NR 568 Final Exam: (Latest 2026/2027 Update) HRT, Contraceptives,
Androgens, ED, BPH, STIs, Parkinson's & Seizure Medications | Q&A | Grade
A | 100% Correct (Verified Answers) – Nursing Program
Subject: NR 568 Final Exam – Hormone Replacement Therapy, Contraceptives, Testosterone, Erectile
Dysfunction, Benign Prostatic Hyperplasia, Sexually Transmitted Infections, Parkinson's Disease, and
Seizure Medications
Source: NR 568 Course Materials / Latest 2026/2027 NCLEX/HESI Pharmacology Blueprint
Format: Q&A Guide with Rationale
1: How does hormone replacement therapy (HRT) help prevent osteoporosis, and when is it
recommended?
Correct Answer: Estrogen therapy helps maintain bone density and prevent osteoporosis in
postmenopausal women. HRT is only recommended when the benefits outweigh the risks.
1. Estrogen inhibits bone resorption by suppressing osteoclast activity, preserving bone mineral
density and reducing fracture risk.
2. HRT is indicated for prevention of osteoporosis in postmenopausal women at high risk who
cannot take non-estrogen medications.
3. Risks include VTE, stroke, and breast cancer; therapy should be used at lowest effective dose
for shortest duration.
2: When should progestin be added to hormone replacement therapy, and when is it unnecessary?
Correct Answer: Progestin should be added to estrogen therapy in women with an intact uterus to
prevent endometrial hyperplasia and reduce risk of endometrial cancer. It is unnecessary in women
without a uterus.
1. Unopposed estrogen stimulates endometrial proliferation, increasing endometrial cancer risk 2-
12 fold in women with an intact uterus.
2. Progestin counteracts endometrial growth by inducing secretory transformation and regular
shedding.
3. Hysterectomized women have no endometrial tissue, so progestin provides no benefit while
adding adverse effects (bloating, mood changes).
3: What are local estrogen options and what are they used for?
Correct Answer: Examples include vaginal rings and creams, used for genitourinary symptoms like
vaginal dryness without significant systemic effects.
1. Low-dose vaginal estrogen (ring, cream, tablet) provides local estrogen effect to reversal of
urogenital atrophy.
2. Systemic absorption is minimal, avoiding the thromboembolic and breast cancer risks
associated with oral estrogen.
3. Indications: dyspareunia, vaginal dryness, recurrent UTIs, and urinary urgency/frequency in
postmenopausal women.
, 4: What are systemic estrogen options and what are they used for?
Correct Answer: Examples include transdermal patches and oral formulations, used for generalized
menopausal symptoms such as hot flashes and prevention of osteoporosis.
1. Systemic estrogen reaches therapeutic blood levels affecting multiple organ systems, relieving
vasomotor symptoms (hot flashes, night sweats).
2. Oral estradiol is convenient but undergoes first-pass hepatic metabolism, increasing clotting
factor and triglyceride production.
3. Systemic therapy is also approved for osteoporosis prevention when other agents are not
appropriate.
5: What are transdermal estrogen options and what are their advantages?
Correct Answer: Transdermal estrogen options have fewer adverse effects compared to oral estrogen
and have a reduced risk of venous thromboembolism and stroke.
1. Transdermal estrogen bypasses first-pass hepatic metabolism, avoiding stimulation of hepatic
clotting factor synthesis.
2. Studies show patch users have VTE risk similar to non-users, whereas oral estrogen increases
risk 2-3 fold.
3. Transdermal route also avoids triglyceride elevation and maintains more stable serum estradiol
levels.
6: Which Selective Estrogen Receptor Modulator (SERM) is used to treat osteoporosis?
Correct Answer: Bazedoxifene – benefits bones and protects against breast cancer.
1. Bazedoxifene is a SERM with estrogen-agonist effects on bone (increasing BMD, reducing
vertebral fractures) and antagonist effects on breast and endometrium.
2. It is approved for osteoporosis prevention and treatment in postmenopausal women, often
combined with conjugated estrogens (Duavee).
3. Unlike raloxifene, bazedoxifene does not increase VTE risk when used alone at standard doses.
7: How do you change a patient from one combination oral contraceptive to another?
Correct Answer: Switch after the last active pill of the previous pack without a break.
1. Continuous active pill switching maintains ovarian suppression without allowing follicular
development or ovulation to resume.
2. A 7-day placebo/break would risk breakthrough ovulation and unintended pregnancy during the
transition.
3. If switching due to adverse effects, monitor for symptom improvement over 2-3 cycles before
considering another change.
Androgens, ED, BPH, STIs, Parkinson's & Seizure Medications | Q&A | Grade
A | 100% Correct (Verified Answers) – Nursing Program
Subject: NR 568 Final Exam – Hormone Replacement Therapy, Contraceptives, Testosterone, Erectile
Dysfunction, Benign Prostatic Hyperplasia, Sexually Transmitted Infections, Parkinson's Disease, and
Seizure Medications
Source: NR 568 Course Materials / Latest 2026/2027 NCLEX/HESI Pharmacology Blueprint
Format: Q&A Guide with Rationale
1: How does hormone replacement therapy (HRT) help prevent osteoporosis, and when is it
recommended?
Correct Answer: Estrogen therapy helps maintain bone density and prevent osteoporosis in
postmenopausal women. HRT is only recommended when the benefits outweigh the risks.
1. Estrogen inhibits bone resorption by suppressing osteoclast activity, preserving bone mineral
density and reducing fracture risk.
2. HRT is indicated for prevention of osteoporosis in postmenopausal women at high risk who
cannot take non-estrogen medications.
3. Risks include VTE, stroke, and breast cancer; therapy should be used at lowest effective dose
for shortest duration.
2: When should progestin be added to hormone replacement therapy, and when is it unnecessary?
Correct Answer: Progestin should be added to estrogen therapy in women with an intact uterus to
prevent endometrial hyperplasia and reduce risk of endometrial cancer. It is unnecessary in women
without a uterus.
1. Unopposed estrogen stimulates endometrial proliferation, increasing endometrial cancer risk 2-
12 fold in women with an intact uterus.
2. Progestin counteracts endometrial growth by inducing secretory transformation and regular
shedding.
3. Hysterectomized women have no endometrial tissue, so progestin provides no benefit while
adding adverse effects (bloating, mood changes).
3: What are local estrogen options and what are they used for?
Correct Answer: Examples include vaginal rings and creams, used for genitourinary symptoms like
vaginal dryness without significant systemic effects.
1. Low-dose vaginal estrogen (ring, cream, tablet) provides local estrogen effect to reversal of
urogenital atrophy.
2. Systemic absorption is minimal, avoiding the thromboembolic and breast cancer risks
associated with oral estrogen.
3. Indications: dyspareunia, vaginal dryness, recurrent UTIs, and urinary urgency/frequency in
postmenopausal women.
, 4: What are systemic estrogen options and what are they used for?
Correct Answer: Examples include transdermal patches and oral formulations, used for generalized
menopausal symptoms such as hot flashes and prevention of osteoporosis.
1. Systemic estrogen reaches therapeutic blood levels affecting multiple organ systems, relieving
vasomotor symptoms (hot flashes, night sweats).
2. Oral estradiol is convenient but undergoes first-pass hepatic metabolism, increasing clotting
factor and triglyceride production.
3. Systemic therapy is also approved for osteoporosis prevention when other agents are not
appropriate.
5: What are transdermal estrogen options and what are their advantages?
Correct Answer: Transdermal estrogen options have fewer adverse effects compared to oral estrogen
and have a reduced risk of venous thromboembolism and stroke.
1. Transdermal estrogen bypasses first-pass hepatic metabolism, avoiding stimulation of hepatic
clotting factor synthesis.
2. Studies show patch users have VTE risk similar to non-users, whereas oral estrogen increases
risk 2-3 fold.
3. Transdermal route also avoids triglyceride elevation and maintains more stable serum estradiol
levels.
6: Which Selective Estrogen Receptor Modulator (SERM) is used to treat osteoporosis?
Correct Answer: Bazedoxifene – benefits bones and protects against breast cancer.
1. Bazedoxifene is a SERM with estrogen-agonist effects on bone (increasing BMD, reducing
vertebral fractures) and antagonist effects on breast and endometrium.
2. It is approved for osteoporosis prevention and treatment in postmenopausal women, often
combined with conjugated estrogens (Duavee).
3. Unlike raloxifene, bazedoxifene does not increase VTE risk when used alone at standard doses.
7: How do you change a patient from one combination oral contraceptive to another?
Correct Answer: Switch after the last active pill of the previous pack without a break.
1. Continuous active pill switching maintains ovarian suppression without allowing follicular
development or ovulation to resume.
2. A 7-day placebo/break would risk breakthrough ovulation and unintended pregnancy during the
transition.
3. If switching due to adverse effects, monitor for symptom improvement over 2-3 cycles before
considering another change.
