Question 1

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

Accepted Answer

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

Question 2

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

Accepted Answer

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 
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 D

Question 3

Education when prescribing androgens to male patients includes advising that:

Accepted Answer

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. 
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. B

Question 4

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

Accepted Answer

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 
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 5

Male patients require ______________________ before and during androgen therapy.

Accepted Answer

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

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

Accepted Answer

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

Question 7

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

Accepted Answer

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 
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 8

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

Accepted Answer

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

Question 9

A 19-year-old female is a nasal Staph aureus carrier and is placed on 5 days of rifampin for treatment. Her only other medication is combined oral contraceptives. What education should she receive regarding her medications?

Accepted Answer

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. 
D)  If she gets nauseated with the medications she should call the office for an antiemetic prescription. 
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. 
D)  If she gets nauseated with the medications she should call the office for an antiemetic prescription.

Question 10

Effects of estrogen include:

Accepted Answer

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)  A and C 
E)  All of the above 
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)  A and C 
E)  All of the above

Question 11

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

Accepted Answer

A)  Counseling regarding decreasing or not smoking while taking oral contraceptives 
B)  Advising a monthly pregnancy test for the first 3 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 1 year for a refill and annual exam 
A)  Counseling regarding decreasing or not smoking while taking oral contraceptives 
B)  Advising a monthly pregnancy test for the first 3 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 1 year for a refill and annual exam

Question 12

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

Accepted Answer

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

Question 13

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:

Accepted Answer

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

Question 14

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

Accepted Answer

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

Question 15

Shana received her first medroxyprogesterone (Depo Provera) injection 6 weeks ago and calls the clinic with a concern that she has been having a light "period" off and on since receiving her Depo shot. What would be the management of Shana?

Accepted Answer

A)  Reassurance 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 4 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. 
A)  Reassurance 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 4 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 16

Postmenopausal women with an intact uterus should not be prescribed:

Accepted Answer

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

Question 17

Absolute contraindications to estrogen therapy include:

Accepted Answer

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

Question 18

The medroxyprogesterone (Depo Provera) injection has a Black Box Warning due to:

Accepted Answer

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 
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

Question 19

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

Accepted Answer

A)  Glucose, calcium, testosterone, and thyroid function 
B)  Calcium, testosterone, PSA, and liver function 
C)  Calcium, testosterone, PSA, liver function, glucose, and lipids 
D)  CBC, testosterone, PSA, and thyroid level 
A)  Glucose, calcium, testosterone, and thyroid function 
B)  Calcium, testosterone, PSA, and liver function 
C)  Calcium, testosterone, PSA, liver function, glucose, and lipids 
D)  CBC, testosterone, PSA, and thyroid level

Question 20

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

Accepted Answer

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

Exam 22: Drugs Affecting the Reproductive System

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

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

Education when prescribing androgens to male patients includes advising that:

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

Male patients require ______________________ before and during androgen therapy.

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

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

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

A 19-year-old female is a nasal Staph aureus carrier and is placed on 5 days of rifampin for treatment. Her only other medication is combined oral contraceptives. What education should she receive regarding her medications?

Effects of estrogen include:

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

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

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:

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

Shana received her first medroxyprogesterone (Depo Provera) injection 6 weeks ago and calls the clinic with a concern that she has been having a light "period" off and on since receiving her Depo shot. What would be the management of Shana?

Postmenopausal women with an intact uterus should not be prescribed:

Absolute contraindications to estrogen therapy include:

The medroxyprogesterone (Depo Provera) injection has a Black Box Warning due to:

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

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

The Role of the Nurse Practitioner

Review of Basic Principles of Pharmacology

Rational Drug Selection

Legal and Professional Issues in Prescribing

Adverse Drug Reactions

Factors That Foster Positive Outcomes

Cultural and Ethnic Influences in Pharmacotherapeutics

An Introduction to Pharmacogenomics

Nutrition and Nutraceuticals

Herbal Therapy and Nutritional Supplements

Information Technology and Pharmacotherapeutics

Pharmacoeconomics

Over-The-Counter Medications

Drugs Affecting the Autonomic Nervous System

Drugs Affecting the Central Nervous System

Drugs Affecting the Cardiovascular and Renal Systems

Drugs Affecting the Respiratory System

Drugs Affecting the Hematopoietic System

Drugs Affecting the Immune System

Drugs Affecting the Gastrointestinal System

Drugs Affecting the Endocrine System

Drugs Affecting the Integumentary System

Drugs Used in Treating Infectious Diseases

Drugs Used in Treating Inflammatory Processes

Drugs Used in Treating Eye and Ear Disorders

Anemia

Chronic Stable Angina and Low-Risk Unstable Angina

Anxiety and Depression

Asthma and Chronic Obstructive Pulmonary Disease

Contraception

Dermatologic Conditions

Diabetes Mellitus

Gastroesophageal Reflux and Peptic Ulcer Disease

Headaches

Heart Failure

Human Immunodeficiency Virus Disease and Acquired Immunodeficiency Syndrome

Hormone Replacement Therapy and Osteoporosis

Hyperlipidemia

Hypertension

Hyperthyroidism and Hypothyroidism

Pneumonia

Smoking Cessation

Sexually Transmitted Infections and Vaginitis

Tuberculosis

Upper Respiratory Infections, Otitis Media, and Otitis Externa

Urinary Tract Infections

Women As Patients

Men As Patients

Children As Patients

Geriatric Patients

Pain Management: Acute and Chronic Pain

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