Lecture 12: Reproduction Flashcards
A nurse is educating a patient about the risks of estrogen therapy. Which patient condition would contraindicate this therapy?
A) Postmenopausal osteoporosis
B) Recurrent deep vein thrombosis
C) Polycystic ovary syndrome
D) Dysfunctional uterine bleeding
B) Recurrent deep vein thrombosis
Explanation: Estrogen therapy is contraindicated in patients with a history of clotting disorders, such as DVT, due to the increased risk of thromboembolic events.
A patient is started on progestin-only oral contraceptives. What should the nurse include in the patient teaching?
A) Backup contraception is unnecessary after the first dose.
B) Withdrawal bleeding is expected monthly.
C) The medication must be taken continuously without breaks.
D) It has a higher efficacy rate than combination oral contraceptives.
C) The medication must be taken continuously without breaks.
Explanation: Progestin-only pills are taken daily and continuously without placebo days to maintain efficacy.
A patient taking combination oral contraceptives develops sudden chest pain and shortness of breath. What is the nurse’s priority action?
A) Instruct the patient to stop the medication immediately.
B) Administer oxygen and prepare for rapid transport.
C) Obtain an electrocardiogram.
D) Ask about the patient’s compliance with the medication regimen.
B) Administer oxygen and prepare for rapid transport.
Explanation: Sudden chest pain and shortness of breath may indicate a pulmonary embolism, a medical emergency often linked to thromboembolic events from contraceptive use.
A patient with a history of breast cancer is prescribed medication for hot flashes. Which drug should the nurse question?
A) Estrogen therapy
B) Non-hormonal alternatives
C) Progestin-only therapy
D) Selective serotonin reuptake inhibitors (SSRIs)
A) Estrogen therapy
Explanation: Estrogen therapy is contraindicated in patients with estrogen-dependent cancers, such as breast cancer.
A nurse is explaining the role of luteinizing hormone (LH) in the menstrual cycle. What is its primary function?
A) Supporting endometrial thickening for implantation
B) Stimulating follicular development
C) Triggering ovulation and forming the corpus luteum
D) Regulating estrogen and progesterone synthesis
C) Triggering ovulation and forming the corpus luteum
Explanation: LH surge triggers ovulation and the transformation of the follicle into the corpus luteum, which secretes progesterone.
A patient with benign prostatic hyperplasia (BPH) is prescribed finasteride. Which patient teaching point is most important?
A) “This medication is safe to take during pregnancy.”
B) “Avoid donating blood while on this medication.”
C) “Take this medication only as needed for symptoms.”
D) “Expect improvement in symptoms within one week.”
B) “Avoid donating blood while on this medication.”
Explanation: Finasteride is teratogenic to male fetuses. Blood donation poses a risk if a pregnant individual receives the blood.
A nurse is discussing the side effects of combination oral contraceptives (OCs) with a patient. Which adverse effect should be emphasized?
A) Risk of bacterial infections
B) Weight loss
C) Thromboembolic events
D) Hyperthyroidism
C) Thromboembolic events
Explanation: Combination OCs can increase the risk of thromboembolic events, especially in smokers or those with clotting disorders.
A nurse is reviewing the mechanism of action of alpha-1 adrenergic antagonists in treating BPH. Which statement accurately describes their effect?
A) Shrinks the size of the prostate gland
B) Reduces smooth muscle tone in the bladder neck
C) Decreases testosterone production
D) Increases urinary pH
B) Reduces smooth muscle tone in the bladder neck
Explanation: Alpha-1 adrenergic antagonists relax smooth muscle in the bladder neck and prostate, relieving dynamic obstruction.
A nurse educates a patient on starting extended-cycle oral contraceptives. What is an expected benefit of this regimen?
A) Monthly menstrual periods
B) Increased risk of thromboembolic events
C) Reduced frequency of withdrawal bleeding
D) No need for backup contraception during the first cycle
C) Reduced frequency of withdrawal bleeding
Explanation: Extended-cycle OCs result in fewer withdrawal bleeding episodes, typically every three months.
A 50-year-old patient with symptoms of BPH asks why finasteride is prescribed instead of an alpha-1 blocker. What is the nurse’s best response?
A) “Finasteride works quickly to relieve symptoms.”
B) “It relaxes the smooth muscles of the prostate.”
C) “Finasteride is more effective for significantly enlarged prostates.”
D) “This drug improves urinary flow immediately.”
C) “Finasteride is more effective for significantly enlarged prostates.”
Explanation: Finasteride reduces the size of the prostate by inhibiting the conversion of testosterone to DHT, making it ideal for larger prostates.
A nurse is caring for a patient taking estrogen for hormone replacement therapy. Which adverse effect should the nurse prioritize monitoring?
A) Weight gain
B) Endometrial hyperplasia
C) Urinary retention
D) Hypotension
B) Endometrial hyperplasia
Explanation: Estrogen can cause endometrial hyperplasia, increasing the risk of endometrial cancer if not balanced with progestin.
A patient taking oral contraceptives is prescribed rifampin for tuberculosis. What adjustment is necessary?
A) Decrease the dose of oral contraceptives
B) Use an additional barrier method of contraception
C) Switch to progestin-only contraceptives
D) Stop rifampin to maintain contraceptive efficacy
B) Use an additional barrier method of contraception
Explanation: Rifampin induces cytochrome P450 enzymes, reducing OC efficacy. A barrier method is recommended.
A nurse is teaching a patient about the non-contraceptive benefits of combination oral contraceptives. Which benefit should be included?
A) Increased bone density
B) Protection against thromboembolic events
C) Decreased risk of ovarian and endometrial cancer
D) Prevention of estrogen-dependent cancers
C) Decreased risk of ovarian and endometrial cancer
Explanation: Combination OCs reduce the risk of ovarian and endometrial cancer through hormone regulation.
A nurse assesses a patient with BPH taking an alpha-1 blocker. What adverse effect should the nurse monitor for?
A) Urinary incontinence
B) Hypertension
C) Orthostatic hypotension
D) Vision changes
C) Orthostatic hypotension
Explanation: Alpha-1 blockers relax smooth muscles but can also reduce blood pressure, leading to orthostatic hypotension.
A patient reports irregular bleeding while on a progestin-only contraceptive. What should the nurse explain?
A) “This is a normal side effect of progestin-only pills.”
B) “You may need to switch to combination oral contraceptives.”
C) “Irregular bleeding indicates the medication is not effective.”
D) “You should stop taking the medication immediately.”
A) “This is a normal side effect of progestin-only pills.”
Explanation: Irregular bleeding is a common, non-dangerous side effect of progestin-only contraceptives.
A nurse is discussing contraceptive options with a patient who smokes and is over 35 years old. Which option should the nurse recommend avoiding?
A) Combination oral contraceptives
B) Progestin-only pills
C) Copper intrauterine device (IUD)
D) Barrier methods
A) Combination oral contraceptives
Explanation: Smokers over 35 have an increased risk of thromboembolic events when taking combination oral contraceptives.
A patient using progestin-only pills forgets to take a dose. What is the nurse’s best advice?
A) “Take the missed pill as soon as possible and use backup contraception for 48 hours.”
B) “Skip the missed dose and continue with the next scheduled pill.”
C) “Discontinue the medication and restart on your next cycle.”
D) “Take two pills at your next scheduled dose.”
A) “Take the missed pill as soon as possible and use backup contraception for 48 hours.”
Explanation: Progestin-only pills require strict adherence; backup contraception is needed after a missed dose.
A nurse educates a patient about estrogen’s mechanism of action. Which effect of estrogen should be included?
A) Preventing endometrial thickening
B) Promoting bone resorption
C) Increasing clotting factors in the liver
D) Reducing vascular inflammation
C) Increasing clotting factors in the liver
Explanation: Estrogen increases clotting factor production, contributing to thromboembolic risks.
A patient with BPH reports dizziness after starting tamsulosin. What is the most likely cause?
A) Urethral irritation
B) Hypotension due to alpha-1 receptor blockade
C) Increased prostate size
D) Fluid retention
B) Hypotension due to alpha-1 receptor blockade
Explanation: Tamsulosin, an alpha-1 blocker, can cause dizziness due to its blood pressure-lowering effects.
A nurse is educating a patient about long-acting reversible contraceptives (LARCs). Which option is included in this category?
A) Transdermal patch
B) Vaginal ring
C) Copper intrauterine device (IUD)
D) Progestin-only pills
C) Copper intrauterine device (IUD)
Explanation: LARCs include devices like IUDs and implants, which provide long-term contraception without daily dosing.
A nurse explains the action of finasteride to a patient with BPH. What is the correct explanation?
A) “It relaxes prostate smooth muscle.”
B) “It reduces the size of the prostate gland over time.”
C) “It increases urine flow immediately.”
D) “It stimulates testosterone production.”
B) “It reduces the size of the prostate gland over time.”
Explanation: Finasteride decreases DHT levels, causing prostate shrinkage and relief of mechanical obstruction.
A patient on oral contraceptives is prescribed an antiepileptic drug. What is the most important nursing intervention?
A) Reinforce the need for consistent OC use.
B) Recommend switching to a higher estrogen dose.
C) Educate on the use of additional barrier contraception.
D) Encourage adherence to antiepileptic therapy.
C) Educate on the use of additional barrier contraception.
Explanation: Antiepileptics induce CYP450 enzymes, reducing OC effectiveness. Backup methods are necessary.
A nurse assesses a patient for BPH symptoms. Which finding supports the diagnosis?
A) Urinary incontinence
B) Decreased urine stream force
C) Hematuria
D) Pain during ejaculation
B) Decreased urine stream force
Explanation: BPH commonly causes weak urine flow due to mechanical or dynamic obstruction of the urethra.
A patient with a history of migraines is prescribed combination oral contraceptives. What action should the nurse take?
A) Instruct the patient to avoid smoking.
B) Monitor for worsening migraines.
C) Educate about increased stroke risk.
D) All of the above
D) All of the above
Explanation: Migraines, especially with aura, increase stroke risk when using combination OCs. Smoking exacerbates this risk.
A patient considering hormonal contraception asks about its mechanism of action. What is the correct response?
A) “It prevents sperm from reaching the egg by thickening cervical mucus.”
B) “It stops egg production by suppressing FSH and LH.”
C) “It destroys sperm in the reproductive tract.”
D) “It changes uterine pH to make it inhospitable for sperm.”
B) “It stops egg production by suppressing FSH and LH.”
Explanation: Hormonal contraception suppresses ovulation by inhibiting FSH and LH secretion.
A patient on finasteride asks about symptom improvement. What is the nurse’s best response?
A) “You should notice a change within 48 hours.”
B) “Symptoms improve gradually over several months.”
C) “If symptoms persist after one week, contact your doctor.”
D) “The medication works immediately.”
B) “Symptoms improve gradually over several months.”
Explanation: Finasteride’s effects take time, as it reduces DHT levels to shrink the prostate.
A nurse is counseling a patient about barrier methods of contraception. Which statement indicates the patient needs further teaching?
A) “Barrier methods protect against most sexually transmitted infections.”
B) “Condoms must be used consistently and correctly to be effective.”
C) “The diaphragm should be left in place for at least 6 hours after intercourse.”
D) “Spermicides can enhance the effectiveness of barrier methods.”
A) “Barrier methods protect against most sexually transmitted infections.”
Explanation: While condoms protect against STIs, not all barrier methods, like diaphragms, offer STI protection.
A nurse is teaching a patient about the adverse effects of oral contraceptives. Which symptom should the patient report immediately?
A) Breast tenderness
B) Mild nausea
C) Unilateral leg swelling and pain
D) Spotting between periods
C) Unilateral leg swelling and pain
Explanation: This could indicate a deep vein thrombosis (DVT), a serious adverse effect of oral contraceptives.
A patient asks how the copper IUD prevents pregnancy. Which is the nurse’s best response?
A) “It prevents ovulation by suppressing FSH and LH.”
B) “It creates a physical barrier to sperm.”
C) “It causes a localized inflammatory reaction toxic to sperm and ova.”
D) “It thickens cervical mucus, making it difficult for sperm to enter.”
C) “It causes a localized inflammatory reaction toxic to sperm and ova.”
Explanation: The copper IUD induces a spermicidal inflammatory response in the uterus.
A nurse is educating a patient on progestin-only pills. Which statement by the patient demonstrates understanding?
A) “I should take this pill at the same time every day.”
B) “This pill will cause monthly withdrawal bleeding.”
C) “I don’t need additional contraception if I miss a pill.”
D) “This method has a higher effectiveness than combination pills.”
A) “I should take this pill at the same time every day.”
Explanation: Progestin-only pills require strict timing for maximum effectiveness.
A patient with a history of abnormal vaginal bleeding is considering oral contraceptives. What should the nurse assess before recommending a method?
A) Liver function tests
B) Smoking history
C) Cause of the abnormal bleeding
D) Family planning goals
C) Cause of the abnormal bleeding
Explanation: Abnormal bleeding must be evaluated to rule out contraindications, such as cancer.
A nurse explains why extended-cycle oral contraceptives are beneficial for some patients. Which condition might benefit most from this method?
A) Polycystic ovary syndrome
B) Endometriosis
C) Fibroids
D) Irregular cycles
B) Endometriosis
Explanation: Extended-cycle OCs reduce the frequency of withdrawal bleeding, alleviating endometriosis symptoms.
A patient with BPH is prescribed tamsulosin. Which patient condition requires the nurse to question the prescription?
A) Hypertension
B) Chronic kidney disease
C) Severe hypotension
D) Erectile dysfunction
C) Severe hypotension
Explanation: Tamsulosin, an alpha-1 blocker, can exacerbate hypotension due to its vasodilatory effects.
A nurse is teaching a group about estrogen receptor locations. Which system has the least expression of beta receptors?
A) Prostate
B) Bones
C) Blood vessels
D) Lungs
C) Blood vessels
Explanation: Beta receptors are less expressed in blood vessels compared to other systems.
A nurse discusses the effects of progestin on cervical mucus. What is the primary action?
A) Thins cervical mucus to facilitate sperm passage
B) Thickens cervical mucus to inhibit sperm penetration
C) Alters cervical pH to create a hostile environment for sperm
D) Reduces cervical mucus production
B) Thickens cervical mucus to inhibit sperm penetration
Explanation: Progestin increases cervical mucus viscosity, preventing sperm from entering the uterus.
A patient using oral contraceptives reports nausea. What is the nurse’s best advice?
A) “Take the pill at bedtime or with food.”
B) “Skip doses until the nausea subsides.”
C) “Stop taking the pill and consult your doctor.”
D) “Increase your fluid intake to alleviate nausea.”
A) “Take the pill at bedtime or with food.”
Explanation: Taking the pill with food or at bedtime can reduce nausea, a common side effect.
A nurse is counseling a patient about non-contraceptive benefits of combination oral contraceptives. Which benefit should be included?
A) Reduced risk of ovarian cancer
B) Decreased risk of thromboembolic events
C) Increased bone resorption
D) Weight loss
A) Reduced risk of ovarian cancer
Explanation: Combination OCs decrease ovarian cancer risk due to hormone regulation.
A nurse is teaching a patient about the differences between monophasic and triphasic oral contraceptives. Which is correct?
A) “Monophasic pills maintain a constant hormone dose throughout the cycle.”
B) “Triphasic pills are taken continuously without inactive pills.”
C) “Monophasic pills have higher failure rates than triphasic pills.”
D) “Triphasic pills reduce the risk of withdrawal bleeding.”
A) “Monophasic pills maintain a constant hormone dose throughout the cycle.”
Explanation: Monophasic OCs deliver a steady dose of hormones, while triphasic OCs vary doses.
