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The OB-GYN nurse is teaching a client at the clinic that use of a spermicide has an increased effectiveness if used with which other items? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. A non-water-based lubricant 2. A diaphragm 3. A contraceptive sponge 4. Prophylactic antibiotics 5. A condom
2, 3, 5 Explanation: 2. Barrier contraceptives such as a diaphragm act by blocking the transport of sperm and are often used in conjunction with a spermicide. 3. Barrier contraceptives such as the contraceptive sponge act by blocking the transport of sperm and are often used in conjunction with a spermicide. 5. Barrier contraceptives such as the condom act by blocking the transport of sperm and are often used in conjunction with a spermicide.
A couple asks the nurse what is the safest method of sterilization. What should the nurse reply? 1. "Laparotomy tubal ligation." 2. "Laparoscopy tubal ligation." 3. "Minilaparotomy." 4. "Vasectomy."
Answer: 4 Explanation: 4. Vasectomy (male sterilization) is a relatively minor procedure.
The nurse is planning an educational session about contraception. What will the nurse emphasize as being the most significant factor in determining the effectiveness of a specific method of contraception to avoid pregnancy? 1. Reliability 2. Ease of use 3. Consistency of use 4. Cost
Answer: 3 Explanation: 3. Consistency of use is the most important factor for determining the effectiveness of a specific type of contraception.
A nurse is providing contraceptive counseling to a perimenopausal client in a monogamous relationship. What comment by the client indicates that further teaching is necessary? 1. "The calendar method is the most reliable method for me to use." 2. "If I use the IUC, I will be at minimal risk for pelvic inflammatory disease." 3. "I should still use birth control, even though I had only three periods last year." 4. "The contraceptive skin patch contains both estrogen and progesterone."
Answer: 1 Explanation: 1. The client who believes the calendar method is the most reliable method requires more teaching. The menstrual cycle of perimenopausal women is irregular, and it is difficult to determine safe and unsafe times.
A client using oral contraceptives tells the nurse that her family is complete, and she now desires permanent contraception. Which statement should the nurse include in teaching this client about sterilization options? 1. "Essure becomes effective 3 months after insertion." 2. "Vasectomy is effective immediately after the procedure." 3. "Tubal ligation cannot be performed until the client is age 35." 4. "Oral contraception should be taken until menopause."
Answer: 1 Explanation: 1. The insertion of Essure creates a tissue response that results in tubal occlusion in about 3 months.
The nurse in the OB-GYN office is explaining the benefits and risks associated with Essure to a client and her husband. What statement made by the client indicates that additional education is needed? 1. "A stainless steel microinsert is placed into the distal section of one fallopian tube." 2. "The Essure method of permanent sterilization requires no surgical incision." 3. "The steel microinserts create a benign tissue response that occludes the fallopian tubes." 4. "Women allergic to nickel should consult their physician before placement."
Answer: 1 Explanation: 1. The stainless steel microinsert is placed in the proximal section of both fallopian tubes.
A woman is asking the nurse about using the calendar method of contraception. She reports that her last six menstrual cycles were 28, 32, 29, 36, 30, and 27 days long, respectively. Based on this information, when should the nurse tell the client to abstain from intercourse? 1. Days 9-25 2. Days 9-15 3. Days 10-21 4. Days 10-16
Answer: 1 Explanation: 1. To calculate the period of abstinence, the nurse must subtract 18 from the shortest cycle length and 11 from the longest cycle length.
What issues should the nurse consider when counseling a client on contraceptive methods? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Cultural perspectives on menstruation and pregnancy 2. Effectiveness of the method 3. Future childbearing plans 4. Whether the client is a vegetarian 5. Age at menarche
Answer: 1, 2, 3 Explanation: 1. Decisions about contraception should be made voluntarily with full knowledge of advantages, disadvantages, effectiveness, side effects, contraindications, and long-term effects. Many outside factors influence this choice, including cultural practices, religious beliefs, personality, cost, effectiveness, availability, misinformation, practicality of method, and self-esteem. 2. Decisions about contraception should be made voluntarily with full knowledge of advantages, disadvantages, effectiveness, side effects, contraindications, and long-term effects. Many outside factors influence this choice, including cultural practices, religious beliefs, personality, cost, effectiveness, availability, misinformation, practicality of method, and self-esteem. 3. Decisions about contraception should be made voluntarily with full knowledge of advantages, disadvantages, effectiveness, side effects, contraindications, and long-term effects. Many outside factors influence this choice, including cultural practices, religious beliefs, personality, cost, effectiveness, availability, misinformation, practicality of method, and self-esteem.
The nurse is educating a client on intrauterine contraception (IUC). Which advantages of IUC will the nurse include? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. It is effective, continuous contraception. 2. It is relatively inexpensive over time. 3. It does not need to be inserted immediately prior to coitus. 4. Small amounts of estrogen are released daily. 5. It slightly increases the risk of ectopic pregnancy.
Answer: 1, 2, 3 Explanation: 1. One advantage of IUC is a high rate of effectiveness. 2. One advantage of IUC is that it is inexpensive over time. 3. It is non-coitus-related contraception.
The nurse teaching a group of new mothers and explains that barrier methods of contraception are appropriate if which of the following conditions exist? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Just started an oral contraceptive 2. Is opposed to systemic medications 3. Is lactating 4. Is unconcerned about using contraception 5. Does not smoke and is perimenopausal
Answer: 1, 2, 3, 5 Explanation: 1. A backup method of contraception is needed for a period of time when beginning oral contraceptives. 2. Opposition to taking systemic medications is a reason to use barriers for contraception. 3. Using a barrier method of contraception is appropriate in the early postpartum period or when lactating. 5. Being perimenopausal and smoking make barrier contraception an appropriate choice.
The culturally sensitive nurse will assess cultural attitudes and beliefs about contraception, which can include which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Gender inequities 2. Religion 3. Deference to authority figures 4. Devaluation of large families 5. Attitudes about bleeding
Answer: 1, 2, 3, 5 Explanation: 1. Gender inequities may prohibit some Arab, Latina, and Eastern Indian women from seeking out or using a contraceptive method unless their husbands do not object. 2. The Roman Catholic Church considers all artificial methods of contraception unacceptable. 3. Deference to authority figures is not uncommon in traditional Chinese, Arab, Latina, and East Indian women, especially if the nurse is male. 5. Attitudes toward bleeding affect a woman's duties to her family and partner. Vaginal bleeding may be seen as "unclean" by Muslim and Orthodox Jewish women. Any contraceptive method that involves irregular bleeding might not be acceptable. Among women who feel a monthly period is necessary, any method that ultimately causes amenorrhea would not be acceptable.
A nurse is teaching contraception to a group of college students during a health class. What reason will the nurse include as to why couples might choose to use contraception? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Couples use contraception to avoid pregnancy. 2. Couples use contraception to space future pregnancies. 3. Couples use contraception to gain control over the number of children conceived. 4. Couples use contraception to avoid decisions about the number of children to have. 5. Couples use contraception to avoid contracting sexually transmitted diseases.
Answer: 1, 2, 3, 5 Explanation: 1. This is the main reason for the use of contraception. 2. Contraception is used to space children. 3. Contraception is used to control the number of children that a couple desires. 5. Some types of birth control will avoid sexually transmitted diseases—for example, some of the barrier methods.
The nurse is discussing the use of contraception with a client who has just become sexually active. What factors should the nurse include when educating the client on contraceptive methods? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Contraindications in the client's health history 2. Religious or moral beliefs 3. Partner's belief in the effectiveness of the choice 4. Personal preferences to use method 5. Future childbearing plans
Answer: 1, 2, 4, 5 Explanation: 1. Decisions about contraception should take into consideration any contraindications the client might have. 2. Religious or moral beliefs often impact which choices are acceptable. 4. Personal preferences need to be considered when deciding on a contraceptive method. 5. Plans for future children should be considered before determining whether sterilization should be performed.
A nurse is teaching a group of college students at a Catholic university about natural family planning (NFP). Teaching was successful if the students say natural family planning is which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. "It is free, safe, and acceptable according to our religion." 2. "It includes breastfeeding for 1 year." 3. "It is useful in helping us plan pregnancies." 4. "It allows us to safely have intercourse during our fertile days." 5. "It does not involve the use of artificial substances or devices."
Answer: 1, 3, 5 Explanation: 1. NFP is free, safe, and acceptable to many whose religious beliefs prohibit other methods. 3. NFP is useful in helping couples to plan a pregnancy. 5. NFP involves no artificial substances or devices.
A client who was raped is in the emergency department. She asks the nurse what her alternatives are for emergency contraception. The nurse tells her she can receive which of the following treatments? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Take levonorgestrel and ethinyl estradiol. 2. Have Essure implanted. 3. Have a laparoscopic tubal ligation. 4. Take levonorgestrel alone, but in a high dose. 5. Take high doses of male hormones.
Answer: 1, 4 Explanation: 1. Preparations for EC include high doses of levonorgestrel and ethinyl estradiol (Yuzpe regimen). 4. Preparations for EC include high doses of levonorgestrel (Plan B).
Extended use combined oral contraceptives (COCs) reduce the side effects of COCs such as which of the following? 1. Cramping 2. Hypertension 3. Breast tenderness 4. Bloating
Answer: 2 Explanation: 2. Complications of COCs include: myocardial infarction, stroke, blood clots, and hypertension.
A client who is currently 12 weeks pregnant is seeking information on pregnancy termination. The nurse is teaching the client about the risks involved if she were to take the medication mifepristone. Which adverse signs would the client need to know and report immediately to a physician? 1. Fatigue, lack of appetite, and inability to concentrate 2. Nausea, diarrhea, vomiting, and stomach pain 3. Increase in heart rate, inability to sit still, and lack of appetite 4. Headache, fatigue, and hunger
Answer: 2 Explanation: 2. Nausea, diarrhea, vomiting, and stomach pain are the symptoms that must be reported immediately to the physician.
The nurse educator is planning a class about contraception, and includes information about the effects of various contraceptive methods on sexually transmitted diseases. Which statement will the nurse include concerning spermicides? 1. "Spermicides are effective against gonorrhea and chlamydia, but not against HIV." 2. "Spermicides are not effective against sexually transmitted diseases, and can increase a woman's susceptibility to HIV." 3. "Spermicides are effective against HIV, but are not effective against the other sexually transmitted diseases." 4. "Whether or not spermicides are effective against sexually transmitted diseases depends on where the woman is in her cycle."
Answer: 2 Explanation: 2. Spermicides are not effective against any sexually transmitted disease. Spermicides have a negative effect on the integrity of vaginal cells, making them more susceptible.
A client is using the contraceptive sponge as a birth control method. What action is important in order to maintain the sponge's effectiveness? 1. Insert the sponge at least 1 hour before intercourse. 2. Thoroughly moisten the sponge with water before inserting. 3. Spermicidal jelly must be inserted at the same time the sponge is inserted. 4. A new sponge must be inserted every time a couple has intercourse.
Answer: 2 Explanation: 2. The sponge is moistened thoroughly with water before use to activate the spermicide.
A client in the clinic asks the nurse about available contraceptives. Before responding, the nurse must assess which of the following factors? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. When menarche occurred 2. How frequently the client has intercourse 3. Whether the client has a history of thrombophlebitis 4. What the client's partner prefers 5. Whether the client is in a monogamous relationship
Answer: 2, 3, 5 Explanation: 2. A factor to consider when choosing a method of contraception is how frequently the client has intercourse. 3. A factor to consider when choosing a method of contraception is whether the client has a history of thrombophlebitis or any other condition that would contraindicate its use. 5. A factor to consider when choosing a method of contraception is whether the client is in a monogamous relationship.
The nurse in the community clinic instructs a client starting on a combined oral contraceptive that she must immediately report which of the following symptoms? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Only four withdrawal bleeds per year 2. Speech problems 3. Unscheduled bleeding 4. Blood pressure of 126/84 5. New lumps in her breast
Answer: 2, 5 Explanation: 2. The woman using combined oral contraceptives should contact her healthcare provider if she develops speech problems. 5. The woman using combined oral contraceptives should contact her healthcare provider if she develops a breast lump.
The nurse is developing a teaching plan for a client undergoing a tubal ligation. What information should be included in the plan? 1. The surgical procedure is easily reversible. 2. Laparotomy is performed following a vaginal birth. 3. Minilaparotomy is performed in the postpartum period soon after a vaginal birth. 4. Tubal ligation can be done at any time the woman is either pregnant or not pregnant.
Answer: 3 Explanation: 3. A tubal ligation minilaparotomy is performed in the postpartum period soon after a vaginal birth.
The nurse is preparing educational materials at a family planning clinic. The client who is an appropriate candidate for using emergency contraception would be one who reports which of the following? 1. Forgetting to start her pill pack yesterday 2. Unprotected intercourse during her menses 3. That a condom broke yesterday in the middle of her cycle 4. Increased dysmenorrhea since IUC insertion
Answer: 3 Explanation: 3. Research indicates that oral hormonal EC taken as soon as possible within 72 hours, but up to 5 days, can reduce the risk of pregnancy after a single act of unprotected intercourse by at least 74%.
The client who was raped is extremely upset when a pregnancy test confirms that she is pregnant, and requests information regarding pregnancy termination. Which statement is best for the nurse to include? 1. "Abortion is morally wrong, and should not be undertaken." 2. "Hypertension is a risk with any abortion." 3. "Surgical abortion in the first trimester is technically easier and safer than abortion in the second trimester." 4. "The most accurate method to determine gestational age are the results of a pregnancy test."
Answer: 3 Explanation: 3. Second-trimester abortion (greater than 13 weeks' gestation up to 24 weeks or as per state law) may be done medically or surgically.
A client asks the nurse, "Can you explain to us how to use the basal body temperature method to detect ovulation and prevent pregnancy?" What response by the nurse is best? 1. "Take your temperature every evening at the same time and keep a record for a period of several weeks. A noticeable drop in temperature indicates that ovulation has occurred." 2. "Take your temperature every day at the same time and keep a record of the findings. A noticeable rise in temperature indicates ovulation." 3. "Take your temperature each day, immediately upon awakening, and keep a record of each finding. A noticeable rise in temperature indicates that ovulation is about to occur." 4. "This is an unscientific and unproven method of determining ovulation, and is not recognized as a means of birth control."
Answer: 3 Explanation: 3. The basal body temperature method is used to detect ovulation by an increase in the basal temperature during the menstrual cycle. It requires that the woman take her temperature every morning upon awakening (before any activity) and record the findings on a temperature graph, and is based on the fact that the temperature almost always rises and remains elevated after ovulation because of the production of progesterone, a thermogenic (heat-producing) hormone.
The nurse is providing instructions for a woman who has just had intrauterine contraception inserted. What is essential for the nurse to teach the client? 1. To palpate her lower abdomen each month to check the patency of the device 2. To remain on bed rest for 24 hours after insertion of the device 3. To report any pain during intercourse to the physician 4. To insert spermicidal jelly within 4 hours of every sexual encounter
Answer: 3 Explanation: 3. The client should report any pain during intercourse to the physician. This can be due to an infection.
When the nurse is teaching a woman about the use of a diaphragm, it is important to instruct her that the diaphragm should be rechecked for correct size how often? 1. Every five years routinely 2. When weight gain or loss beyond five pounds has occurred 3. After each birth 4. Only after significant weight loss
Answer: 3 Explanation: 3. The diaphragm should be rechecked for correct size after each childbirth and whenever a woman has gained or lost 10 pounds or more.
The nurse in the clinic instructs a client using the natural method of contraception to begin counting the first day of her cycle as which day? 1. The day her menstrual period ceases 2. The first day after her menstrual period ceases 3. The first day of her menstrual period 4. The day of ovulation
Answer: 3 Explanation: 3. The first day of menstruation is the first day of the cycle.
A woman comes into the emergency department stating she was raped the day before, and requests emergency contraception. She states that she is in the middle of her cycle. The nurse knows which of the following about the client? 1. This client has waited too long before coming to the emergency department. 2. The client will have to wait 10 days before she can have emergency contraception. 3. The client can receive emergency contraception up to 72 hours to 5 days after the intercourse. 4. The client will have to wait and see whether she misses a period.
Answer: 3 Explanation: 3. This client is within the 72-hour to 5-day timeframe, and is able to receive the medicine.
The nurse is instructing a client in the use of combined oral contraceptives. The nurse knows that additional teaching is required when the client makes which statement about the risks of taking combined oral contraceptives? 1. "They will lower my risk for breast cancer." 2. "They will increase my risk for cervical cancer." 3. "They will lower my risk for ovarian cancer." 4. "They will increase my risk for uterine cancer."
Answer: 3 Explanation: 3. This is true. There is a reduction in the incidence of ovarian cancer.
A client who wants to use the vaginal sponge method of contraception shows that she understands the appropriate usage when she makes which statement? 1. "I need to use a lubricant prior to insertion." 2. "I need to add spermicidal cream prior to intercourse." 3. "I need to moisten it with water prior to use." 4. "I need to leave it in no longer than 6 hours."
Answer: 3 Explanation: 3. To activate the spermicide in the vaginal sponge, it must be moistened thoroughly with water.
The nurse in the clinic is seeing four clients. Which one is the best candidate for receiving an IUC? 1. An unmarried, 22-year-old college graduate 2. A married 24-year-old who has never been pregnant 3. An unmarried 25-year-old with a history of chlamydia 4. A married 26-year-old who has two children
Answer: 4 Explanation: 4. This client is the best candidate, as she is in a stable relationship, and has children.
During a counseling session on natural family planning techniques, the nurse explains that cervical mucus at the time of ovulation should be of what consistency? 1. Egg white appearance and stretchable 2. Opaque and acidic 3. High in leukocytes 4. Lacking in quantity
Answer: 1 Explanation: 1. Cervical mucus at the time of ovulation has an "egg white" appearance and is known as fertile mucus; it is friendly to sperm because it assists passage through the cervix and uterus up into the fallopian tubes.
When assessing a client asking about birth control, the nurse knows that the client would not be a good candidate for Depo-Provera (DMPA) if which of the following is true? 1. She wishes to get pregnant within 3 months. 2. She is a nursing mother. 3. She has a vaginal prolapse. 4. She weighs 200 pounds.
Answer: 1 Explanation: 1. Return of fertility after use may be delayed for an average of 10 months.
A female client who is 36 years old, weighs 200 pounds, is monogamous, and does not smoke desires birth control. The nurse understands that which contraceptive method is inappropriate for this client? 1. Intrauterine device 2. Vaginal sponge 3. Combined oral contraceptives 4. Transdermal hormonal contraception
Answer: 4 Explanation: 4. Transdermal hormonal contraception is contraindicated because of the client's obesity.
A client in the women's clinic asks the nurse, "How is the cervical mucus method of contraception different from the rhythm method?" The appropriate response by the nurse is that the cervical mucus method is which of the following? 1. More effective for women with irregular cycles 2. Not acceptable to women of many different religions 3. Harder to work with than is the rhythm method 4. Requires an artificial substance or device
Answer: 1 Explanation: 1. The cervical mucus method (Billings Ovulation Method) can be used by women with irregular cycles.
