NGR 6172 QUIZ 7 UPDATED ACTUAL QUESTIONS AND CORRECT ANSWERS

NGR 6172 QUIZ 7 UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS

Question:
A patient is taking finasteride [Proscar] for benign prostatic hyperplasia (BPH). The
nurse should explain that this medication has what effect?
A. Decreases the size of the prostate gland
B. Relaxes smooth muscle of the prostate gland
C. Reduces the risk of prostate cancer
D. Improves sexual performance during intercourse
Answer:
Answer: A Rationale: Finasteride [Proscar] promotes the regression of prostate
epithelial tissue and decreases the size of the mechanical obstruction.

Question:
The nurse should instruct a patient prescribed sildenafil [Viagra] to avoid taking this
medication with what?
A. Grapefruit juice
B. Milk
C. Crackers
D. Eggs
Answer:
Answer: A Rationale: Inhibitors of CYP3A4 (e.g., ketoconazole, itraconazole,
erythromycin, cimetidine, saquinavir, ritonavir, and grapefruit
juice) can suppress metabolism of sildenafil, thereby increasing its levels.

Question:
Effects of Estrogen on Reproduction during the Follicular Phase
Answer:
Ductal breast growth Thickening of vaginal epithelium Uterine epithelial proliferation
Endocervical mucous secretion

Question:
Metabolic Actions of Estrogen
Answer:
‘ BMD (Decreased bone resorption) ‘ HDL, “ LDL (cardioprotective pre-menopause)
Favors coagulation (‘ clotting factors) ‘ Insulin sensitivity Neuroprotective against
oxidative stress + injury

Question:
Early S/S of Menopause
Answer:
Irregular cycle, some anovulatory cycles Alternating amenorrhea + Menses

,Question:
Effects of Menopause from Lack of Estrogen
Answer:
Vasomotor S/S (hot flashes/night sweats) Sleep disturbances Urogenital atrophy (urge
incontinence/frequency) Urethritis/UTI/Dryness/Dyspareunia Female Sexual
Interest-Arousal Disorder (FSIAD) “ Short-term memory/problem solving Osteoporosis ‘
LDL + “ HDL

Question:
Therapeutic Uses of Estrogen
Answer:
Hormone therapy (HT) in postmenopausal women Acne (in OC form) Turner Syndrome,
Hypopituatarism, Oophrectomy Palliation for prostate/some breast cancers

Question:
Basics on Phytoestrogens
Answer:
Soy-based compounds Not recommended Can take weeks before effects are noticed

Question:
How to decrease risk of endometrial carcinoma in Menopausal women taking Hormone
Therapy (HT)
Answer:
Add progestin (don't just use estrogen)

Question:
Minimizing Nausea from Estrogen Therapy
Answer:
Diminishes over time In the meantime, avoid cooking odors + warm/stuffy areas Dry
food + raw fruits/veggies = decreased nausea

Question:
Ongoing Monitoring for Estrogen Therapy
Answer:
BP, WT, Triglycerides TSH (if thyroid replacement required) Regular breast/pelvic
exams Endometrial biopsy for unscheduled bleeding that continues for 6 months

Question:
Baseline Data for Estrogen Therapy
Answer:
HR, BP, WT Pregnancy, TSH, Lipids, Screen for BC + CV disease

Question:
Pt education for Intravaginal Estrogen Insert (not the ring)
Answer:
1x daily for 2 weeks Then, 2x week Insert as deep as possible using applicator

,Question:
Pt education for Intravaginal Estrogen Ring
Answer:
Insert as deep as possible Change every 3 months

Question:
Pt education for Intravaginal Estrogen Cream
Answer:
Apply high into vagina at bedtime using applicator

Question:
Pt education for Transdermal Estrogen Spray
Answer:
Apply 1-3 sprays daily to inner forearm. Let dry 2 min before dressing or 30 min before
washing

Question:
Pt education for Transdermal Estrogen Gel
Answer:
Apply daily to one arm (shoulder’wrist) after showering

Question:
Pt education for Transdermal Estrogen Emulsion
Answer:
Apply to top of B/L Thighs + back of calves every morning

Question:
Pt education for Transdermal Estrogen
(Patch) Administration
Answer:
Apply to clean,dry, intact skin on trunk (not breast or waist) Press into place for 10 sec
Apply new patch 1-2 times/week Rotate application sites

Question:
Benefits of Transdermal Estrogen
Answer:
“ Total dose (bypasses liver) “ N/V “ Risk of DVT/PE/Stroke “ Estrogen Level Fluctuation

Question:
Contraindications for Estrogen
Answer:
Hx of DVT, PE, MI secondary to thromboembolism Hx of Liver disease
Pregnancy/Vaginal bleeding of unknown cause Estrogen-dependent cancers + BC

, Question:
Adverse Effects of Estrogen
Answer:
Endometrial Hyperplasia/Cancer (when unopposed by progestin) Thromboembolism
(DVT, PE, MI, stroke) #1 = Nausea (Decreased over time) Cholelithiasis, Jaundice, HA
Chloasma (patchy brown face discoloration) Fluid retention w/ edema

Question:
Tamoxifen Uses + Adverse Fx
Answer:
Uses: Fights/Prevents BC + Osteoporosis Adverse Fx of Tamoxifen
- Hot flashes
- ‘ Thromboembolism risk
- ‘ Endometrial cancer risk

Question:
Raloxifene Uses + Adverse Fx
Answer:
Uses: Prevents BC + Osteoporosis Adverse Fx:
- Hot Flashes
- ‘ Thromboembolism Risk
- Does NOT ‘ risk of any CA

Question:
Effects of Progesterone:
Answer:
Thickens mucous, Breast tissue growth Depression, Sleepiness Ovulation = ‘ Body temp
(1℉) Pregnancy = Milk production, “ GI motility,

Question:
Therapeutic Uses of Progestins
Answer:
Postmenopausal HT Dysfunctional uterine bleeding, Amenorrhea Suppression of
Endometrial hyperplasia (precancer) Palliation in metastatic endometrial carcinoma
Contraception

Question:
Adverse Effects of Progestins
Answer:
Breast tenderness, HA, abd discomfort Arthralgia, Depression Irregular menses,
spotting Teratogenic effect (high doses)

Question:
Contraindications of Progestins
Answer:
Undiagnosed vaginal bleeding Hysterectomy Active/hx of thromboembolism BC