A patient is seen for hormone replacement therapy due to menopausal symptoms. Evaluation
demonstrates history of endometrial cancer and smoking. Which of the following is the most important
information to give to this patient?
1 "The treatment can lead to thromboembolic events."
2 "You will have to quit smoking while undergoing the therapy."
3 "The treatment should be initiated at the earliest.
4 "The treatment is liable to result in endometrial cancer." Do you think this question resembles? Answer
1 "The therapy may result in thromboembolic events."
She should be informed first that progesterone therapy can lead to thromboembolic events. Estrogen
therapy can increase the possibility of recurrence of cancer in patients with a history of endometrial
cancer. The nurse can advise the patient to avoid smoking once the therapy is initiated. The treatment is
not begun sooner to possibly prevent the treatment altogether.
A patient's clinical report is indicating thrombosis while undergoing estrogen therapy. Which event could
be suspected by the nurse as a cause of the thrombosis?
1. The patient smokes cigarettes.
2. The patient fluid intake is scant.
3. The patient takes herbal supplements.
4. The patient takes tricyclic antidepressants. -Answer 1. The patient smokes cigarettes.
Smoking precipitates thrombosis in patients receiving estrogen therapy. A decrease in fluids does not
result in thrombosis. Herbal medications such as St. John's wort decrease the estrogenic effect of drugs.
The concomitant use of estrogen therapy with tricyclic antidepressants precipitates toxicity of the
antidepressant.
For a patient in labor, which monitoring parameters should be evaluated for effectiveness of the drug
,oxytocin? Select all that apply.
1 Fetal heart rate
2 Not asking any questions regarding fetal movement
3 Not discontinuing the agent in uterine hyperactivity
4 The administration of blood pressure and pulse of the patient during the oxytocic agent administration
- Answer 1, 4
Before the use of uterine stimulants such as oxytocin or prostaglandins, it is necessary for the nurse to
establish a baseline fetal heart rate and contraction-related fetal heart rates and record these findings.
The patient's blood pressure, pulse, and respiration should be recorded. It is unsafe to continue the
agent when uterine hyperactivity occurs. Asking no questions about fetal movement will not reveal
anything useful for assessment.
Test-Taking Tip: Watch for grammatical discrepancies. If the answer is supposed to complete the stem
(an incomplete sentence) and doesn't make grammatical sense to you, it may be a distractor and not the
correct answer. The question writers usually try to minimize these discrepancies.
Which of the following phases of the menstrual cycle involves the release of an unfertilized ovum?
1. Phase 1
2. Phase 2
3. Phase 3
4. Phase 4 - Answer 3. Phase 3
The menstrual cycle consists of four phases. Phase 3 is the ovulation phase, which involves the release of
the unfertilized ovum from the ovum. Phase 1 is referred to as the menstruation phase. It is the starting
phase of the cycle and continues for 5 to 7 days. Phase 2 is referred to as the follicular phase. During this
phase, the mature ovum develops from the ovarian follicle. luteal phase is Phase 4. During this phase,
the corpus luteum forms from the ruptured ovarian follicle.
The nurse is teaching a patient about the effects of estrogen therapy. Which effect listed by the patient
requires further teaching?
,1 Prevention of breast cancer
2 Treatment of prostate cancer
3 Reduction in vasomotor symptoms
4 Alleviation of atrophic vaginitis - Answer 1. Prevention of breast cancer
Estrogen therapy has been shown to increase the risk of breast cancer in women. Specific indications for
estrogen therapy include atrophic vaginitis, female hypogonadism, inadequate primary ovarian function,
abnormal uterine bleeding, and severe vasomotor symptoms in females. This medication is also used in
the treatment of prostate cancer.
A patient is determined to be pregnant even though she has been taking oral contraceptives. Which one
of the following could be a cause of the unplanned pregnancy?
1 The patient has diabetes.
2 The patient is hypertensive.
3 The patient is taking anticonvulsants
4 The patient is on antibiotic therapy. -Answer 4 The patient is on antibiotic therapy.
Antibiotics reduce the efficacy of oral contraceptives; thus the nurse should instruct the patient to use
other methods of birth control while taking a course of antibiotics. Diabetes does not reduce the
effectiveness of oral contraceptives. Hypertension is a potential side effect of oral contraceptives.
Anticonvulsants have reduced efficacy when taken with oral contraceptives.
Test-Taking Tip: Many times the correct answer is the longest alternative given, but do not count on it.
Item writers, those who write the questions, also are aware of this and attempt to avoid offering you
such "helpful hints."
Which medication is used to induce labor?
1 Oxytocin
2 Terbutaline
3 Methylergonovine
, 4 Magnesium sulfate - Answer 1 Oxytocin
Oxytocin is a uterine stimulant used to induce contractions of the uterus for labor. Terbutaline is a
medication to arrest preterm labor. Methylergonovine is used for treatment of postpartum hemorrhage.
Magnesium sulfate is used for treatment of gestational hypertension.
Which medication is utilized for the treatment of infertility?
1 Oxytocin
2 Clomiphene
3 Indomethacin
4 Dinoprostone - Answer 2 Clomiphene
Infertility is the inability to ovulate as a result of an imbalance of the reproductive hormones.
Clomiphene stimulates gonadotropin hormone secretion, which induces ovulation. Oxytocin is used to
induce labor in cases where uterine contractions are weak. Indomethacin is given for preterm labor.
Dinoprostone is indicated for miscarriage to evacuate uterine contents and for cervical ripening.
At what phase of the menstrual cycle does ovulation usually occur?
1. Day 3
2. Day 7
3. Day 14
4. Day 21-Answer 3. Day 14
The middle of the cycle, day 14, ovulation occurs as a result of the rupture of the mature follicle and the
release of its ovum. Days 3, 7, and 21 are not when it occurs.
Test-Taking Tip: Look for options that are similar in nature. If all are correct, either the question is poor
or all options are incorrect, the latter of which is more likely. Example: If the answer you are seeking is
directed to a specific treatment and all but one option deal with signs and symptoms, you would be
correct in choosing the treatment-specific option.
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