AGNP BOARD EXAM
QUESTIONS Womens Health
Prescription (101 Questions)
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,AGNP BOARD EXAM QUESTIONS Womens Health Prescription (101 Questions)
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
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); C-
Severe chest pain or shortness of breath; H-Severe headaches; E-eye problems (blurred vision, flashing
lights, or blindness); S-Severe leg pain.
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.
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.
Explanation:
Nonhormonal treatments for menopausal symptoms include selective serotonin reuptake inhibitors and
serotonin norepinephrine reuptake inhibitors.
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
gonadotropin-sensitive ovarian androgen production, and increases hepatic production of sex hormone
binding globulin (SHBG), which further decreases free testosterone.
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.
Question:
The copper component of the ParaGard intrauterine device to prevent pregnancy is thought to:
thicken the endometrium and cervical mucus.
decrease the movement of ovum through the fallopian tubes.
interfere with estrogen uptake and decrease sperm motility. Correct
suppress ovulation.
, Explanation:
The copper component in the ParaGard intrauterine device is thought to prevent pregnancy by interfering
with estrogen uptake, potentiating the local inflammatory response, and decreasing sperm motility.
Question:
The drug of choice to control mild abnormal uterine bleeding in a teenage patient is:
estrogen only.
androgen therapy.
gonadotropin-releasing hormone analogs.
combination estrogen/progesterone. Correct
Explanation:
A combined estrogen/progesterone oral contraceptive or progesterone only would be the treatment of
choice for mild abnormal uterine bleeding in a teenager. 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 to manage refractory bleeding.
Question:
A benefit associated with the use of medroxyprogesterone acetate (Depo-Provera), a progestin-only
contraceptive, is:
decreased risk of pelvic inflammatory disease. Correct
decreased risk of cardiovascular risk factors.
decreased risk of weight gain.
decreased risk of osteoporosis.
Explanation:
Benefits associated with the use of medroxyprogesterone acetate (Depo-Provera), a progestin-only
contraceptive, include decreased risk of endometrial cancer and pelvic inflammatory disease. Further
benefits of Depo-Provera are decreased menstrual cramps, reduction in heavy uterine bleeding, decreased
premenstrual syndrome symptoms, and decreased breast tenderness. Patients receiving Depo-Provera are
at increased risk for experiencing a significant decrease in bone mineral density.
Question:
Progestin-only contraceptives:
do not alter the quality or quantity of breast milk. Correct
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.
Explanation:
Progestin-only contraceptives do not alter the quality or quantity of breast milk in lactating women. They
may be used in women with cardiovascular risk factors. They are also safe for use in women who have an
absolute or relative contraindication to estrogen and combined oral contraceptives, such as: age >45 years,
breastfeeding, smoking, mild to moderate hypertension, well-controlled diabetes, or history of stroke or
depression.
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