Chapter 38 Gonadal Hormones

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Chapter 38  Gonadal Hormones

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. A female patient with a history of endometriosis presents with bilateral lower quadrant pain reportedly at midcycle. Which gonadal drug is indicated for treating symptoms of endometriosis?
a.
Estrogen
b.
Progesterone
c.
Androgens
d.
Gonadotropins

ANS: B
Progesterones are used to treat secondary amenorrhea, breakthrough uterine bleeding, and endometriosis. They may be combined with estrogens as contraceptives. Estrogen products are used for relieving the hot flash symptoms of menopause; for contraception; for hormone replacement therapy after an oophorectomy; in conjunction with appropriate diet, calcium, and physical therapy in the treatment of osteoporosis; for treatment of severe acne in females; and to slow the disease progress (and minimize discomfort) in patients with advanced prostatic cancer and certain types of breast cancer. Androgens are used to treat hypogonadism, eunuchism, androgen deficiency, and palliation of breast cancer in postmenopausal women with certain cell types of cancer. When androgens are used for palliation of cancer in women, they suppress cancer cell growth. Gonadotropin is a hormone secreted in the pituitary; it regulates the release of the gonadal hormones.

DIF: Cognitive Level: Comprehension REF: Page 592 OBJ: 3
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Hormonal Regulation

2. What is the rationale for using an androgen as part of breast cancer treatment?
a.
For maintenance of fat stores
b.
To promote nutrition
c.
To prevent wasting resulting from cancer growth
d.
For palliative treatment to suppress cancer cell growth

ANS: D
When androgens are used for palliation of breast cancer in women, they suppress cancer cell growth. Androgens affect muscle growth, not fat stores. Estrogen affects fat stores. Although androgens may be used to stimulate appetite and improve nutrition, this is not the indication in this case. Although androgens may be used to prevent wasting, this is not the indication in this case.

DIF: Cognitive Level: Comprehension REF: Page 593 OBJ: 2 | 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Hormonal Regulation; Cellular Regulation

3. The health of a patient receiving androgen therapy for breast cancer declines and she becomes bed bound. Which condition will this patient be at risk of developing?
a.
Electrolyte imbalances
b.
Hypercalcemia
c.
Hyperglycemia
d.
Fluid overload

ANS: B
Immobilized patients receiving androgens for palliative breast cancer treatment are at risk for hypercalcemia. The nurse should monitor patients for nausea, vomiting, constipation, poor muscle tone, and lethargy. Immobilization does not affect electrolyte balance, blood glucose, or fluid balance in this case.

DIF: Cognitive Level: Comprehension REF: Page 593 OBJ: 4
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety; Hormonal Regulation

4. Which patient on oral contraceptive therapy will be at greatest risk for heart attack?
a.
A 34-year-old woman with a history of osteoporosis
b.
A 28-year-old woman with a history of eczema
c.
A 36-year-old woman who smokes half a pack per day
d.
A 36-year-old woman who has a history of abnormal Pap smears

ANS: C
The incidence of fatal heart attacks is increased for women older than 35 years of age who use gonadal hormones and smoke. Osteoporosis, eczema, and cervical dysplasia do not increase risk for heart attack.

DIF: Cognitive Level: Application REF: Pages 589-590
OBJ: 4 TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Hormonal Regulation; Safety

5. Which is most important for the nurse to remember when instructing the patient about treatment with gonadal hormones?
a.
Dosage, schedule, and adverse effects
b.
Cost, storage, and route of administration
c.
Drug interactions and food interactions
d.
Scheduling follow-up appointments and lab studies

ANS: A
Most gonadal hormones are prescribed to patients for prolonged self-administration. Therefore, planning should stress patient education specific to the type of gonadal hormone prescribed and its intended actions, including monitoring of adverse effects to expect and report. Cost, storage, and route of administration are lesser concerns. There are few, if any, interactions between gonadal hormones and food or other drugs. Follow-up appointments and lab studies are lesser concerns.

DIF: Cognitive Level: Application REF: Page 589 OBJ: 2 | 4
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Hormonal Regulation; Safety; Patient Education; Health Promotion

 

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