menopause Flashcards
1
Q
44. The average onset of perimenopause in North American women is between the ages of: A. 35 to 40 years. B. 40 to 45 years. C. 45 to 50 years. D. 50 to 55 years.
A
B. 40 to 45 years.
2
Q
- Which of the following statements regarding
perimenopause is false?
A. Menstruation ceases during perimenopause.
B. Hot flashes and flushes are common during the
week before menses.
C. Pregnancy is still possible during perimenopause.
D. Ovulation becomes more erratic during
perimenopause.
A
A. Menstruation ceases during perimenopause.
3
Q
- In advising a woman about menopause, the NP
considers that:
A. the average age at last menstrual period for a North
American woman is 47 to 48 years.
B. hot flashes and night sweats occur in about 60% to
90% of women.
C. women with surgical menopause usually have
milder symptoms.
D. follicle-stimulating hormone (FSH) and luteinizing
hormone (LH) levels are suppressed.
A
B. hot flashes and night sweats occur in about 60% to
90% of women.
4
Q
- Findings in estrogen deficiency (atrophic) vaginitis
include:
A. a malodorous vaginal discharge.
B. an increased number of lactobacilli.
C. a reduced number of white blood cells.
D. a pH greater than 5.0.
A
D. a pH greater than 5.0.
5
Q
- A 53-year-old woman who is taking hormone therapy (HT) with conjugated estrogen, 0.45 mg/day, with medroxyprogesterone acetate (MPA), 1.5 mg, has
bothersome atrophic vaginitis symptoms. You
advise that:
A. her oral estrogen dose should be increased.
B. the addition of a topical estrogen can be helpful.
C. the MPA component should be discontinued.
D. baking soda douche should be tried.
A
B. the addition of a topical estrogen can be helpful.
6
Q
49. For a woman with bothersome hot flashes who cannot take HT, alternative options with demonstrated efficacy and limited adverse effects include the use of all of the following except: A. venlafaxine. B. sertraline. C. gabapentin. D. clonidine.
A
D. clonidine.
7
Q
50. Absolute contraindications to postmenopausal HT include: A. unexplained vaginal bleeding. B. seizure disorder. C. dyslipidemia. D. migraine headache.
A
A. unexplained vaginal bleeding.
8
Q
- In advising a perimenopausal woman about HT, you
consider that it can:
A. reduce the risk of venous thrombotic events.
B. significantly reduce serum triglyceride levels.
C. worsen hypertension in most women.
D. help preserve bone density.
A
D. help preserve bone density.
9
Q
- Postmenopausal HT use usually results in:
A. a reduction in the rate of cardiovascular disease.
B. an increase in the rate of rheumatoid arthritis.
C. a reduction in the frequency and severity of
vasomotor symptoms.
D. a disturbance in sleep patterns.
A
C. a reduction in the frequency and severity of
vasomotor symptoms.
10
Q
- The progestin component of HT is given to:
A. counteract the negative lipid effects of estrogen.
B. minimize endometrial hyperplasia.
C. help with vaginal atrophy symptoms.
D. prolong ovarian activity.
A
B. minimize endometrial hyperplasia.
11
Q
- Concerning selective estrogen receptor modulator
therapy such as raloxifene (Evista®), which of the
following statements is correct?
A. Concurrent progestin opposition is needed.
B. Hot flashes are reduced in frequency and severity.
C. Use is contraindicated when a woman has a history
of breast cancer.
D. Osteoporosis risk is reduced with use.
A
D. Osteoporosis risk is reduced with use.
12
Q
- During perimenopause, which of the following is likely to be noted?
A. The length of the menstrual cycle and duration of
menstrual flow are often unpredictable.
B. The length of the perimenopausal period is predictable.
C. Symptoms are less severe in women who smoke.
D. Hot flashes are uncommon.
A
A. The length of the menstrual cycle and duration of
menstrual flow are often unpredictable.
13
Q
56. A 48-year-old woman complains of increased frequency and severity of hot flashes. Her last menses occurred 6 months ago. You would expect all of the following laboratory findings except: A. increased levels of LH. B. elevated levels of testosterone. C. reduced levels of estradiol. D. reduced levels of progesterone.
A
B. elevated levels of testosterone.
14
Q
- Which of the following is likely to be noted with
short-term (less than 1 to 2 years) HT use in a
postmenopausal woman?
A. reduction in dementia risk
B. significant increase in breast cancer risk
C. minimized hot flashes
D. increase in cardiovascular risk
A
C. minimized hot flashes
15
Q
58. Which body area has the greatest concentration of estrogen receptors? A. vulva B. vascular bed C. heart D. brain
A
A. vulva
16
Q
- When counseling a 46-year-old woman who is experiencing debilitating hot flashes, you advise all of the following regarding higher- and lower-dose hormone replacement therapy except:
A. current clinical guidelines recommend using the
lowest effective dose possible.
B. higher-dose HT will relieve hot flashes faster than
lower-dose regimens.
C. lower-dose HT is better tolerated than higherdose
HT.
D. the duration of lower-dose HT is usually shorter
than that of higher-dose regimens.
A
D. the duration of lower-dose HT is usually shorter
than that of higher-dose regimens.
17
Q
- You see a 51-year-old woman who is considering
HT. She has a family history of endometrial cancer,
hyperlipidemia, and VTE. You advise her on all of the
following except:
A. the use of progestin can minimize the risk of
endometrial cancer for a woman on HT and who
has not had a hysterectomy.
B. supplemental estrogen should be avoided in women who are at high risk of breast cancer or uterine
cancer.
C. supplemental estrogen should be avoided in women who are at high risk of cardiovascular disease.
D. short-term studies demonstrate that oral HT is
associated with lower thromboembolic risk than
transdermal forms of HT.
A
D. short-term studies demonstrate that oral HT is
associated with lower thromboembolic risk than
transdermal forms of HT.
18
Q
61. Examples of phytoestrogens include all of the following except: A. red clover. B. ginseng. C. vitamin E. D. soy products.
A
C. vitamin E.
19
Q
62. The typical HT regimen contains \_\_\_\_ or less of the estrogen dose of COC. A. one-eighth B. one-fourth C. one-half D. three-fourths
A
B. one-fourth
20
Q
63. For the woman with a history of DVT who is having significant vasomotor symptoms, which of the following can be can be used for symptom management? A. 17β-estradiol patch B. drospirenone C. estrone. D. paroxetine.
A
D. paroxetine.
21
Q
64. Long-term calcium supplementation is recommended in postmenopausal women as its use reduces the risk of fracture by approximately: A. 25%. B. 50%. C. 65%. D. 80%.
A
B. 50%.
22
Q
65. In postmenopausal women, a major benefit from the use of topical or local estrogen is: A. decreased rate of breast cancer. B. reduced risk of recurrent UTIs. C. reduced risk of type 2 diabetes. D. increased levels of androgens.
A
B. reduced risk of recurrent UTIs.
23
Q
- When reviewing the use of nutritional supplements for the management of menopausal symptoms, the NP
considers that:
A. few high-quality studies support the use of these
products.
B. the use of these products is consistently reported
to be helpful.
C. the products can be safely used as long as blood
hormone levels are carefully evaluated.
D. the use of these products is associated with a greater reduction in menopausal symptoms than with
prescription HT.
A
A. few high-quality studies support the use of these
products.
24
Q
- A 51-year-old woman is using a vaginal estrogen
preparation with effect to manage localized menopause symptoms. Anticipated effects of this therapy include a potential for:
A. lower rate of urinary tract infection.
B. endometrial atrophy.
C. fewer vasomotor symptoms.
D. resumption of menses.
A
A. lower rate of urinary tract infection.
25
Q
- Which of the following statements is true?
A. Many over-the-counter progesterone creams
contain sterols that the human body is unable
to use.
B. All progesterones are easily absorbed via
the skin.
C. Alfalfa is an example of a phytoprogesterone.
D. Progesterones, whether synthetic or plant-based,
should not be used by a woman who has undergone
a hysterectomy.
A
A. Many over-the-counter progesterone creams
contain sterols that the human body is unable
to use.
