NSG 6320 AGNP BOARD EXAM WOMENS HEALTH PRESCRIPTION| AGNP BOARD EXAM WOMENS HEALTH PRESCRIPTION 2020

NSG 6320 AGNP BOARD EXAM WOMENS HEALTH PRESCRIPTION (101 QUESTIONS) Question: Which of the following is NOT a common side effect associated with the use of etonogestrel/ethinyl estradiol (NuvaRing), a contraceptive vaginal ring? Vaginitis Breast tenderness Increased appetite Severe headache Correct Explanation: A common side effect NOT associated with the use of etonogestrel/ethinyl estradiol (NuvaRing) is severe headache. The systemic side effects of NuvaRing are the same as with oral contraceptives. Vaginitis and local skin irritation may occur with the use of the intravaginal ring. Danger signs of contraceptives can be remembered using the acronym ACHES: A-Severe abdominal pain (may be indicative of hepatic tumors); C- Severe chest pain or shortness of breath; H-Severe headaches; E-eye problems (blurred vision, flashing lights, or blindness); S-Severe leg pain. Question: A common side effect associated with the use of progestin-only contraceptives is: depression. amenorrhea. Correct hypertension. edema. Explanation: Common side effects of progestin-only contraceptives are menstrual cycle changes (e.g., spotting, breakthrough bleeding, prolonged cycles and eventually, amenorrhea). Other side effects are breast tenderness, headaches, and mood changes. Question: The drug of choice to control mild abnormal uterine bleeding in a 25-year-old woman with future childbearing plans is: estrogen only. androgen therapy gonadotropin-releasing hormone analogs. progesterone only. Correct Explanation: A combined estrogen/progesterone oral contraceptive or progesterone only would be the treatment of choice for mild abnormal uterine bleeding in a woman of childbearing age. Severe uterine bleeding is usually treated on an emergency basis with a short course of high-dose estrogen therapy. Treatment with androgens would only be indicated for short-term use for refractory bleeding. Question: Nonhormonal treatments for menopausal symptoms include: benzodiazepines. copper intrauterine device. selective serotonin reuptake inhibitors. Correct antiepileptic/antiseizure medications. Explanation: Nonhormonal treatments for menopausal symptoms include selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors. Question: In the presence of mild hyperandrogenic symptoms related to polycystic ovarian syndrome (PCOS), the initial recommended treatment is: norethindrone/ethinyl estradiol (Lo Loestrin). Correct medroxyprogesterone (Provera). ethinyl estradiol (Estinyl). metformin (Glucophage). Explanation: In the presence of mild hyperandrogenic symptoms related to polycystic ovarian syndrome (PCOS), the initial recommended treatment is a combination oral contraceptive (i.e. norethindrone/ethinyl estradiol [Lo Loestrin]). Combined oral contraceptive therapy modestly inhibits gonadotropin secretion and thus gonadotropin- sensitive ovarian androgen production, and increases hepatic production of sex hormone binding globulin (SHBG), which further decreases free testosterone. Question: Which of the following medications would NOT be beneficial in the treatment of pain associated with fibrocystic breast disease? Spironolactone (Aldactone) Norethindrone/ethinyl estradiol (Lo Loestrin) Danazol Fluoxetine (Sarafem) Correct Explanation: Fluoxetine (Sarafem), an SSRI, is NOT recommended for the treatment of pain associated with fibrocystic breast disease. Spironolactone, a potassium-sparing diuretic; danazol, an androgen; and norethindrone/ethinyl estradiol, a combination oral contraceptive, may all be used for the treatment of pain associated with fibrocystic breast disease. Vitamin B6, vitamin E and evening primrose oil may be beneficial as well. Bromocriptine (Parlodel) may be used for more severe disease. Question: The copper component of the ParaGard intrauterine device to prevent pregnancy is thought to: thicken the endometrium and cervical mucus. decrease the movement of ovum through the fallopian tubes. interfere with estrogen uptake and decrease sperm motility. Correct suppress ovulation. Explanation: The copper component in the ParaGard intrauterine device is thought to prevent pregnancy by interfering with estrogen uptake, potentiating the local inflammatory response, and decreasing sperm motility. Question: The drug of choice to control mild abnormal uterine bleeding in a teenage patient is: estrogen only. androgen therapy. gonadotropin-releasing hormone analogs. combination estrogen/progesterone. Correct Explanation: A combined estrogen/progesterone oral contraceptive or progesterone only would be the treatment of choice for mild abnormal uterine bleeding in a teenager. Severe uterine bleeding is usually treated on an emergency basis with a short course of high-dose estrogen therapy. Treatment with androgens would only be indicated for short-term use to manage refractory bleeding. Question: A benefit associated with the use of medroxyprogesterone acetate (Depo-Provera), a progestin-only contraceptive, is: decreased risk of pelvic inflammatory disease. Correct decreased risk of cardiovascular risk factors. decreased risk of weight gain. decreased risk of osteoporosis. Explanation: Benefits associated with the use of medroxyprogesterone acetate (Depo-Provera), a progestin-only contraceptive, include decreased risk of endometrial cancer and pelvic inflammatory disease. Further benefits of Depo-Provera are decreased menstrual cramps, reduction in heavy uterine bleeding, decreased premenstrual syndrome symptoms, and decreased breast tenderness. Patients receiving Depo-Provera are at increased risk for experiencing