again be given solely for its bone health benefits.
C)The risk of deep vein thrombosis (DVT) is not as high as previously thought.
D)Supplementation has a great CV benefit if started after the first five years of menopause.

Question 28

Patients taking hormonal contraceptives and hormone replacement therapy need to take the drug daily at the same time to prevent:

A)Nausea
B)Breakthrough bleeding
C)Breast tenderness
D)Pregnancy

Question 29

Effects of estrogen include:

A)Regulation of the menstrual cycle
B)Maintenance of bone density by increasing bone reabsorption
C)Maintenance of the normal structure of the skin and blood vessels
D)1 and 3