A patient with menopausal symptoms is seeking hormone replacement therapy. During the
assessment, the nurse finds that the patient has a history of endometrial cancer and is a
smoker. Which is the most important information for this patient?
1 "The therapy may cause thromboembolic events."
2 "You may need to stop smoking during the therapy."
3 "The treatment should be started as soon as possible."
4 "The treatment is likely to cause endometrial cancer." - correct answer 1 "The therapy may
cause thromboembolic events."
Progesterone therapy may result in thromboembolic events, which should be the first
information shared with the patient. In patients with a history of endometrial cancer, estrogen
therapy may increase the possibility of recurrence of cancer. The nurse may advise the patient
to stop smoking if she starts the therapy. The treatment is not started as soon as possible, but
may be prevented.
The clinical report of a patient who is undergoing estrogen therapy indicates thrombosis. Which
event may the nurse suspect as the cause of thrombosis?
1 The patient smokes cigarettes.
2 The patient's fluid intake is low.
3 The patient takes herbal supplements.
4 The patient takes tricyclic antidepressants. - correct answer 1 The patient smokes cigarettes.
Smoking causes thrombosis in patients who undergo estrogen therapy. Thrombosis is not
caused by a decrease in fluids. Herbal medicines such as St. John's wort decrease the estrogenic
effect of drugs. The use of estrogen therapy with tricyclic antidepressants causes toxicity of the
antidepressant.
What monitoring parameter should be evaluated for drug effectiveness for a patient in labor
who is receiving oxytocin? Select all that apply.
1 Fetal heart rate
2 Asking no questions about fetal movement
3 Continuing the agent if uterine hyperactivity occurs
,4 The patient's blood pressure and pulse during administration of the oxytocic agent - correct
answer 1, 4
Before administering uterine stimulants (e.g., oxytocin or prostaglandins), the nurse should
determine the fetal heart rate and contraction-related fetal heart rates and document findings.
The nurse should also assess and document the patient's blood pressure, pulse, and respiration.
Continuing the agent if uterine hyperactivity occurs is not safe. Asking no questions about fetal
movement will not reveal anything useful for assessment.
Test-Taking Tip: Be alert for grammatical inconsistencies. If the response is intended to
complete the stem (an incomplete sentence) but makes no grammatical sense to you, it might
be a distractor rather than the correct response. Question writers typically try to eliminate
these inconsistencies.
Which phase of the menstrual cycle involves the release of an unfertilized ovum?
1. Phase 1
2. Phase 2
3. Phase 3
4. Phase 4 - correct answer 3. Phase 3
The menstrual cycle has four phases. The unfertilized ovum is released from the ovum during
phase 3, which is the ovulation phase. Phase 1 is referred to as the menstruation phase. The
phase initiates the cycle and lasts 5 to 7 days. Phase 2 is known as the follicular phase. During
this phase, the mature ovum develops from the ovarian follicle. Phase 4 is the luteal phase.
During this phase, the corpus luteum is formed from the ruptured ovarian follicle.
The nurse is explaining the effects of estrogen therapy to a patient. Which effect mentioned by
the patient indicates a need for additional teaching?
1 Prevention of breast cancer
2 Treatment of prostate cancer
3 Decrease in vasomotor symptoms
4 Improvement of atrophic vaginitis - correct answer 1. Prevention of breast cancer
,Estrogen therapy increases the chances of breast cancer in women. Estrogen therapy leads to
improvement of atrophic vaginitis, female hypogonadism, insufficient primary ovarian function,
abnormal uterine bleeding, and severe vasomotor symptoms in women. It is also used to treat
prostate cancer.
A patient tests positive for pregnancy even though she has been taking oral contraceptives.
What is a possible cause of this unintended pregnancy?
1 The patient has diabetes.
2 The patient has hypertension.
3 The patient takes anticonvulsants.
4 The patient is on antibiotic therapy. - correct answer 4 The patient is on antibiotic therapy.
Antibiotics reduce the effectiveness of oral contraceptives; hence, the nurse needs to instruct
patients to use alternative birth control methods during antibiotic therapy. Diabetes does not
reduce the effect of oral contraceptives. Hypertension may be an adverse effect of oral
contraceptives. The effectiveness of anticonvulsants is reduced 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) are also 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 - correct answer 1 Oxytocin
Oxytocin is a uterine stimulant that is used to induce uterine contractions for labor. Terbutaline
is a medication used to arrest preterm labor. Methylergonovine is used to treat postpartum
hemorrhage. Magnesium sulfate is used to treat gestational hypertension.
Which medication is used for treating infertility?
1 Oxytocin
, 2 Clomiphene
3 Indomethacin
4 Dinoprostone - correct answer 2 Clomiphene
Infertility is an absence of ovulation caused by an imbalance in reproductive hormones.
Clomiphene stimulates the production of gonadotropin hormones, which in turn leads to
ovulation. Oxytocin is used to induce labor when uterine contractions are weak. Indomethacin
is used during preterm labor. Dinoprostone is used to evacuate the uterine contents during
miscarriage and for cervical ripening.
Ovulation commonly occurs at which day during the menstrual cycle?
1. Day 3
2. Day 7
3. Day 14
4. Day 21 - correct answer 3. Day 14
Ovulation typically occurs at day 14 in the menstrual cycle, when the mature follicle ruptures
and releases its ovum. It does not occur on day 3, 7, or 21.
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.
If fertilization of an ovum does not occur during a menstrual cycle, which of the following
structures responds to the increased levels of estrogen and progesterone?
1 Ovary
2 Hypothalamus
3 Pituitary gland
4 Corpus luteum - correct answer 3. Pituitary gland
assessment, the nurse finds that the patient has a history of endometrial cancer and is a
smoker. Which is the most important information for this patient?
1 "The therapy may cause thromboembolic events."
2 "You may need to stop smoking during the therapy."
3 "The treatment should be started as soon as possible."
4 "The treatment is likely to cause endometrial cancer." - correct answer 1 "The therapy may
cause thromboembolic events."
Progesterone therapy may result in thromboembolic events, which should be the first
information shared with the patient. In patients with a history of endometrial cancer, estrogen
therapy may increase the possibility of recurrence of cancer. The nurse may advise the patient
to stop smoking if she starts the therapy. The treatment is not started as soon as possible, but
may be prevented.
The clinical report of a patient who is undergoing estrogen therapy indicates thrombosis. Which
event may the nurse suspect as the cause of thrombosis?
1 The patient smokes cigarettes.
2 The patient's fluid intake is low.
3 The patient takes herbal supplements.
4 The patient takes tricyclic antidepressants. - correct answer 1 The patient smokes cigarettes.
Smoking causes thrombosis in patients who undergo estrogen therapy. Thrombosis is not
caused by a decrease in fluids. Herbal medicines such as St. John's wort decrease the estrogenic
effect of drugs. The use of estrogen therapy with tricyclic antidepressants causes toxicity of the
antidepressant.
What monitoring parameter should be evaluated for drug effectiveness for a patient in labor
who is receiving oxytocin? Select all that apply.
1 Fetal heart rate
2 Asking no questions about fetal movement
3 Continuing the agent if uterine hyperactivity occurs
,4 The patient's blood pressure and pulse during administration of the oxytocic agent - correct
answer 1, 4
Before administering uterine stimulants (e.g., oxytocin or prostaglandins), the nurse should
determine the fetal heart rate and contraction-related fetal heart rates and document findings.
The nurse should also assess and document the patient's blood pressure, pulse, and respiration.
Continuing the agent if uterine hyperactivity occurs is not safe. Asking no questions about fetal
movement will not reveal anything useful for assessment.
Test-Taking Tip: Be alert for grammatical inconsistencies. If the response is intended to
complete the stem (an incomplete sentence) but makes no grammatical sense to you, it might
be a distractor rather than the correct response. Question writers typically try to eliminate
these inconsistencies.
Which phase of the menstrual cycle involves the release of an unfertilized ovum?
1. Phase 1
2. Phase 2
3. Phase 3
4. Phase 4 - correct answer 3. Phase 3
The menstrual cycle has four phases. The unfertilized ovum is released from the ovum during
phase 3, which is the ovulation phase. Phase 1 is referred to as the menstruation phase. The
phase initiates the cycle and lasts 5 to 7 days. Phase 2 is known as the follicular phase. During
this phase, the mature ovum develops from the ovarian follicle. Phase 4 is the luteal phase.
During this phase, the corpus luteum is formed from the ruptured ovarian follicle.
The nurse is explaining the effects of estrogen therapy to a patient. Which effect mentioned by
the patient indicates a need for additional teaching?
1 Prevention of breast cancer
2 Treatment of prostate cancer
3 Decrease in vasomotor symptoms
4 Improvement of atrophic vaginitis - correct answer 1. Prevention of breast cancer
,Estrogen therapy increases the chances of breast cancer in women. Estrogen therapy leads to
improvement of atrophic vaginitis, female hypogonadism, insufficient primary ovarian function,
abnormal uterine bleeding, and severe vasomotor symptoms in women. It is also used to treat
prostate cancer.
A patient tests positive for pregnancy even though she has been taking oral contraceptives.
What is a possible cause of this unintended pregnancy?
1 The patient has diabetes.
2 The patient has hypertension.
3 The patient takes anticonvulsants.
4 The patient is on antibiotic therapy. - correct answer 4 The patient is on antibiotic therapy.
Antibiotics reduce the effectiveness of oral contraceptives; hence, the nurse needs to instruct
patients to use alternative birth control methods during antibiotic therapy. Diabetes does not
reduce the effect of oral contraceptives. Hypertension may be an adverse effect of oral
contraceptives. The effectiveness of anticonvulsants is reduced 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) are also 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 - correct answer 1 Oxytocin
Oxytocin is a uterine stimulant that is used to induce uterine contractions for labor. Terbutaline
is a medication used to arrest preterm labor. Methylergonovine is used to treat postpartum
hemorrhage. Magnesium sulfate is used to treat gestational hypertension.
Which medication is used for treating infertility?
1 Oxytocin
, 2 Clomiphene
3 Indomethacin
4 Dinoprostone - correct answer 2 Clomiphene
Infertility is an absence of ovulation caused by an imbalance in reproductive hormones.
Clomiphene stimulates the production of gonadotropin hormones, which in turn leads to
ovulation. Oxytocin is used to induce labor when uterine contractions are weak. Indomethacin
is used during preterm labor. Dinoprostone is used to evacuate the uterine contents during
miscarriage and for cervical ripening.
Ovulation commonly occurs at which day during the menstrual cycle?
1. Day 3
2. Day 7
3. Day 14
4. Day 21 - correct answer 3. Day 14
Ovulation typically occurs at day 14 in the menstrual cycle, when the mature follicle ruptures
and releases its ovum. It does not occur on day 3, 7, or 21.
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.
If fertilization of an ovum does not occur during a menstrual cycle, which of the following
structures responds to the increased levels of estrogen and progesterone?
1 Ovary
2 Hypothalamus
3 Pituitary gland
4 Corpus luteum - correct answer 3. Pituitary gland
