Chapter 61: Estrogens and Progestrin

Question 1

A 50-year-old postmenopausal patient who has had a hysterectomy has moderate to severe vasomotor symptoms and is discussing estrogen therapy (ET) with the nurse. The patient is concerned about adverse effects of ET. The nurse will tell her that:
a.
an estrogen-progesterone product will reduce side effects.
b.
an intravaginal preparation may be best for her.
c.
side effects of ET are uncommon among women her age.
d.
transdermal preparations have fewer side effects.

Answer 1

D

Question 2

2. A patient who is at risk for osteoporosis will begin taking the selective estrogen receptor modulator raloxifene [Evista]. Which statement will the nurse include when teaching this patient about the medication?
   a.
   Raloxifene reduces the risk of thromboembolism.
   b.
   The drug is associated with an increased risk of breast cancer.
   c.
   Use of this drug increases the risk of endometrial carcinoma.
   d.
   Vasomotor symptoms are a common side effect of this drug.

Answer 2

D

Question 3

3. A nurse provides teaching to a patient who has had a hysterectomy and is about to begin hormone therapy to manage menopausal symptoms. Which statement by the patient indicates understanding of the teaching?
   a.
   “Because I am not at risk for uterine cancer, I can take hormones indefinitely.”
   b.
   “I can take estrogen to reduce my risk of cardiovascular disease.”
   c.
   “I should take the lowest effective dose for the shortest time needed.”
   d.
   “I will need a progestin/estrogen combination since I have had a hysterectomy.”

Answer 3

C

Question 4

4. A nurse provides teaching to a group of nursing students about the risks and benefits of hormone therapy (HT), including estrogen therapy (ET) and combination estrogen/progestin therapy (EPT). Which statement by a student indicates understanding of the teaching?
   a.
   “ET can provide protection against coronary heart disease and reverse osteoporosis.”
   b.
   “EPT is generally safer than ET, especially in women who have undergone hysterectomies.”
   c.
   “In women with established coronary heart disease, EPT can protect against myocardial infarction.”
   d.
   “Principle benefits of ET are suppression of menopausal symptoms and prevention of bone loss.”

Answer 4

D

Question 5

A postmenopausal patient who has had a hysterectomy and who has a family history of coronary heart disease reports experiencing vaginal dryness and pain with intercourse but tells the nurse that she doesn’t want to take hormones because she is afraid of adverse effects. The nurse will suggest that the woman ask her provider about:
a.
Depo Provera.
b.
Estraderm.
c.
low-dose estrogens.
d.
Premarin vaginal.

Answer 5

D

Question 6

6. A patient with osteopenia asks a nurse about the benefits of hormone therapy in preventing osteoporosis. Which statement by the nurse is correct?
   a.
   “Estrogen can help reverse bone loss.”
   b.
   “Hormone therapy increases bone resorption.”
   c.
   “Hormone therapy does not decrease fracture risk.”
   d.
   “When hormone therapy is discontinued, bone mass is qui

Answer 6

D

Question 7

7. A patient who will begin combination estrogen/progestin therapy (EPT) for menopause asks the nurse why she can’t take an estrogen-only preparation. The patient has not had a hysterectomy, has a slightly increased risk of cardiovascular disease, and has mild osteopenia. The nurse will tell her that the progestin is necessary to:
   a.
   decrease her risk of endometrial cancer.
   b.
   increase bone resorption to prevent fractures.
   c.
   lower her risk of myocardial infarction (MI).
   d.
   prevent deep vein thrombosis (DVT).

Answer 7

A

Question 8

8.	The nurse is providing patient education about the application of transdermal estrogen spray. Which statement made by the patient best demonstrates understanding of the application of this medication? “I should apply this medication to my:
a.
waistline and shoulders.”
b.
abdomen and arms.”
c.
breasts and abdomen.”
d.
thighs and calves.”

Answer 8

D

Question 9

1.	According to studies of estrogen/progestin therapy (EPT), what are its known benefits? (Select all that apply.)
a.
Cardiovascular protection in older patients
b.
Decreased osteoporosis risk
c.
Glycemic control
d.
Improved wound healing
e.
Prevention of colorectal cancer

Answer 9

B. C. D.

Question 10

2.	The nurse is providing patient education for a postmenopausal patient who is considering EPT. Which risks associated with EPT should the nurse discuss with the patient? (Select all that apply.)
a.
Increased colon cancer
b.
Stroke
c.
Deep vein thrombosis
d.
Ovarian cancer
e.
Decreased bone density

Answer 10

B. C. D