Chapter 25 Estrogens, Progestogens, and Androgens
MULTIPLE CHOICE
1. A woman is taking a combination oral contraceptive and asks the nurse why progestin
is necessary. The nurse will explain that progestin helps prevent pregnancy by which
method? a. Altering the quantity and viscosity of cervical mucus
b. Inhibiting proliferative and secretory changes in the endometrium
c. Increasing motility of muscles and cilia in the fallopian tubes
d. Stimulating a surge in luteinizing hormone
ANS A
Progestin alters the quantity and viscosity of cervical mucus, making it thick and hostile to
sperm penetration. Estrogen inhibits proliferative and secretory changes in the endometrium.
Progestin decreases muscle and ciliary motility and decreases the LH surge.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 847 TOP
NURSING PROCESS Nursing Intervention
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
2. A woman will begin taking a combination oral contraceptive (COC) that has a higher
estrogenic activity than her previous COC. When teaching this woman about the new
product, the nurse will explain that she may experience which effect(s)? a. Cyclic breast
changes and chloasma
b. Decreased dysmenorrhea and menorrhagia
c. Decreased libido
d. Weight gain and fatigue
ANS A
Increased estrogenic activity may include side effects such as cyclic breast changes and
chloasma as well as increased dysmenorrhea and menorrhagia. Increased progestin
causes decreased libido, weight gain, and fatigue.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 847
TOP NURSING PROCESS Nursing Intervention Patient Teaching
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
3. A woman who has recently begun taking a combination oral contraceptive calls the clinic to
report breakthrough bleeding. The nurse will
a. advise her to use a backup method of contraception.
b. counsel her to continue taking the contraceptive as prescribed.
c. recommend discussing an alternative contraceptive with her provider.
d. suggest that she perform a home pregnancy test to rule out pregnancy.
ANS B
Breakthrough bleeding is more common at the start of COC use, and there is no evidence that
an episode of bleeding is associated with a decrease in the COCs effectiveness as long as the
, patient continues to take the pill as prescribed. She does not need to use backup contraception.
Unless the bleeding continues and is problematic, there is no need to change products. A
pregnancy test is not indicated.
DIF COGNITIVE LEVEL Applying (Application) REF dm 847
TOP NURSING PROCESS Evaluation
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
4. A young woman who is taking Ortho-Tri-Cyclen for contraception tells the nurse that
her provider has told her it will help to treat her acne. The nurse explains that this is
because this product is
a. high in progestin.
b. low in androgenic activity.
c. low in estrogen.
d. triphasic.
ANS B
Products with low androgenic activity help to reduce acne.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 847 TOP
NURSING PROCESS Nursing Intervention Patient Teaching
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
5. The nurse is caring for a woman who will begin taking ibuprofen to treat arthritis. The
woman tells the nurse that she takes Yasmin for contraception. The nurse will perform which
action? a. Counsel the patient to use a backup method of contraception while taking ibuprofen.
b. Notify the provider to discuss an alternate combination oral contraceptive.
c. Suggest a COX-2 inhibitor instead of ibuprofen for arthritis pain.
d. Tell the patient to use a lower dose of ibuprofen to prevent adverse effects.
ANS B
Yasmin contains drospirenone, which is derived from spironolactone. Drospirenone can alter
water and electrolyte balances in women, and women taking this product should avoid
NSAIDs to avoid compounding this effect. The provider may want to consider another COC
product. It does not alter fertility.
DIF COGNITIVE LEVEL Applying (Application) REF dm 848 TOP
NURSING PROCESS Assessment
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
6. A woman who is taking a combined oral contraceptive (COC) that contains 21 days of active
pills and 7 days of inert pills reports having headaches accompanying withdrawal bleeding
every month. The nurse will
a. counsel her to take ibuprofen to counter these side effects.
b. notify her provider to discuss these adverse effects.
c. recommend a Loestrin Fe product.
d. suggest she ask her provider about Mircette.
MULTIPLE CHOICE
1. A woman is taking a combination oral contraceptive and asks the nurse why progestin
is necessary. The nurse will explain that progestin helps prevent pregnancy by which
method? a. Altering the quantity and viscosity of cervical mucus
b. Inhibiting proliferative and secretory changes in the endometrium
c. Increasing motility of muscles and cilia in the fallopian tubes
d. Stimulating a surge in luteinizing hormone
ANS A
Progestin alters the quantity and viscosity of cervical mucus, making it thick and hostile to
sperm penetration. Estrogen inhibits proliferative and secretory changes in the endometrium.
Progestin decreases muscle and ciliary motility and decreases the LH surge.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 847 TOP
NURSING PROCESS Nursing Intervention
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
2. A woman will begin taking a combination oral contraceptive (COC) that has a higher
estrogenic activity than her previous COC. When teaching this woman about the new
product, the nurse will explain that she may experience which effect(s)? a. Cyclic breast
changes and chloasma
b. Decreased dysmenorrhea and menorrhagia
c. Decreased libido
d. Weight gain and fatigue
ANS A
Increased estrogenic activity may include side effects such as cyclic breast changes and
chloasma as well as increased dysmenorrhea and menorrhagia. Increased progestin
causes decreased libido, weight gain, and fatigue.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 847
TOP NURSING PROCESS Nursing Intervention Patient Teaching
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
3. A woman who has recently begun taking a combination oral contraceptive calls the clinic to
report breakthrough bleeding. The nurse will
a. advise her to use a backup method of contraception.
b. counsel her to continue taking the contraceptive as prescribed.
c. recommend discussing an alternative contraceptive with her provider.
d. suggest that she perform a home pregnancy test to rule out pregnancy.
ANS B
Breakthrough bleeding is more common at the start of COC use, and there is no evidence that
an episode of bleeding is associated with a decrease in the COCs effectiveness as long as the
, patient continues to take the pill as prescribed. She does not need to use backup contraception.
Unless the bleeding continues and is problematic, there is no need to change products. A
pregnancy test is not indicated.
DIF COGNITIVE LEVEL Applying (Application) REF dm 847
TOP NURSING PROCESS Evaluation
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
4. A young woman who is taking Ortho-Tri-Cyclen for contraception tells the nurse that
her provider has told her it will help to treat her acne. The nurse explains that this is
because this product is
a. high in progestin.
b. low in androgenic activity.
c. low in estrogen.
d. triphasic.
ANS B
Products with low androgenic activity help to reduce acne.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 847 TOP
NURSING PROCESS Nursing Intervention Patient Teaching
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
5. The nurse is caring for a woman who will begin taking ibuprofen to treat arthritis. The
woman tells the nurse that she takes Yasmin for contraception. The nurse will perform which
action? a. Counsel the patient to use a backup method of contraception while taking ibuprofen.
b. Notify the provider to discuss an alternate combination oral contraceptive.
c. Suggest a COX-2 inhibitor instead of ibuprofen for arthritis pain.
d. Tell the patient to use a lower dose of ibuprofen to prevent adverse effects.
ANS B
Yasmin contains drospirenone, which is derived from spironolactone. Drospirenone can alter
water and electrolyte balances in women, and women taking this product should avoid
NSAIDs to avoid compounding this effect. The provider may want to consider another COC
product. It does not alter fertility.
DIF COGNITIVE LEVEL Applying (Application) REF dm 848 TOP
NURSING PROCESS Assessment
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
6. A woman who is taking a combined oral contraceptive (COC) that contains 21 days of active
pills and 7 days of inert pills reports having headaches accompanying withdrawal bleeding
every month. The nurse will
a. counsel her to take ibuprofen to counter these side effects.
b. notify her provider to discuss these adverse effects.
c. recommend a Loestrin Fe product.
d. suggest she ask her provider about Mircette.
