Deck 55: Hormone Replacement Therapy

Question 1

A woman with a family history of breast cancer had her last menstrual period 12 months ago and is experiencing hot flashes.She has not had a hysterectomy.The primary care NP should recommend:

A) black cohosh.
B) estrogen-only therapy.
C) progesterone-only therapy.
D) limiting alcohol and caffeine intake.

Answer 1

limiting alcohol and caffeine intake.

Question 2

Osteopenia is diagnosed in a 55-year-old woman who has not had a period in 15 months.She has a positive family history of breast cancer.The primary care NP should recommend:

A) testosterone therapy.
B) estrogen-only therapy.
C) nonhormonal drugs for osteoporosis.
D) estrogen-progesterone therapy for 1 to 2 years.

Answer 2

nonhormonal drugs for osteoporosis.

Question 3

A 50-year-old woman with a family history of CHD is experiencing occasional hot flashes and is having periods every 3 to 4 months.She asks the primary care NP about HT to relieve her symptoms.The NP should:

A) prescribe estrogen-only therapy.
B) initiate oral contraceptive pills now.
C) discuss using bioidentical HT.
D) plan to use estrogen-progesterone therapy when menopause begins.

Answer 3

plan to use estrogen-progesterone therapy when menopause begins.

Question 4

A 52-year-old woman reports having hot flashes and intense mood swings.After a year of having irregular menstrual periods,she has not had a period for 6 months.The primary care NP should diagnose:

A) menopause.
B) dysmenorrhea.
C) perimenopause.
D) postmenopause.

Question 5

A 55-year-old woman has not had menstrual periods for 5 years and tells the primary care nurse practitioner (NP)that she is having increasingly frequent vasomotor symptoms.She has no family history or risk factors for coronary heart disease (CHD)or breast cancer but is concerned about these side effects of hormone therapy (HT).The NP should:

A) tell her that starting HT now may reduce her risk of breast cancer.
B) advise a short course of HT now that may decrease her risk for CHD.
C) tell her that HT will not help control her symptoms during postmenopause.
D) recommend herbal supplements for her symptoms to avoid HT side effects.

Question 6

A male patient tells the primary care NP he is experiencing decreased libido,lack of energy,and poor concentration.The NP performs an examination and notes increased body fat and gynecomastia.A serum testosterone level is 225 ng/dL.The NP's next action should be to:

A) order LH and FSH levels.
B) order a serum prolactin level.
C) prescribe testosterone replacement.
D) obtain a morning serum testosterone level.

Question 7

A perimenopausal woman tells the primary care NP that she is having hot flashes and increasingly severe mood swings.The woman has had a hysterectomy.The NP should prescribe:

A) estrogen-only HT.
B) low-dose oral contraceptive therapy.
C) selective serotonin reuptake inhibitor therapy until menopause begins.
D) estrogen-progesterone HT.

Question 8

The primary care NP sees a woman who has been taking HT for menopausal symptoms for 3 years.The NP decreases the dosage,and several weeks later,the woman calls to report having several hot flashes each day.The NP should:

A) increase the HT dose.
B) discontinue HT.
C) recommend black cohosh to alleviate symptoms.
D) reassure her that these symptoms will diminish over time.

Question 9

A patient who has diabetes mellitus and congestive heart failure takes insulin and warfarin.The patient will begin taking exogenous testosterone to treat secondary hypogonadism.The primary care NP should recommend:

A) increasing the dose of warfarin.
B) more frequent blood glucose monitoring.
C) a higher than usual dose of testosterone.
D) increasing insulin doses to prevent hypoglycemia.

Question 10

A man who has secondary hypogonadism associated with pituitary dysfunction will begin exogenous testosterone therapy.The patient asks the primary care NP about future chances of fathering children.The NP should tell him that:

A) fertility may improve with testosterone therapy.
B) exogenous testosterone therapy will shut down sperm production.
C) fertility can be restored when testosterone therapy is discontinued.
D) he should store sperm ahead of the initiation of testosterone therapy.

Question 11

A 50-year-old woman reports severe,frequent hot flashes and vaginal dryness.She is having irregular periods.She has no family history of CHD or breast cancer and has no personal risk factors.The primary care NP should recommend:

A) estrogen-only HT.
B) low-dose oral contraceptive therapy.
C) selective serotonin reuptake inhibitor therapy until menopause begins.
D) estrogen-progesterone HT.

Question 12

A thin 52-year-old woman who has recently had a hysterectomy tells the primary care NP she is having frequent hot flashes and vaginal dryness.A recent bone density study shows early osteopenia.The woman's mother had CHD.She has no family history of breast cancer.The NP should prescribe:

A) estrogen-only HT now.
B) estrogen-only HT in 5 years.
C) estrogen-progesterone HT now.
D) estrogen-progesterone HT in 5 years.