TEST BANK LEHNE’S PHARMACOLOGY
CHAPTERS 61-65
Chapter 61: Estrogens and Progestins: Basic
Pharmacology and Non-contraceptive Applications
MULTIPLE CHOICE
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.
ANS: D
Transdermal preparations of estrogen have fewer adverse effects, use lower doses of
estrogen, and have less fluctuation of estrogen levels than do oral preparations.
Progesterone is contraindicated in women who have undergone hysterectomy.
Intravaginal preparations are most useful for treating local estrogen deficiency such as
vaginal and vulvar atrophy. Side effects of ET are the same at the patient’s age as for
other women using ET.
DIF: Cognitive Level: Application REF: Estrogens | Routes of
Administration | Transdermal TOP: Nursing Process: Planning
MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
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.
ANS: D
Raloxifene can induce hot flashes in patients taking the drug. It increases the risk for
thromboembolism. It protects against breast cancer and does not pose a risk of uterine
cancer.
, DIF: Cognitive Level: Application REF: Selective Estrogen Receptor
Modulators (SERMS) TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
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.”
ANS: C
For patients who have undergone hysterectomy, progestin is unnecessary; estrogen-
only preparations still carry increased risk of breast cancer and should be taken in the
lowest effective dose for the shortest time possible. Even though uterine cancer is no
longer a possibility, breast cancer is still a risk. Studies have shown no protection
against coronary heart disease but increased risk of stroke and breast cancer with
estrogens.
DIF: Cognitive Level: Application REF: Menopausal Hormone Therapy |
Landmark Studies: WHI and HERS TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
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 osteoporosis.”
ANS: D
ET can be used to suppress menopausal symptoms and to prevent osteoporosis, but it
carries risks of breast cancer and stroke, while conferring no preventive benefit for
coronary heart disease. ET does not reverse osteoporosis but may help prevent it. EPT
is not safer than ET; progestins appear to increase the risk of breast cancer. EPT does
not prevent MI in patients with coronary heart disease.
, DIF: Cognitive Level: Application REF: Estrogens | Physiologic and
Pharmacologic Effects TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
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 asks her provider about:
a. Depo Provera.
b. Estraderm.
c. low-dose estrogens.
d. Premarin vaginal.
ANS: D
Estrogens for intravaginal administration are used for local effects, primarily to treat
vulval and vaginal atrophy. Because these preparations bypass the liver, the total dose
is reduced and there is a lower risk of systemic effects. Depo Provera is a
progesterone and is not indicated. Transdermal estrogen is used to treat hot flushes.
Low-dose estrogens still have systemic effects.
DIF: Cognitive Level: Application REF: Estrogens | Routes of
Administration TOP: Nursing Process: Implementation MSC:
NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential
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 quickly lost.”
ANS: D
Benefits of HT for patients with osteopenia are not permanent; bone loss resumes
when HT is discontinued. HT does not reverse bone loss that has already occurred.
HT reduces bone resorption. HT can decrease fracture risk by a small amount.
DIF: Cognitive Level: Application REF: Benefits of Hormone Therapy |
Prevention of Osteoporosis and Related Fractures TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
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
CHAPTERS 61-65
Chapter 61: Estrogens and Progestins: Basic
Pharmacology and Non-contraceptive Applications
MULTIPLE CHOICE
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.
ANS: D
Transdermal preparations of estrogen have fewer adverse effects, use lower doses of
estrogen, and have less fluctuation of estrogen levels than do oral preparations.
Progesterone is contraindicated in women who have undergone hysterectomy.
Intravaginal preparations are most useful for treating local estrogen deficiency such as
vaginal and vulvar atrophy. Side effects of ET are the same at the patient’s age as for
other women using ET.
DIF: Cognitive Level: Application REF: Estrogens | Routes of
Administration | Transdermal TOP: Nursing Process: Planning
MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
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.
ANS: D
Raloxifene can induce hot flashes in patients taking the drug. It increases the risk for
thromboembolism. It protects against breast cancer and does not pose a risk of uterine
cancer.
, DIF: Cognitive Level: Application REF: Selective Estrogen Receptor
Modulators (SERMS) TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
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.”
ANS: C
For patients who have undergone hysterectomy, progestin is unnecessary; estrogen-
only preparations still carry increased risk of breast cancer and should be taken in the
lowest effective dose for the shortest time possible. Even though uterine cancer is no
longer a possibility, breast cancer is still a risk. Studies have shown no protection
against coronary heart disease but increased risk of stroke and breast cancer with
estrogens.
DIF: Cognitive Level: Application REF: Menopausal Hormone Therapy |
Landmark Studies: WHI and HERS TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
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 osteoporosis.”
ANS: D
ET can be used to suppress menopausal symptoms and to prevent osteoporosis, but it
carries risks of breast cancer and stroke, while conferring no preventive benefit for
coronary heart disease. ET does not reverse osteoporosis but may help prevent it. EPT
is not safer than ET; progestins appear to increase the risk of breast cancer. EPT does
not prevent MI in patients with coronary heart disease.
, DIF: Cognitive Level: Application REF: Estrogens | Physiologic and
Pharmacologic Effects TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
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 asks her provider about:
a. Depo Provera.
b. Estraderm.
c. low-dose estrogens.
d. Premarin vaginal.
ANS: D
Estrogens for intravaginal administration are used for local effects, primarily to treat
vulval and vaginal atrophy. Because these preparations bypass the liver, the total dose
is reduced and there is a lower risk of systemic effects. Depo Provera is a
progesterone and is not indicated. Transdermal estrogen is used to treat hot flushes.
Low-dose estrogens still have systemic effects.
DIF: Cognitive Level: Application REF: Estrogens | Routes of
Administration TOP: Nursing Process: Implementation MSC:
NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential
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 quickly lost.”
ANS: D
Benefits of HT for patients with osteopenia are not permanent; bone loss resumes
when HT is discontinued. HT does not reverse bone loss that has already occurred.
HT reduces bone resorption. HT can decrease fracture risk by a small amount.
DIF: Cognitive Level: Application REF: Benefits of Hormone Therapy |
Prevention of Osteoporosis and Related Fractures TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
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
