Chapter 29: Contraception and Unplanned Pregnancies
A nurse is completing an informed consent on a client preparing for a tubal ligation. Which statement by the client would require the nurse to notify the health care provider?
"I will be able to have my third child in about a year from now."
The nurse completes instructing a female patient on the process of in vitro fertilization. Which statement indicates that patient teaching has been effective?
"It can be done with frozen donor sperm."
After teaching a group of college-aged students about condom use, the nurse determines that additional teaching is needed when the students make which statement?
"It's okay to use petroleum jelly with a latex condom."
The nurse instructs a patient on cervical mucus changes that occur during ovulation. Which statement indicates that teaching has been effective?
"When the mucus is thin and watery, then ovulation is occurring."
The client has heard of extended-cycle oral contraceptive regimens and desires more information. The nurse explains that these regimens consist of active combination pills, followed by placebo pills. How many days of active combination pills and placebo pills are contained in these regimens?
84 active; 7 placebo
A nurse is preparing a client for intrauterine device (IUD) insertion. What should the nurse inform the client when educating her on IUDs?
A regular check of threads must be done.
A client who delivered her baby 3 months ago is seen in the clinic and tells the nurse that she and her husband have yet to resume a sexual relationship. The nurse notes that no contraception is currently being used. What is the most appropriate nursing diagnosis for this client?
Altered sexual pattern related to fear of pregnancy
A client asks the nurse, "What would be the best way to get pregnant." The nurse would incorporate which of the following in the response?
Conception is more likely when intercourse occurs within 72 hours of ovulation
The nurse is caring for a client at the ambulatory care clinic who questions the nurse for information about contraception. The client reports that she is not comfortable about using any barrier methods and would like the option of regaining fertility after a couple of years. Which method should the nurse suggest to this client?
CycleBeads or medroxyprogesterone injection
A client presents at the clinic and is interested in obtaining emergency contraception (EC). The nurse explains that EC must be used within 72 hours of unprotected sex to be effective. This is because:
ECs simply prevent embryo creation and uterine implantation from occurring in the first place.
The school nurse is counseling a sexually active 16-year-old adolescent about the various forms of contraception. She is afraid of getting pregnant or contracting a sexually transmitted infection because her boyfriend refuses to use a condom. In answering the client's questions as to which option will be best suit her needs, which form should the nurse recommend?
Female condom
When conducting a health history with a couple who are experiencing subfertility, the nurse will include which of the following?
General health Surgical history Sexual history Medication history
The nurse is assessing a man concerned about his ability to father children because he has an "abnormality of the penis." The nurse finds that the urethral opening is on the ventral surface of the penis. How would the nurse document this finding?
Hypospadias
A 45-year-old client and her spouse are present in the clinic. Results of fertility testing indicate that the client has damage to her fallopian tubes. Which would be the most appropriate infertility option for this client?
In vitro fertilization
A young woman comes into the clinic stating that she is pregnant and does not want to have a baby. After counseling, the woman decides to terminate the pregnancy by having an abortion. The nurse explains that the procedure will be what type of abortion?
Induced abortion
A client is requesting information on the various available contraceptives. When explaining a vaginal spermicide, which information should the nurse prioritize?
Insert the product by applicator in the vagina several hours prior to intercourse.
A patient received a scheduled dose of depot medroxyprogesterone acetate (DMPA) 6 weeks ago. Today, the patient reports that a regular menstrual cycle is 2 weeks late. What is the first thing that should be done for this patient?
Perform a pregnancy test.
A 26-year old mother of three children tells the nurse at her annual check-up that she does not want to have any more children; however, her religion forbids the use of contraceptive devices. Which of the following methods would be the best option for this client?
Rhythm method
The nurse is preparing to teach a client how to conduct the BBT method to determine her fertile window. Which instruction should the nurse prioritize?
Temperature should be taken prior to any activity every morning.
The nurse completes instructing a patient on the use of the contraceptive patch. Which patient response indicates that teaching has been effective?
The patch should be applied to the abdomen, buttocks, or back.
The nurse is planning an education seminar on safer sexual practices for a group of young adults. Which information should the nurse include in this teaching?
Void immediately after having sex. Avoid sex with intravenous drug users. Use a latex condom for intercourse.
A woman is 40 years old and a heavy smoker. She has a single sexual partner but has very irregular menstrual cycles. She wants a highly reliable contraceptive. Which method would be the best recommendation?
a diaphragm and spermicide
A client prescribed COC has presented for a routine visit. Which finding upon assessment should the nurse prioritize?
abdominal pain
A woman comes to the clinic because she has been unable to conceive. When reviewing the woman's history, the nurse would least likely identify which factor as a possible risk?
age of 25 years
The nurse is teaching a young couple, who desire to start their family, the various methods for determining fertility. After discovering the woman regulary travels internationally for work, deals with a lot of job anxiety and frequently uses an electric blanket at home, the nurse will discourage the use of which method?
basal body temperature method
A nurse is teaching a couple about how to use a condom. The nurse determines the couple can properly apply the condom when they state that it should be applied at which time to be most effective?
before penile-vulvar contact
A woman is to receive methotrexate and misoprostol to terminate a first-trimester pregnancy. When preparing the teaching plan for this client, the nurse understands that misoprostol works by:
causing uterine contractions to expel the uterine contents.
A woman in the 15th week of gestation is planning on terminating the pregnancy. The procedure done for second trimester terminations is which of the following?
dilatation and extraction
A clinic nurse explains to a client who is undergoing an infertility workup that the patency of her fallopian tubes will be checked. Which test is currently used to do this?
hysterosalpingography
When discussing contraceptive options, the nurse would recommend which option as being the most reliable?
intrauterine system
The nurse informs the client that a diaphragm is an example of which type of contraception?
mechanical barrier
A woman has just been prescribed clomiphene citrate to stimulate ovulation. Which possible effect should the nurse warn the woman about?
overstimulation of the ovary resulting in potential multiple births
A female patient who has been trying to conceive for 1 year comes to the fertility clinic and will be undergoing a subfertility evaluation. When discussing the components involved, which information would the nurse most likely include?
semen analysis of the partner ovulation monitoring tubal patency assessment
When using the contraceptive patch, a client should understand that it:
should be applied to the abdomen, buttocks, or back.
The nurse is assessing a male client who is concerned about his ability to produce enough sperm to have a child. He tells the nurse, "I have had some issues in my younger years." What questions would be important for the nurse to ask this client?
"Are you exposed to X-rays or other radioactive substances?" "Do you use drugs or use alcohol excessively? "Have you ever had any type of trauma or surgery on or near your testicles?"
A young patient comes to the clinic and requests birth control pills to prevent a pregnancy. She tells the nurse that she is worried that she will get mixed up on what days to take the pills. Which would be the best type of pills to prescribe this patient?
COCs packaged with 28 pills
A couple who has not conceived after 6 years of not using birth control are being seen in the infertility clinic. In assessing the client's psychosocial response to infertility, which might the nurse expect to find?
Fear of the possible outcome of the testing Anger toward others who have conceived Guilt related to the lack of conception
A couple consults with the nurse regarding their infertility issues. The female says "I don't know what I have done so bad that God would punish me like this." What would be the most appropriate nursing diagnosis for this couple?
Spiritual distress related to inability to conceive
The nurse in a primary care clinic and a client have come to see the primary care provider because the client is getting married and wants to have a prenuptial gynecologic examination. After the exam, the nurse asks about the woman's plan to have a family. The woman responds, "Why do I have to plan for a family?" What would be the nurses's best response?
The couple can control the time between births when they plan their family.
A couple is considering vasectomy as a contraception option. However, the husband is nervous about how such a procedure would affect his sexual functioning. Which information should the nurse mention to the man?
The man will still have full erection capacity.
The nurse is preparing a presentation for a group of adolescents and young adults about sexually transmitted infections and the use of condoms. Which information would the nurse most likely include?
applying the condom before there is any penile-vulvar contact
Which definition best explains the term "subfertility/infertility"?
failure to achieve pregnancy after 1 year of unprotected intercourse
