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?

Accepted Answer

Mifepristone (RU 486) is most effective when taken within 7 weeks (49 days) of conception for a medical abortion. It works by blocking the hormone progesterone, which is necessary for pregnancy to continue. Choices A, B, and D describe timing that is not specific to the use of mifepristone for a medical abortion.

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?

Accepted Answer

Estrogen therapy is recognized as the most effective treatment for relieving menopausal symptoms such as hot flashes and vaginal dryness.

Question 3

How will the provider initiate contraception with intramuscular medroxyprogesterone acetate?

Accepted Answer

D

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?

Accepted Answer

Carbamazepine is an enzyme inducer that can decrease the effectiveness of oral contraceptives by increasing the metabolism of estrogen. Increasing the estrogen content in the contraceptive can help counteract this effect and reduce spotting.

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?

Accepted Answer

Transdermal estrogen therapy has been associated with fewer side effects compared to oral preparations. This is because transdermal therapy avoids first-pass metabolism in the liver, potentially reducing the risk of certain side effects such as thromboembolic events and possibly impacting the risk profile for stroke and gallbladder disease.

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?

Accepted Answer

Progestin-only contraception is recommended in situations where estrogen is contraindicated, such as prior to major surgery, due to the increased risk of venous thromboembolism (VTE) associated with estrogen-containing contraceptives.

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?

Accepted Answer

A vaginal conjugated estrogen is specifically designed for local application to alleviate symptoms such as vaginal dryness and pain with intercourse, with minimal systemic absorption and therefore minimal systemic estrogen effects. This makes it a suitable option for patients concerned about the adverse effects of systemic hormone therapy.

Question 8

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

Accepted Answer

Combination estrogen and progestin therapy is typically chosen for women who have not had a hysterectomy (i.e., still have their uterus) to reduce the risk of endometrial cancer, which can be increased by estrogen alone. The other options listed do not specifically indicate the need for combination therapy over estrogen only.

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?

Accepted Answer

A woman with multiple sexual partners may have a higher risk of sexually transmitted infections (STIs), and the insertion of an IUD could potentially increase the risk of pelvic inflammatory disease (PID) if an STI is present. This does not mean IUDs are contraindicated for all women with multiple partners, but they should be counseled on the risks and benefits, and screening for STIs should be considered. The other options (A, B, D) are not contraindications for IUD use.

Question 10

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

Accepted Answer

When switching combination oral contraceptives, it is generally recommended to change products at the beginning of the next cycle to maintain contraceptive effectiveness and minimize hormonal fluctuations.

Question 11

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

Accepted Answer

The etonogestrel subdermal implant is a long-acting, reversible contraceptive method, not irreversible. However, among the options provided, it is the most effective in preventing pregnancy. The question seems to have a mistake in asking for an "irreversible" method, as none of the options listed are irreversible forms of contraception like surgical sterilization. The etonogestrel implant, under the skin, provides up to three years of continuous pregnancy prevention, making it the most effective option listed.

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?

Accepted Answer

Skipping the inert pills and starting a new pack immediately can delay menstruation, which is often suggested to avoid having a period during inconvenient times like a honeymoon.

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?

Accepted Answer

Mid-cycle spotting and irregular menstrual cycles are common side effects of progestin-only oral contraceptives, especially in the first few months of use.

Question 14

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

Accepted Answer

The answer of A provider prescribes transdermal estrogen spray. Which...

Question 15

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

Accepted Answer

Hormone therapy can help maintain bone density and reduce fracture risk, but once it is discontinued, bone loss typically 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?

Accepted Answer

The answer of An adolescent female patient with multiple sexual...

Quiz 11: Womens Health