MCQ Quiz-Reproductive Years 

MCQ Quiz: Reproductive Years

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The reproductive years encompass a significant and dynamic phase of life, presenting unique health considerations and pharmacotherapy needs. This area of care includes contraception, management of menstrual disorders, fertility planning, and preconception health. For PharmD students, developing expertise in these topics is essential for providing comprehensive, patient-centered counseling and care that empowers individuals to make informed decisions about their reproductive health.

1. A primary mechanism of action for combined oral contraceptives (COCs) is:

  • Thickening of the cervical mucus
  • Inhibition of ovulation
  • Preventing implantation of a fertilized egg
  • Spermicidal activity


Answer: Inhibition of ovulation

2. Which of the following is the most effective form of emergency contraception when taken within 120 hours (5 days) of unprotected intercourse?

  • Levonorgestrel 1.5 mg
  • Combined oral contraceptive pills (Yuzpe method)
  • Ulipristal acetate
  • Copper IUD


Answer: Ulipristal acetate

3. A key component of preconception planning for all individuals of childbearing potential is the daily supplementation with:

  • Vitamin D
  • Iron
  • Folic acid
  • Calcium


Answer: Folic acid

4. A patient with a history of a deep vein thrombosis (DVT) has an absolute contraindication to which of the following contraceptive methods?

  • Copper IUD
  • Estrogen-containing combined hormonal contraceptives
  • Progestin-only pills
  • Condoms


Answer: Estrogen-containing combined hormonal contraceptives

5. First-line pharmacologic treatment for primary dysmenorrhea (painful menstruation) is typically:

  • Opioid analgesics
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Acetaminophen
  • Selective serotonin reuptake inhibitors (SSRIs)


Answer: Nonsteroidal anti-inflammatory drugs (NSAIDs)

6. What is a critical counseling point for a patient using a progestin-only pill (“mini-pill”)?

  • The pill must be taken at the same time every day to be effective.
  • It is more effective than combined oral contraceptives.
  • It can be taken within a 12-hour window without loss of efficacy.
  • It significantly increases the risk of blood clots.


Answer: The pill must be taken at the same time every day to be effective.

7. Clomiphene citrate is a medication commonly used for what purpose in women’s health?

  • As a form of emergency contraception
  • To treat heavy menstrual bleeding
  • To induce ovulation in the treatment of infertility
  • To manage symptoms of menopause


Answer: To induce ovulation in the treatment of infertility

8. Premenstrual Dysphoric Disorder (PMDD) is a severe form of PMS. What class of medications is often used as a first-line treatment?

  • Benzodiazepines
  • Beta-blockers
  • Selective Serotonin Reuptake Inhibitors (SSRIs)
  • NSAIDs


Answer: Selective Serotonin Reuptake Inhibitors (SSRIs)

9. When counseling a patient starting combined oral contraceptives (COCs) using the “Sunday Start” method, what is the most important instruction regarding back-up contraception?

  • No back-up method is needed at any time.
  • Use a back-up method for the entire first month.
  • Use a back-up method, like condoms, for the first 7 days of the first cycle.
  • Back-up contraception is only needed if a pill is missed.


Answer: Use a back-up method, like condoms, for the first 7 days of the first cycle.

10. What is the primary purpose of preconception planning?

  • To choose the gender of the baby.
  • To optimize health and minimize risks for the mother and baby before pregnancy occurs.
  • To ensure the baby is born on a specific date.
  • To select a name for the baby.


Answer: To optimize health and minimize risks for the mother and baby before pregnancy occurs.

11. The levonorgestrel-releasing IUD (e.g., Mirena) works primarily by:

  • Preventing sperm from entering the uterus.
  • Inhibiting ovulation and thickening cervical mucus.
  • Causing an inflammatory reaction that is spermicidal.
  • Destroying the uterine lining.


Answer: Inhibiting ovulation and thickening cervical mucus.

12. The “ACHES” acronym is used to counsel patients on the warning signs of serious adverse effects from estrogen-containing contraceptives. The “A” stands for:

  • Abdominal pain
  • Acne
  • Anxiety
  • Appetite increase


Answer: Abdominal pain

13. A case-based approach to contraception counseling is effective because it:

  • Allows the pharmacist to apply knowledge to a specific patient’s needs and preferences.
  • Provides a single correct answer for all patients.
  • Eliminates the need for patient interaction.
  • Focuses only on the cost of the medication.


Answer: Allows the pharmacist to apply knowledge to a specific patient’s needs and preferences.

14. Infertility is generally defined as the inability to conceive after how long of regular, unprotected intercourse?

  • 3 months
  • 6 months
  • 12 months
  • 24 months


Answer: 12 months

15. A patient taking certain antibiotics (like rifampin) while on oral contraceptives should be counseled to:

  • Stop taking the oral contraceptive immediately.
  • Use a back-up method of contraception.
  • Double the dose of their oral contraceptive.
  • Ignore the potential interaction.


Answer: Use a back-up method of contraception.

16. Which of the following is NOT a hormonal method of contraception?

  • Transdermal patch
  • Progestin-only pill
  • Vaginal ring
  • Copper IUD


Answer: Copper IUD

17. The management of premenstrual disorders, according to ACOG guidelines, may include:

  • Lifestyle modifications like exercise and stress reduction.
  • Pharmacologic treatment with SSRIs or hormonal contraceptives.
  • Nutritional supplements like calcium.
  • All of the above.


Answer: All of the above.

18. Levonorgestrel 1.5 mg for emergency contraception is most effective when taken:

  • Within 72 hours of unprotected intercourse.
  • Exactly 5 days after unprotected intercourse.
  • Before unprotected intercourse occurs.
  • On the first day of the menstrual cycle.


Answer: Within 72 hours of unprotected intercourse.

19. A key aspect of preconception planning for a patient with a chronic condition like diabetes is:

  • Discontinuing all medications immediately upon planning a pregnancy.
  • Achieving optimal disease control before conception.
  • Ignoring the chronic condition until after the baby is born.
  • Switching to herbal remedies exclusively.


Answer: Achieving optimal disease control before conception.

20. A patient misses two consecutive active pills in the third week of her combined oral contraceptive pack. What should she be advised to do?

  • Finish the active pills in the current pack, skip the placebo week, and start a new pack immediately.
  • Stop taking all pills and wait for her period to start.
  • Take the two missed pills at once and continue the pack as normal.
  • Discard the entire pack and use no contraception.


Answer: Finish the active pills in the current pack, skip the placebo week, and start a new pack immediately.

21. Polycystic Ovarian Syndrome (PCOS) is a common menstruation-related disorder. What is often a first-line treatment for managing its symptoms?

  • Weight loss and lifestyle changes.
  • Combined hormonal contraceptives.
  • Metformin.
  • All of the above.


Answer: All of the above.

22. Ulipristal acetate for emergency contraception requires a(n) _________ to be dispensed.

  • patient interview
  • prescription
  • blood test
  • insurance pre-authorization


Answer: prescription

23. The depot medroxyprogesterone acetate (DMPA) injection is a contraceptive method administered how often?

  • Every week
  • Every month
  • Every 3 months
  • Every year


Answer: Every 3 months

24. The presence of state laws impacting access to medications like abortifacients presents what challenge for pharmacists?

  • A complex legal and ethical environment.
  • A simplified dispensing process.
  • No challenge, as pharmacists are not involved.
  • A purely financial consideration.


Answer: A complex legal and ethical environment.

25. A pharmacist’s role in contraception counseling is to:

  • Choose a method for the patient.
  • Provide accurate, unbiased information about all available options so the patient can make an informed choice.
  • Only discuss the most expensive methods.
  • Discourage the use of all contraception.


Answer: Provide accurate, unbiased information about all available options so the patient can make an informed choice.

26. Heavy menstrual bleeding can be managed with which of the following?

  • NSAIDs
  • Combined hormonal contraceptives
  • Tranexamic acid
  • All of the above.


Answer: All of the above.

27. A key component of the female reproductive cycle pathophysiology is the interplay between:

  • The hypothalamus, pituitary gland, and ovaries.
  • The liver and the kidneys.
  • The pancreas and the adrenal glands.
  • The heart and the lungs.


Answer: The hypothalamus, pituitary gland, and ovaries.

28. What is a common side effect during the first few months of starting a combined oral contraceptive?

  • Weight gain of 20 pounds
  • Breakthrough bleeding or spotting
  • Permanent infertility
  • Severe hypertension


Answer: Breakthrough bleeding or spotting

29. The main difference between PMS and PMDD is the ________ of the symptoms.

  • timing
  • type
  • severity and impact on daily functioning
  • cause


Answer: severity and impact on daily functioning

30. Which of the following should be reviewed during a preconception planning visit?

  • Vaccination history (e.g., rubella, varicella)
  • The patient’s retirement plan
  • The patient’s car insurance policy
  • The patient’s favorite brand of coffee


Answer: Vaccination history (e.g., rubella, varicella)

31. Long-Acting Reversible Contraceptives (LARCs), such as IUDs and implants, are highly effective because they:

  • Are easy for patients to use correctly.
  • Minimize the potential for user error.
  • Are changed on a daily basis.
  • Are available over-the-counter.


Answer: Minimize the potential for user error.

32. The primary mechanism of the copper IUD is:

  • Inhibition of ovulation.
  • Thickening of cervical mucus.
  • Creating a local inflammatory reaction that is spermicidal.
  • Delaying the menstrual cycle.


Answer: Creating a local inflammatory reaction that is spermicidal.

33. Infertility can be caused by:

  • Male factors
  • Female factors
  • A combination of both or be unexplained
  • All of the above


Answer: All of the above

34. A patient using the transdermal contraceptive patch should be counseled to apply a new patch:

  • Every day
  • Once a month
  • Once a week for three weeks, followed by a patch-free week
  • Only when they remember


Answer: Once a week for three weeks, followed by a patch-free week

35. A key part of the “Reproductive Years” module is understanding that a woman’s health needs:

  • Remain static from puberty to menopause.
  • Change over time, requiring different strategies and counseling approaches.
  • Are identical to men’s health needs.
  • Are not a focus of pharmacy practice.


Answer: Change over time, requiring different strategies and counseling approaches.

36. A patient who smokes more than 15 cigarettes per day and is over 35 years old should generally avoid which contraceptive method?

  • Progestin-only pills
  • The copper IUD
  • Estrogen-containing combined hormonal contraceptives
  • Condoms


Answer: Estrogen-containing combined hormonal contraceptives

37. When dispensing emergency contraception, a pharmacist should counsel the patient that it:

  • Is intended for regular, ongoing use as a primary contraceptive method.
  • Is not effective if taken after unprotected intercourse.
  • Does not protect against sexually transmitted infections (STIs).
  • Will terminate an established pregnancy.


Answer: Does not protect against sexually transmitted infections (STIs).

38. The “C” in the ACHES acronym for COC warning signs stands for:

  • Cough
  • Chest pain
  • Constipation
  • Confusion


Answer: Chest pain

39. For a patient trying to conceive, a pharmacist can provide counseling on:

  • The use of ovulation prediction kits.
  • Guaranteed methods to choose the baby’s sex.
  • Complex in-vitro fertilization procedures.
  • The best time of year to get pregnant.


Answer: The use of ovulation prediction kits.

40. A case-based approach to teaching contraception allows students to practice:

  • Applying clinical knowledge to realistic patient scenarios.
  • Memorizing drug names without context.
  • Following a single, rigid algorithm.
  • Avoiding patient communication.


Answer: Applying clinical knowledge to realistic patient scenarios.

41. The vaginal ring contraceptive is used by:

  • Inserting it once a week.
  • Inserting it for 3 weeks, followed by a 1-week ring-free period.
  • Taking it orally every day.
  • Applying it as a patch to the skin.


Answer: Inserting it for 3 weeks, followed by a 1-week ring-free period.

42. One of the main goals of therapy for PCOS is to:

  • Induce menopause.
  • Manage symptoms like irregular periods, hirsutism, and acne.
  • Increase testosterone levels.
  • Promote weight gain.


Answer: Manage symptoms like irregular periods, hirsutism, and acne.

43. A pharmacist’s role in preconception care for a patient taking a known teratogen (e.g., isotretinoin) is to:

  • Ensure the patient is aware of the risks and is on effective contraception.
  • Recommend doubling the dose.
  • Tell the patient the risks are not significant.
  • Refuse to dispense the medication.


Answer: Ensure the patient is aware of the risks and is on effective contraception.

44. What is primary amenorrhea?

  • The cessation of periods after they have already started.
  • The absence of menstruation by age 15 in someone with normal growth.
  • Unusually heavy menstrual bleeding.
  • Painful menstruation.


Answer: The absence of menstruation by age 15 in someone with normal growth.

45. Which of the following is NOT a component of preconception planning?

  • Folic acid supplementation.
  • Review of medications.
  • Management of chronic diseases.
  • Selection of a retirement community.


Answer: Selection of a retirement community.

46. The effectiveness of emergency contraception can be reduced by:

  • The patient’s body weight or BMI.
  • Taking it with food.
  • The time of day it is taken.
  • The patient’s hair color.


Answer: The patient’s body weight or BMI.

47. Which of the following is an example of a long-acting reversible contraceptive (LARC)?

  • The contraceptive implant (e.g., Nexplanon).
  • Progestin-only pills.
  • The transdermal patch.
  • Male condoms.


Answer: The contraceptive implant (e.g., Nexplanon).

48. A patient complains of mood swings, bloating, and irritability that occur the week before her period and resolve after her period starts. This is characteristic of:

  • Infertility.
  • Amenorrhea.
  • Premenstrual Syndrome (PMS).
  • Menopause.


Answer: Premenstrual Syndrome (PMS).

49. Pharmacists can play a key role in public health during the reproductive years by:

  • Increasing access to and education about contraception and preconception health.
  • Only dispensing medications without counseling.
  • Discouraging all family planning.
  • Focusing exclusively on treating infertility.


Answer: Increasing access to and education about contraception and preconception health.

50. The ultimate goal of providing care during the reproductive years is to:

  • Ensure every patient uses the same contraceptive method.
  • Empower individuals to make safe and informed decisions about their health and family planning goals.
  • Increase the birth rate.
  • Eliminate all menstrual-related symptoms for every patient.


Answer: Empower individuals to make safe and informed decisions about their health and family planning goals.

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