Deck 70: Estrogens, Progestins, and Drugs Modifying Uterine Function

Question 1

A 65-year-old man is receiving estrogen as therapy for prostate cancer.The client's wife is very confused about the reason this medication is being given, because it is a medication for "women." How can the nurse best explain this use of estrogen to this family?
1)"Estrogen helps to lift the mood of clients who have cancer."
2)"Estrogen blocks the hormones that allow the prostate cancer to grow."
3)"Estrogen will help the hot flashes that clients with prostate cancer usually have."
4)"Estrogen will help to restore sexual drive in a man with prostate cancer."

Answer 1

2

Question 2

Which client would benefit most from using hormone replacement therapy?
1)The client who is unable to sleep because of continual hot flashes and night sweats
2)The client who wants to prevent the development of osteoporosis
3)The client who finds sexual intercourse painful
4)The client who has a family history of colorectal cancer

Answer 2

1

Question 3

Which statement by a client who is taking medroxyprogesterone acetate (Provera)for treatment of dysfunctional uterine bleeding requires further instruction?
1)"I'm planning a trip to the beach this weekend."
2)"I take this medication with a bedtime snack."
3)"I plan to cut back on sweets while I am on this medication."
4)"My husband and I will use condoms when we have sexual intercourse while I take this medication."

Answer 3

1

Question 4

A client is being treated pharmacologically for endometriosis.Which statement by the client indicates a need for further instruction?
1)"I will probably have to take this medication for 3-6 months."
2)"I will be able to get pregnant as soon as I finish taking this medication."
3)"This medication could cause my voice to get deeper."
4)"I should dress in layers, because I might get hot flashes while I take this medication."

Question 5

Which statement by a client taking estrogen/progesterone combination HRT requires immediate intervention by the nurse?
1)"I have gained six pounds since I began taking this medication three months ago."
2)"I got nauseated and had right shoulder pain after I ate fried fish last night."
3)"My ankles are swollen when I go to bed at night."
4)"Sexual intercourse is still slightly uncomfortable, even though I have been on the medication for two months."

Question 6

During the menstrual cycle, the majority of progesterone is secreted by:
1)The anterior pituitary gland.
2)The ovarian follicle.
3)The hypothalamus.
4)The corpus luteum.

Question 7

A 16-year-old client has come to a women's clinic with complaints of oligomenorrhea.She states that her periods have been infrequent since she began menstruating last year.What is the most likely cause of this client's problem?
1)Abnormal uterine lining
2)Polycystic ovarian syndrome
3)Anovulatory cycles
4)Pregnancy

Question 8

A client is being treated for infertility.She has used clomiphene (Clomid)for six months without success.The client is now going to be treated with a group of drugs called follitropins.Which statement by this client would require immediate intervention by the health care provider?
1)"My husband is going to give me these injections."
2)"I have had a headache since I began using these medications."
3)"I have had three diarrhea stools each day since I started these medications."
4)"I began wheezing last night."

Question 9

A woman at 25 weeks' gestation has experienced a fetal demise.What medication is most likely to be used first to induce labor in this client?
1)Parenteral oxytocin (Pitocin)
2)Carboprost (Hemabate)
3)Dinoprostone (Cervidil)
4)Ergonovine (Ergotrate)

Question 10

Which client would not be a good candidate for induction of labor using parenteral oxytocin (Pitocin)?
1)The client who is at 38 weeks' gestation and has developed signs of pre-eclampsia
2)The client who is at 39 weeks' gestation and had a uterine fibroid removed two years ago
3)The client who is at 37 weeks' gestation and whose fetus has developed an abnormal heart rate
4)The client who is at 38 weeks' gestation and has gestational diabetes

Question 11

A school nurse is teaching a class about the female reproductive system to a group of middle school students.Which statement by the student most accurately describes the reason menstruation begins?
1)"You have to have your period every 28 days to be normal."
2)"Your brain sends a signal that there is enough estrogen and progesterone.These hormone levels drop, and you get your period."
3)"Your uterus starts to contract, and this causes the lining to come out, which is your period."
4)"You get your period when you ovulate."

Question 12

A 59-year-old female is at the health care provider's office for a regularly scheduled yearly examination.The health care provider tells this client that her blood work indicates that her level of "good" cholesterol is decreasing while her level of "bad" cholesterol is rising.The health care provider tells the client that it is related to her completion of menopause.How does the health care provider best explain this to the client?
1)"At menopause, your body quits producing progesterone, which keeps your cholesterol level low."
2)"During menopause, a woman's estrogen level decreases dramatically.Estrogen helps to keep the 'good' cholesterol high and the 'bad' cholesterol low, and also helps to protect the heart."
3)"Menopause weakens the blood vessels and allows the bad cholesterol to become more prominent."
4)"Cholesterol problems are all hereditary.Your 'bad' cholesterol levels are probably rising in the same manner as your family members' did."

Question 13

A client had an anterior pituitary tumor removed a few years ago.She is curious to know if this will affect her ability to become pregnant.What is the best response by the nurse to this client?
1)"You shouldn't have any problems at all, because you still have your ovaries and uterus."
2)"You shouldn't have any problems at all.The important hormones for conception are contained in the posterior pituitary."
3)"You might have trouble getting pregnant.The hormones necessary for stimulating the ovaries are contained in the anterior pituitary."
4)"You will have trouble getting pregnant, because the anterior pituitary secretes gonadotropin-releasing hormone (GnHR), which is necessary for conception."

Question 14

A client at 35 weeks' gestation has begun to have contractions.She is diagnosed with preterm labor.Which statement by the nurse best describes the rationale for giving this client magnesium sulfate?
1)"Magnesium sulfate will cause your baby to gain weight quickly so he will be more developed when he is born."
2)"Magnesium sulfate is used to decrease your stress level.This will cause your contractions to stop."
3)"Magnesium sulfate will allow you to be monitored from home."
4)"Magnesium sulfate relaxes your uterus and slows contractions.This gives the baby's lungs a few more days to develop."

Question 15

Which of the following clients should not receive progestin therapy for the treatment of dysfunctional uterine bleeding?
1)The client who has a history of asthma
2)The client who has a history of hepatitis
3)The client who has a history of glaucoma
4)The client who has a history of a blood clot

Question 16

Which statement by a 52-year-old female client reflects an advantage of using estrogen/progesterone combination hormone replacement therapy?
1)"I am protected from developing Alzheimer's disease because I am taking this medication."
2)"I have a decreased chance of developing breast cancer while I am taking this medication."
3)"I have a decreased chance of having a heart attack until I turn 60."
4)"This medication protects me from uterine cancer."

Question 17

A 56-year-old postmenopausal female has received a recommendation to have a bone density test performed.The client wonders why she must have this test done, because she states that she has never broken a bone in her life and that her bones are fine.What is the nurse's best response to this client?
1)"This is a very quick test, and it won't cause you any pain."
2)"Because you are not ovulating, you are not producing as much estrogen as before.Estrogen helps to keep your bones strong."
3)"It is important to find out if you are losing bone density because you do not produce as much estrogen as you did previously.This test will see if you are developing osteoporosis."
4)"I'll remind the HCP about your bone history.You might not need a bone density test until you are in your 60s."

Question 18

Which outcome statement indicates the client has effectively been treated with conjugated estrogen (Premarin)for treatment of severe and frequent hot flashes?
1)The client is able to sleep 4-5 hours every night.
2)The client reports 1-2 hot flashes per day.
3)The client reports an improvement in mood.
4)The client reports experiencing headaches while taking this drug.

Question 19

The nurse is taking a medication history from a client who is seeking information about infertility treatments.Which drug taken by this client could potentially contraindicate the use of clomiphene (Clomid)?
1)Levothyroxine sodium (Synthroid)
2)Amoxicillin (Amoxil)
3)Cimetidine (Tagamet)
4)Saint John's wort

Question 20

Which nursing diagnosis would be most appropriate for a client who is experiencing vaginal atrophy as a result of menopause?
1)Knowledge Deficient
2)Impaired Skin Integrity
3)Injury, risk for
4)Impaired Body Image

Question 21

A client reports infertility in spite of trying to get pregnant for the last 18 months.What should be a priority assessment in this client?
1)An assessment of the client's understanding of ovulation and timing of intercourse
2)An assessment of the client's height and weight
3)An assessment of the client's preferred method of sexual intercourse
4)An assessment of the client's job status

Question 22

A 19-year-old client is scheduled to receive oxytocin (Pitocin)for induction of labor contractions.The nurse is reviewing the client's labor and delivery plan.Which statement by the client requires additional instruction from the nurse?
1)"I realize my blood pressure will need to taken frequently as long as I am on this medication."
2)"I want to walk around as much as possible to help stimulate my labor more."
3)"I realize the medication will have to be discontinued if my contractions become too forceful or too frequent.'
4)"I will tell you if I develop a headache."

Question 23

Medroxyprogesterone acetate (Provera)should be used with caution in a client who reports which of the following previous illnesses?
1)The client who had a cyst removed from her kidney six months ago
2)The client who was hospitalized for depression three months ago
3)The client who has just been diagnosed with anemia
4)The client who was treated for acute bronchitis two weeks ago

Question 24

A nurse is leading a group discussion about the treatment of infertility.Which statement concerning clomiphene (Clomid)does not accurately represent this medication?
1)"Clomiphene may be given to males to increase the motility of the sperm."
2)"A woman who takes clomiphene has a small chance (5% or less)of having a pregnancy that results in multiple gestations."
3)"Clomiphene attempts to cause ovulation in a woman who does not ovulate on a regular basis."
4)"Women who take clomiphene often experience a small weight gain."