NSG 6320 AGNP Board Exam – Women’s Health Prescription
Exam Which of the following is NOT a common side effect associated with the use
... [Show More] of
etonogestrel/ethinyl estradiol (NuvaRing), a contraceptive vaginal ring?
Vaginitis
Breast tenderness
Increased appetite
Severe headache Correct
Explanation:
A common side effect NOT associated with the use of etonogestrel/ethinyl estradiol
(NuvaRing) is severe headache. The systemic side effects of NuvaRing are the same as
with oral contraceptives. Vaginitis and local skin irritation may occur with the use of
the intravaginal ring. Danger signs of contraceptives can be remembered using the
acronym ACHES: A-Severe abdominal pain (may be indicative of hepatic tumors); CSevere
chest pain or shortness of breath; H-Severe headaches; E-eye problems (blurred
vision, flashing lights, or blindness); S-Severe leg pain.
2. Question:
A common side effect associated with the use of progestin-only contraceptives is:
depression.
amenorrhea. Correct
hypertension.
edema.
Explanation:
Common side effects of progestin-only contraceptives are menstrual cycle changes (e.g.,
spotting, breakthrough bleeding, prolonged cycles and eventually, amenorrhea). Other
side effects are breast tenderness, headaches, and mood changes.
3. 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. Correct
Explanation:
A combined estrogen/progesterone oral contraceptive or progesterone only would be
the treatment of choice for mild abnormal uterine bleeding in a woman of childbearing
age. Severe uterine bleeding is usually treated on an emergency basis with a short
course of high-dose estrogen therapy. Treatment with androgens would only be
indicated for short-term use for refractory bleeding.
4. Question:
Nonhormonal treatments for menopausal symptoms include:
benzodiazepines.
copper intrauterine device.
selective serotonin reuptake inhibitors. Correct
antiepileptic/antiseizure medications.
Explanation:
Nonhormonal treatments for menopausal symptoms include selective serotonin
reuptake inhibitors and serotonin norepinephrine reuptake inhibitors.
5. Question:
In the presence of mild hyperandrogenic symptoms related to polycystic ovarian
syndrome (PCOS), the initial recommended treatment is:
norethindrone/ethinyl estradiol (Lo Loestrin). Correct
medroxyprogesterone (Provera).
ethinyl estradiol (Estinyl).
metformin (Glucophage).
Explanation:
In the presence of mild hyperandrogenic symptoms related to polycystic ovarian
syndrome (PCOS), the initial recommended treatment is a combination oral
contraceptive (i.e. norethindrone/ethinyl estradiol [Lo Loestrin]). Combined oral
contraceptive therapy modestly inhibits gonadotropin secretion and thus gonadotropinsensitive
ovarian androgen production, and increases hepatic production of sex
hormone binding globulin (SHBG), which further decreases free testosterone.
6. Question:
Which of the following medications would NOT be beneficial in the treatment of pain
associated with fibrocystic breast disease?
Spironolactone (Aldactone)
Norethindrone/ethinyl estradiol (Lo Loestrin)
Danazol
Fluoxetine (Sarafem) Correct
Explanation:
Fluoxetine (Sarafem), an SSRI, is NOT recommended for the treatment of pain
associated with fibrocystic breast disease. Spironolactone, a potassium-sparing diuretic;
danazol, an androgen; and norethindrone/ethinyl estradiol, a combination oral
contraceptive, may all be used for the treatment of pain associated with fibrocystic
breast disease. Vitamin B6, vitamin E and evening primrose oil may be beneficial as
well. Bromocriptine (Parlodel) may be used for more severe disease [Show Less]