Chapter 29: Contraception and Unplanned Pregnancies
A client reports that she has multiple sex partners and has a lengthy history of various pelvic infections. She would like to know if there is any temporary contraceptive method that would suit her condition. Which method should the nurse suggest for this client? 1 intrauterine device (IUD) 2 condoms 3 oral contraceptives (OCs) 4 tubal ligation
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A woman opts to use a diaphragm for contraception. Which instruction would be most important for the nurse to provide? 1 "Replace the diaphragm every 6 months." 2 "Have your diaphragm refitted if you lose 10 pounds (4.5 kilograms) or more." 3 "Keep the diaphragm in place for no more than 4 hours after intercourse." 4 "Wet the diaphragm with water first before inserting it."
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A client decides to use the cervical mucus method as her contraceptive method. When describiing this method, the nurse explains that the client can determine ovulation based on which characteristic of the mucus? 1 thick consistency with clumping 2 acidic odor and slightly yellow color 3 thin and slippery 4 transparent with the odor of eggs
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A nurse is receiving a client from the post anesthesia unit to the recovery unit at the ambulatory surgery center. The client just had a laparoscopic tubal ligation. Which is the nurse's priority assessment? 1 Pain 2 Depression 3 Bleeding 4 Abdominal bloating
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A female patient has forgotten to take an ovulation suppressant for two mornings in a row. What should the nurse advise the patient to do? 1 Take two pills a day for the rest of the month. 2 Take three pills immediately and avoid coitus for the remainder of the month. 3 Start a new cycle of 21 pills immediately plus additional estrogen for the next 3 days. 4 Take two pills now and use a second method of contraception for the remainder of the month.
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When discussing contraceptive options, the nurse would recommend which option as being the most reliable? 1 coitus interruptus 2 lactational amenorrheal method (LAM) 3 natural family planning 4 intrauterine system
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FSH hormone
follicle stimulating hormone. stimulates the growth of the ovarian follicle, production of estrogen in females, and production of sperm in males
LH hormone
luteinizing hormone, signals ovulation
A young couple is exploring their contraceptive options and are curious about using an intrauterine contraceptive device. The nurse explains that there are two types, one that uses hormones and one that uses: 1 copper. 2 magnesium. 3 silicone. 4 potassium.
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The client has heard of extended 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? 1 84 active; 7 placebo 2 70 active; 6 placebo 3 56 active; 5 placebo 4 42 active; 4 placebo
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The public health nurse is teaching a community class of couples on fertility awareness-based methods. The nurse determines that additional teaching is needed when one of the couples states that they will be using which method? 1 coitus interruptus method 2 cervical mucus ovulation method 3 basal body temperature method 4 symptothermal method
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When teaching the client how to use a contraceptive sponge, the nurse must tell the client that leaving the sponge in place longer than 30 hours may lead to: 1 toxic shock syndrome. 2 pelvic inflammatory disorder. 3 sexually transmitted infections. 4 cervical inflammation.
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The nurse is conducting a well-visit physical assessment on a 29-year-old female. The nurse determines the client is probably ovulating based on which condition of the cervical mucus? 1 Thin, slippery, and stretchy 2 Cloudy, thick, and watery 3 Clear and of large quantity 4 Thin and red-tinged
1 The mucus at the time of ovulation is thin, slippery, and stretchy to allow for the passage of sperm into the uterus. This is called spinnbarkeit fiber. If the mucus is too thick, it will inhibit fertilization. Before ovulation, the mucus is thick and does not stretch easily.
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? 1 calendar method 2 basal body temperature method 3 cervical mucus method 4 symptothermal method
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The nurse working in a free health clinic assess a 17-year-old client interested in contraceptives. Which statement, if said by the client, would indicate that female or male condoms would be the appropriate recommendation for this client? 1 "I have no problems swallowing medications." 2 "Last year I was diagnosed with HPV." 3 "I am leaving for college in just a few months." 4 "I do not want to follow in my sister's footsteps."
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A female client is having a procedure this morning that involves radiologic examination of the fallopian tubes using a radiopaque medium. What procedure should the nurse document as being performed? 1 a uterine endometrial biopsy 2 a sonohysterography 3 a hysterosalpingography 4 a hysteroscopy
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A female patient being treated for infertility is completing the third course of clomiphene citrate. What information should the nurse prepare for the patient in the event this course does not result in conception? 1 Agencies that coordinate adoptions 2 Strategies to improve sperm motility 3 Additional options to achieve conception 4 Informed consent for taking a fourth course of the medication
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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? 1 as part of foreplay 2 at least 1 hour prior to coitus 3 before penile-vulvar contact 4 immediately after ejaculation
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A patient who has unprotected intercourse has obtained the morning after pill but has not yet taken the prescribed dosage. What nursing diagnosis should the nurse identify as appropriate for the patient at this time? 1 Powerlessness 2 Spiritual distress 3 Decisional conflict 4 Readiness for enhanced knowledge
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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? 1 menstrual extraction 2 dilatation and curettage 3 dilatation and extraction 4 hysterotomy
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A young couple is having difficulty getting pregnant. The nurse is preparing the couple for the initial tests to determiine their fertility. When asked by the couple why they need to start with a sperm analysis, what will be the nurse's best response? 1 Asking the male to undergo diagnostic procedures first is the best way to assess interest in treatment of infertility. 2 The man is found to be fertile in over 75 percent of couples with infertility problems. 3 Male fertility testing is time-consuming and therefore should be initiated early. 4 Sperm analysis is one of the easiest tests to complete.
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A woman has just been prescribed clomiphene citrate to stimulate ovulation. Which possible effect should the nurse warn the woman about? 1 overstimulation of the ovary resulting in potential multiple births 2 extensive bleeding during menstruation 3 elevation of her blood glucose level 4 hypertension
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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? 1 Female condom 2 Tubal ligation 3 Oral contraceptive 4 Coitus interruptus
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The school nurse is preparing a health education session on the topic of birth control for a college group. Which method should the nurse emphasize for this group? 1 barrier 2 hormonal 3 rhythm 4 transdermal
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What important information should the nurse give a client about the use of a diaphragm during menstruation? 1 Toxic shock syndrome is possible 2 Vaginal discharges may occur 3 It may cause genital burning 4 Use during menstruation can lead to abdominal pain
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The nurse is asked to schedule a hysterosalpingogram. Which question would be most important for the nurse to ask the woman before scheduling the procedure? 1 When do you expect your next menstrual flow? 2 Are you allergic to any sedatives? 3 What is your blood type and Rh factor? 4 When did you have coitus last?
1 Because a radiograph is involved, the procedure should be done in the few days following a menstrual flow when she is not apt to be pregnant.
A nurse is preparing a client for intrauterine device (IUD) insertion. What should the nurse inform the client when educating her on IUDs? 1 There is reduced menstrual flow after insertion. 2 The insertion procedure is painless. 3 A regular check of threads must be done. 4 There are continuous cramps after insertion.
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The nurse completes instructing a patient on the use of the contraceptive patch. Which patient response indicates that teaching has been effective? 1 The patch is immediately effective after application. 2 The patch should be applied to the breasts, hips, or back. 3 The patch should be applied to the abdomen, buttocks, or back. 4 The patch should be covered when swimming because of chlorine's effect on the adhesive.
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x A couple comes to the clinic for a fertility evaluation. The male partner is to undergo a semen analysis. After teaching the partner about this test, which client statement indicates that the client has understood the instructions? 1 "I need to bring the specimen to the lab the day after collecting it." 2 "I will place the specimen in a special plastic bag to transport it." 3 "I have to abstain from sexual activity for about 1 to 2 days before the sample." 4 "I will withdraw before I ejaculate during sex to collect the specimen."
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A patient comes into the family planning clinic and requests a prescription for birth control pills. Which assessment finding indicates that an ovulation suppressant would not be the best contraceptive method for the patient? 1 Age 30 years 2 Allergy to foreign protein 3 Irregular menstrual cycles 4 History of thromboembolism
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A school health nurse is providing education to a group of adolescents regarding the proper procedure for male condom use. The nurse knows the teaching has been effective when which statement is made by a student? 1 "Ensure your condom is always available, so store condoms in your wallet." 2 "It is important to put the condom on just before the penis is erect." 3 "Use only petroleum-based lubricants, such as body lotion or massage oil." 4 "Withdraw the penis erect, holding the condom firmly against the penis."
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The estrogen content in the contraceptive pill performs which action? 1 decreases the permeability of cervical mucus 2 increases the level of luteinizing hormone (LH) 3 interferes with endometrial proliferation 4 suppresses follicle-stimulating hormone (FSH)
4 Estrogen has a direct effect on the pituitary gland suppressing FSH; progesterone increases permeability of cervical mucus and endometrial proliferation.
The female partner of a young couple is concerned about what the results of fertility tests might reveal. Which nursing diagnosis should the nurse use to plan care for this patient? 1 Fear related to possible outcome of subfertility studies 2 Deficient knowledge related to measures to promote fertility 3 Anxiety related to the procedures necessary for fertility testing 4 Situational low self-esteem related to the apparent inability to conceive
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A healthy 28-year-old female client who has a sedentary lifestyle and is a chain smoker is seeking information about contraception. The nurse informs this client of the various options available and the benefits and the risks of each. Which should the nurse recognize as contraindicated in the case of this client? 1 the medroxyprogesterone injection 2 combination oral contraceptives 3 a copper intrauterine device 4 implantable contraceptives
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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? 1 It depends on the average temperature taken each morning. 2 Temperature should be taken prior to any activity every morning. 3 Avoid intercourse only on the days the temperature drops. 4 It is the best method for predicting ovulation.
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