APEA Pharm- Women's Health Exam (100 out of 100) Questions and Verified Answers (Latest Update)

APEA Pharm- Women's Health Exam (100 out of 100) Questions and Verified Answers (Latest Update) Question: In the prevention of pregnancy, medroxyprogesterone acetate (Depo-Provera) should be administered at least every: 4 weeks. 8 weeks. 10 weeks. 12 weeks Answer:. 12 weeks. 13 week effectiveness Question: Patients taking oral contraceptives do NOT need to use a back-up method of contraception if taking: ampicillin. ketoconazole. phenytoin (Dilantin). metformin (Glucophage). metformin (Glucophage). Question: When initiating progestin-only contraceptives, women should be advised to: Answer:. take with food anytime of the day. resume with the next dose, if one dose is missed. immediately report irregular uterine bleeding. use a backup method of contraception for the first month. use a backup method of contraception for the first month. Question: The drug of choice to control mild abnormal uterine bleeding in a 25-year-old woman with future childbearing plans is: estrogen only. androgen therapy gonadotropin-releasing hormone analogs. progesterone only. Answer:. progesterone only. or a combination estrogen/progesterone therapy Question: The highest risk of deep vein thrombosis (DVT) is associated with combined estrogen and progesterone therapy that is administered via: the oral route. transdermal patch. intravaginal cream. intravaginal ring. Answer:. the oral route. Question: Combined contraceptive patches: Answer:. are replaced every 14 days. have fewer side effects than oral contraceptives. may not be as effective in women weighing more than 200 pounds. are safer than oral contraceptives in patients with hypertension. may not be as effective in women weighing more than 200 pounds. Question: Danazol is indicated in the treatment of: ectopic pregnancy. endometriosis. gonadal hypertrophy. ovulatory dysfunction. Answer:. endometriosis. Question: Which of the following would NOT be an appropriate choice for the treatment of primary dysmenorrhea in an 18-year-old woman? Nonsteroidal anti-inflammatory medications Oral contraceptives Vitamin B6 Intrauterine devices Answer:. Intrauterine devices all other 3 are first line IUD = last resort Question: A 23-year-old woman with a desire for pregnancy needs treatment for symptoms related to polycystic ovarian syndrome (PCOS). The initial choice is: liraglutide (Victoza). metformin (Glucophage). spironolactone (Aldactone). finasteride (Proscar). Answer:. metformin (Glucophage). Question: Spironolactone and finasteride are second-line therapy options. Answer:. Victoza is not indicated in the treatment of PCOS. Question: For treatment of menopausal symptoms in a woman with a history of hormone-sensitive breast cancer, the nurse practitioner should consider: androgen therapy. gonadotropin-releasing hormone analogs. selective serotonin reuptake inhibitors. progesterone-only therapy. Answer:. selective serotonin reuptake inhibitors. Question: Nonhormonal treatments for menopausal symptoms include: benzodiazepines. copper intrauterine device. selective serotonin reuptake inhibitors. antiepileptic/antiseizure medications. Answer:. selective serotonin reuptake inhibitors. Question: Which of the following is NOT true about the administration of medroxyprogesterone acetate (DepoProvera)? Few drug-drug interactions are associated with intramuscular Depo-Provera compared to oral contraceptives. Depo-Provera must be discontinued and an alternate contraceptive considered at least 6 months before attempting pregnancy. Menses may not return for 3 to 12 months after the last Depo-Provera injection. Patients should be advised to take calcium and vitamin D while taking Depo-Provera. Answer:. Few drug-drug interactions are associated with intramuscular Depo-Provera compared to oral contraceptives. Question: In addition to inhibiting ovulation, combined contraceptives further prevent pregnancy by: creating a toxic environment for sperm. increasing the viscosity of cervical mucus. decreasing production of sex hormone-binding globulin. thinning the uterine wall. Answer:. increasing the viscosity of cervical mucus. Question: Combined oral contraceptives are NOT likely to cause: thromboembolism. hypertension. gallbladder disease. ovarian cysts. Answer:. ovarian cysts. Question: Combined contraceptives, whether oral, patch or intravaginal, work in the ovulatory phase by: increasing follicle-stimulating hormone and luteinizing hormone. decreasing follicle-stimulating hormone and increasing luteinizing hormone. suppressing follicle-stimulating hormone and luteinizing hormones. increasing the release of follicle-stimulating hormone and luteinizing hormone. Answer:. suppressing follicle-stimulating hormone and luteinizing hormones. Question: Before prescribing oral contraceptives, the nurse practitioner should check for: anemia. human papillomavirus via Pap test. sexually transmitted diseases. pregnancy. Answer:. pregnancy. Question: Etonogestrel (Nexplanon) implant for contraception contains: estrogen only. progesterone only. equal amounts of estrogen and progesterone. a higher dose of progesterone than estrogen. Answer:. progesterone only. Question: Tranexamic acid (Lysteda), used in the treatment of abnormal uterine bleeding, is classified as a(n): estrogen. progesterone. androgen. antifibrinolytic. Answer:. .antifibrinolytic. Question: Levonorgestrel (Plan B) for women who do not desire pregnancy: is prescription only. should be taken within 7 days of unprotected sex. is 99% effective against pregnancy. inhibits fertilization or implantation of fertilized egg. inhibits Answer:. fertilization or implantation of fertilized egg. Question: Combination estrogen and progesterone therapy: does not increase the risk of heart attack or stroke. increases the risk for deep vein thrombosis (DVT) and gallbladder disease. only increases breast cancer risk in the presence of family history. preserves ovarian function in premenopausal women. increases the risk for Answer:. deep vein thrombosis (DVT) and gallbladder disease. Question: Tranexamic acid (Lysteda), used in the treatment of abnormal uterine bleeding, should not be administered concomitantly with: nonsteroidal antiinflammatory drugs (NSAIDs). combination hormonal contraceptives. statins. selective serotonin reuptake inhibitors. combination hormonal Answer:. contraceptives. concomitant use of hormonal contraception and Lysteda may further exacerbate the increased thrombotic risk associated with combination hormonal contraceptives Question: Which medication is NOT the best first choice for the treatment of anxiety/mood disorders related to premenstrual dysphoric disorder? Ethinyl estradiol/drospirenone (Yaz) Fluoxetine hydrochloride (Sarafem) Paroxetine (Paxil) Clonazepam (Klonopin) Answer:. Clonazepam (Klonopin) Benzodiazepines are not first line Question: Oral contraceptive regimens in which the estrogen and progestin both vary throughout the cycle are considered: monophasic. biphasic. triphasic. quadriphasic. Answer:. quadriphasic. Question: An oral contraceptive known as the "mini-pill" contains: estrogen only. progesterone only. equal parts estrogen and progesterone. a higher dose of progesterone than estrogen. Answer:. progesterone only. Question: If a patient is experiencing breast tenderness and hypertension, she may be taking an oral contraceptive with: not enough estrogen. too much estrogen. not enough progestin. too much progestin. too Answer:. much estrogen. Question: In oral contraceptives, when the estrogen dose remains the same for the first 21 days of the cycle and progestin is lower in the first half and higher in the second half, the regimen is classified as: monophasic. biphasic. triphasic. quadriphasic. Answer:. biphasic. Question: A common side effect associated with the use of progestin-only contraceptives is: depression. amenorrhea. hypertension. edema. Answer:. amenorrhea. Changes in normal menstrual cycle Other side effects are breast tenderness, headaches, and mood changes. Question: Etonogestrel/ethinyl estradiol (NuvaRing), a contraceptive vaginal ring,: contains only estrogen. contains only progestin. is replaced weekly for 3 weeks, followed by 1 week ring-free. releases higher doses of progestin steroids per day than estrogen. releases Answer:. higher doses of progestin steroids per day than estrogen. Question: Late breakthrough bleeding or amenorrhea while taking an oral contraceptive may mean that the oral contraceptive has: not enough estrogen. too much estrogen. not enough progestin. too much progestin. not enough progestin. Question: The copper component of the ParaGard intrauterine device to prevent pregnancy is thought to: Answer:. thicken the endometrium and cervical mucus. decrease the movement of ovum through the fallopian tubes. interfere with estrogen uptake and decrease sperm motility. suppress ovulation. interfere with estrogen uptake and decrease sperm motility. Question: Intrauterine devices should NOT be implanted in women: until they are at least 2 weeks postpartum. who have had a sexually transmitted infection in the past 3 months. who have recurrent bladder infections. with a history of toxic shock syndrome. Answer:. who have had a sexually transmitted infection in the past 3 months. Question: The best choice for short-term treatment of severe abnormal uterine bleeding is: estrogen only. androgen therapy. gonadotropin-releasing hormone analogs. combination estrogen/progesterone. Answer:. estrogen only. Question: A Bartholin's gland abscess caused by Staphylococcal aureus infection is best treated with: amoxicillin-clavulanate (Augmentin). cephalexin (Keflex). clindamycin (Cleocin). metronidazole (Flagyl). clindamycin (Cleocin). Answer:. Due to high rates of resistance, penicillin and cephalosporins are not recommended. Metronidazole is not indicated in the treatment of staphylococcal infections. Question: Levonorgestrel (Plan B), an emergency contraceptive, is absolutely contraindicated: in the presence of psychiatric illness. in the presence of known or suspected pregnancy. in a woman who is breastfeeding. in women with intrauterine fibroids. Answer:. in the presence of known or suspected pregnancy. Question: Danazol, classified as an androgen, is used in the treatment of abnormal uterine bleeding and endometriosis. It works by suppressing: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). human chorionic gonadotrophin (HCG) and luteinizing hormone (LH). gonadotrophin-releasing hormone (GnRH) and human chorionic gonadotropin (HCG). gonadotrophin-releasing hormone (GnRH) and sex Answer:. binding hormone. follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Question: Medications that may be helpful in the treatment of vulvodynia include: oral contraceptives. selective serotonin reuptake inhibitors. antidepressants and anticonvulsants. antibiotics and anti-inflammatories. Answer:. antidepressants and anticonvulsants. Question: Women who have had levonorgestrel (Mirena) implanted to prevent pregnancy do NOT need to immediately report: painful intercourse. fever with vaginal discharge. string disappearance. Answer:. amenorrhea. amenorrhea. Question: A woman who has had a hysterectomy complains of vaginal dryness, burning, and itching. A hormonal treatment is: progesterone only. oral combination contraceptives. low-dose oral estrogen. implanted testosterone pellets. low-dose Answer:. oral estrogen. Question: Which statement is true about diaphragms in comparison to pharmacologic methods of contraception? They are as effective as oral contraceptives. They can be removed immediately after intercourse. They may cause recurrent bladder infections. They are not as effective in preventing sexually transmitted diseases. Answer:. They may cause recurrent bladder infections. They are helpful in the prevention of sexually transmitted diseases. Diaphragms are less effective than oral contraceptives, require dexterity to insert properly, must be left in place for at least 6 hours after intercourse, and may cause bacterial vaginosis and vaginal yeast infections. Question: Etonogestrel (Nexplanon) implant, used for contraception, is contraindicated in women: who are breastfeeding. who have migraine headaches. with a personal history of breast cancer. who have coronary artery disease. with a Answer:. personal history of breast cancer. Question: Intrauterine devices for contraception: have no systemic effect on hormones. are not safe for long-term use. may cause uncomfortable intercourse. never spontaneously expel. Answer:. have no systemic effect on hormones. Question: Which of the following is NOT a common side effect associated with the use of etonogestrel/ethinyl estradiol (NuvaRing), a contraceptive vaginal ring? Vaginitis Breast tenderness Increased appetite Answer:. Severe headache Severe headache Question: The first-line treatment for mixed somatic and behavior symptoms related to severe premenstrual syndrome (PMS) when pregnancy is desired is: metformin (Glucophage). spironolactone (Aldactone). fluoxetine hydrochloride (Sarafem). ibuprofen (Motrin). fluoxetine Answer:. hydrochloride (Sarafem). Question: When a woman experiences weight gain, fatigue and changes in mood, her oral contraceptive may have too: little estrogen. much estrogen. little progestin. much progestin. Answer:. much progestin Question: Combined oral contraceptive use is absolutely contraindicated in patients who: are older than 35 years and smoke a pack of cigarettes/day. develop migraine headaches after starting oral contraceptives. are 6-12 weeks postpartum and breastfeeding. had breast cancer more than 5 years ago. Answer:. are older than 35 years and smoke a pack of cigarettes/day. Combined oral contraceptive use is absolutely contraindicated in patients who are older than 35 and smoke more than 15 cigarettes per day. Cigarette smoking increases the risk of cardiovascular side effects. The risk increases with age (35 years) and heavy smoking (15 or more cigarettes per day). Question: Which of the following is NOT true about hormone replacement therapy (HRT) in menopause? Regardless of route of hormone replacement therapy, the lowest dose for the shortest amount of time should be utilized. Estrogen and progestin should be given together if the uterus is still intact. Every woman should be placed on hormone replacement therapy for at least 2 years to prevent cardiovascular effects of menopause. Estrogen therapy is contraindicated with a history of breast cancer, active thrombosis or thrombophlebitis and active liver disease. Answer:. Every woman should be placed on hormone replacement therapy for at least 2 years to prevent cardiovascular effects of menopause. Question: A 23-year-old woman complains of breakthrough bleeding 1 month after being started on a combination oral contraceptive (OC). The nurse practitioner should: advise the patient to use additional protection during intercourse, until resolved. change to a progestin-only formulation. advise the patient that breakthrough bleeding in the first 3 months is common. change to a contraceptive patch for better regulation of hormones. Answer:. advise the patient that breakthrough bleeding in the first 3 months is common. Question: Levonorgestrel (Mirena) intrauterine device to prevent pregnancy should be changed every: 3 years. 5 years. 7 years. 10 years. Answer:. 5 years. Question: Serious adverse reactions of progesterone therapy that warrant immediate medical attention include: breakthrough bleeding. nipple discharge. low blood pressure. calf pain and swelling. Answer:. calf pain and swelling. Spironolactone (Aldactone), sometimes used to reduce the symptoms of hirsutism related to polycystic ovarian syndrome, is classified as a(n): androgen agonist. estrogen agonist. progesterone antagonist. androgen receptor blocker. androgen receptor blocker. Question: Danazol, an androgen, may cause: clitoral atrophy. breast tenderness. edema. weight loss. Answer:. edema. Question: Which of the following medications is an aldosterone receptor antagonist and is used in the treatment of fibrocystic breast disease? Amiloride (Midamor) Chlorthalidone Indapamide Spironolactone (Aldactone) Spironolactone Answer:. (Aldactone) Question: The mechanism of action of levonorgestrel in the Mirena intrauterine device is to: thicken the endometrium and cervical mucus. decrease the movement of ovum through fallopian tubes. increase estrogen uptake and decrease sperm motility. suppress gonadotropic hormones. Answer:. thicken the endometrium and cervical mucus. Question: Fluconazole (Diflucan), an antifungal,: should be decreased in dose in the presence of renal impairment. should be administered with food. is only effective against Candida albicans. is not effective in the treatment of oropharyngeal and esophageal candidiasis. Answer:. should be decreased in dose in the presence of renal impairment. Question: Progestin-only contraceptives: do not alter the quality or quantity of breast milk. are not safe for use in women with cardiovascular disease. increase a patient's risk for pelvic inflammatory disease. are contraindicated in the presence of moderate hypertension. Answer:. do not alter the quality or quantity of breast milk. Question: Progestin-only contraceptives are contraindicated in women: with moderate hypertension. who have a personal history of stroke. with pulmonary hypertension. Answer:. who are lactating. with pulmonary hypertension. Question: ParaGard intrauterine device should be changed every: 3 years. 5 years. 7 years. 10 years. Answer:. 10 years. Question: A benefit associated with the use of medroxyprogesterone acetate (Depo-Provera), a progestin-only contraceptive, is: decreased risk of pelvic inflammatory disease. decreased risk of cardiovascular risk factors. decreased risk of weight gain. decreased risk of osteoporosis. Answer:. decreased risk of pelvic inflammatory disease. Question: Medroxyprogesterone acetate (Provera) reduces abnormal uterine bleeding by: halting the production of estrogen. stimulating the pituitary gland to produce follicle-stimulating hormone (FSH). maintaining the corpus luteum and thus uterine thickness. preventing overgrowth of the endometrium. Answer:. preventing overgrowth of the endometrium. Question: Spermicides to prevent pregnancy: cannot be used in conjunction with a condom. help to prevent gonorrhea and chlamydia. may affect long-term fertility. should not be use as a back-up method for other contraceptives. Answer:. help to prevent gonorrhea and chlamydia.