Deck 11: Womens Health

Question 1

A provider is discussing various ways to obtain a medical abortion with a patient. Which statement by the patient best demonstrates understanding of mifepristone (RU 486) scheduling?

A) "I need to take the medication before I miss my first period."
B) "The medication is most effective when taken the day after unprotected intercourse."
C) "Effectiveness is best if the medication is taken within 7 weeks of conception."
D) "I need to take the medication immediately after ovulation."

Answer 1

"Effectiveness is best if the medication is taken within 7 weeks of conception."

Question 2

A prescriber provides teaching to a patient about the risks and benefits of estrogen therapy (ET) in the peri-menopausal period. Which statement by the patient indicates understanding of the teaching?

A) "Estrogen therapy can provide protection against breast cancer."
B) "Estrogen therapy decreases the risk for thrombosis and stroke."
C) "Estrogen therapy increases the risk for osteoporosis."
D) "Estrogen therapy is the most effective drug for suppression of menopausal symptoms."

Answer 2

"Estrogen therapy is the most effective drug for suppression of menopausal symptoms."

Question 3

How will the provider initiate contraception with intramuscular medroxyprogesterone acetate?

A) Have the medication administer and prescribe backup contraception for 7 days.
B) Administer the injection today and assure her that protection is immediate.
C) Obtain a pregnancy test to rule out pregnancy before administering the drug.
D) Schedule an appointment for her to receive the injection in 3 weeks when her period starts.

Answer 3

Schedule an appointment for her to receive the injection in 3 weeks when her period starts.

Question 4

A patient who prescribed a combination oral contraceptive begins taking carbamazepine. After several weeks, the patient reports that she has begun experiencing spotting during her cycle. What action will the provider discuss with the patient to address this occurrence?

A) Using an alternative form of birth control such as condoms instead of oral contraceptives
B) Changing to an oral contraceptive with increased estrogen
C) Decreasing the carbamazepine dosage
D) Increasing the carbamazepine dosage

Question 5

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 provider. When the patient expresses concerns about adverse effects of ET, what information will the provider share with her?

A) An estrogen-progesterone product will reduce side effects.
B) An intravaginal preparation may be best for her.
C) Side effects of ET are uncommon among women her age.
D) Transdermal preparations have fewer side effects.

Question 6

A patient who takes a combination oral contraceptive (OC) shares that she is planning to undergo knee replacement surgery in 1 month. What change in contraceptive management will the provider make for this patient?

A) Prescribe an OC containing less progestin.
B) Prescribe progestin-only contraception.
C) Prescribe an OC containing less estrogen.
D) Prescribe estrogen-only hormone therapy.

Question 7

The patient who reports vaginal dryness and pain with intercourse is opposed to using lubricants but is concerned about hormonal adverse effects. Which hormone formulation will the provider choose to decrease systemic estrogen effects?

A) Medroxyprogesterone acetate
B) Transdermal estrogen
C) Low-dose estrogens
D) A vaginal conjugated estrogen

Question 8

For which patient situation will a provider select combination estrogen and progestin therapy over estrogen only therapy for management of menopausal symptoms?

A) Has never had surgery
B) Has osteoporosis
C) At risk for myocardial infarction
D) History of deep vein thrombosis

Question 9

A provider in a family planning clinic is teaching a class on intrauterine devices (IUDs). Which patient should be advised against using an IUD for contraception?

A) A woman with four children
B) A teenager
C) A woman with multiple sexual partners
D) A nulliparous woman

Question 10

When changing a patient's combination oral contraceptive (OC) to a different combination product, what advice will the provider give the patient?

A) Stop the old OC and begin taking the new product immediately.
B) Change products at the beginning of her next cycle.
C) Stop the old OC 1 week before starting the new OC.
D) Use an alternate method of contraception while transitioning to the new OC.

Question 11

A teenager requests the most effective irreversible form of contraception. Which method of contraception will the provider recommend?

A) Etonogestrel subdermal implant
B) Combined oral contraceptives
C) Intramuscular medroxyprogesterone acetate
D) Diaphragm with spermicide

Question 12

After purchasing a 1-year supply of 28-day-cycle oral contraceptives, a patient calculates that her period will begin during her upcoming honeymoon. What will the prescriber suggest?

A) Discard the inert pills and start a new pack during the honeymoon.
B) Discontinue the oral contraceptives and use an alternative form of birth control.
C) Consider switching to an extended-cycle product.
D) Change to medroxyprogesterone acetate injections.

Question 13

A patient who has taken a progestin-only oral contraceptive for 3 months reports mid-cycle spotting and irregular menstrual cycles. What action will the provider take?

A) Question the patient about any possible missed doses of the pill.
B) Reassure the patient that this is normal with this form of contraception.
C) Recommend that she take a pregnancy test to rule out pregnancy.
D) Suggest that she use a backup form of contraception until these symptoms resolve.

Question 14

A provider prescribes transdermal estrogen spray. Which patient statement demonstrates understanding of the application of this medication?

A) "I will apply the medication to my waistline and shoulders."
B) "My abdomen and arms are the primary point of application."
C) "This medication will work best if applied to my breasts and abdomen."
D) "I need to put the medication on my thighs and calves."

Question 15

A patient with osteopenia asks about the benefits of hormone therapy in preventing osteoporosis. Which statement by the provider is correct?

A) "Estrogen can help reverse bone loss."
B) "Hormone therapy increases bone resorption."
C) "Hormone therapy does not decrease fracture risk."
D) "When hormone therapy is discontinued, bone loss resumes."

Question 16

An adolescent female patient with multiple sexual partners has difficulty adhering to her daily oral contraceptive schedule. Which contraceptive product will the provider recommend?

A) An intrauterine device
B) Medroxyprogesterone acetate
C) Tubal ligation
D) Progestin-only oral contraceptives