A 21-year-old female-to-male transitioning client wishes to begin treatment with hormone therapy. Which of the following would be appropriate to suppress female hormones?
Leuprolide (Lupron)
Spironolactone
Estrogen
Testosterone
The Correct Answer is A
Choice A reason: Leuprolide is a gonadotropin-releasing hormone (GnRH) agonist that initially stimulates and then suppresses the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), leading to decreased estrogen production from the ovaries. It is commonly used in transgender men to suppress endogenous female hormone production prior to or alongside testosterone therapy. This suppression helps reduce menstruation and estrogen-driven secondary sex characteristics, facilitating masculinization.
Choice B reason: Spironolactone is primarily used in male-to-female (MTF) transitions to block androgen receptors and reduce testosterone effects. It is not used to suppress estrogen in female-to-male (FTM) transitions and would not be appropriate for this client.
Choice C reason: Estrogen is a feminizing hormone and would counteract the goals of masculinization in a female-to-male transition. Administering estrogen would increase female secondary sex characteristics, which is the opposite of the desired effect.
Choice D reason: Testosterone is the primary hormone used to induce masculinization in female-to-male transitions. However, it does not suppress endogenous estrogen production directly. While it promotes male secondary sex characteristics, it is often combined with agents like GnRH agonists (e.g., Leuprolide) to effectively suppress female hormone activity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: 120/80 mmHg is considered normal blood pressure. It is not a treatment threshold under JNC 8 guidelines and does not warrant pharmacologic intervention unless other risk factors are present.
Choice B reason: 130/80 mmHg is the threshold used in more recent guidelines such as ACC/AHA 2017, but JNC 8 recommends a higher threshold for older adults. For individuals over 60 years old, the treatment threshold is 150/90 mmHg.
Choice C reason: 140/90 mmHg is the treatment threshold for adults younger than 60 years or those with diabetes or chronic kidney disease. For patients over 60 without these conditions, JNC 8 recommends initiating treatment at 150/90 mmHg.
Choice D reason: According to JNC 8, for adults aged 60 years or older without diabetes or chronic kidney disease, pharmacologic treatment should be initiated when systolic blood pressure is ≥150 mmHg or diastolic is ≥90 mmHg. This recommendation is based on evidence showing reduced stroke and cardiovascular events at this threshold.
Correct Answer is C
Explanation
Choice A reason: Bazedoxifene is a selective estrogen receptor modulator (SERM) primarily used in postmenopausal women for osteoporosis prevention and treatment. It is not approved or recommended as first-line therapy for men with osteoporosis due to its estrogen-related mechanism of action.
Choice B reason: Risedronate is a bisphosphonate and is effective in treating osteoporosis. However, it is a specific agent within the bisphosphonate class. While it may be used, the broader class of bisphosphonates is considered first-line, allowing for individualized selection among agents like alendronate, risedronate, or zoledronic acid.
Choice C reason: Bisphosphonates are the first-line therapy for osteoporosis in men. They work by inhibiting osteoclast-mediated bone resorption, thereby increasing bone mineral density and reducing fracture risk. Their efficacy, safety profile, and long-term data support their use as the standard initial treatment.
Choice D reason: Denosumab is a monoclonal antibody that inhibits RANKL, reducing bone resorption. It is effective in treating osteoporosis and may be used in men, especially those who cannot tolerate bisphosphonates or have contraindications. However, it is considered second-line or alternative therapy, not first-line.
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