Chapter 25 Questions
A patient who was taking oral contraceptives has recently begun to use a barrier contraceptive, namely the male condom. What does the nurse tell the patient? 1 "Ensure that you have access to emergency contraception." 2 "Add spermicide to condoms to lower the risk of pregnancy." 3 "Polyurethane condoms offer better protection than latex condoms against pregnancy." 4 "Use natural skin condoms to prevent sexually transmitted infections."
1 Barrier contraceptives like condoms may tear during intercourse and increase the risk for pregnancy. Therefore, the patient needs to have access to emergency contraceptive pills, which can be taken after intercourse to prevent pregnancy. There is no evidence that adding spermicide to male condoms lowers the risk for pregnancy. Polyurethane condoms are not as effective as latex condoms, because they may slip or lose contour. Natural skin condoms have small pores that can allow the passage of viruses such as hepatitis B, herpes simplex virus (HSV), and human immunodeficiency virus (HIV), and therefore do not prevent STI
A patient is prescribed griseofulvin (Fulvicin P/G) for the treatment of ringworm. After reviewing the medical history of the patient, the nurse finds that the patient is taking oral contraceptives. What advice should the nurse gives to the patient? 1 "Use other forms of contraceptive methods." 2 "Use a double dose of oral contraceptive." 3 "Take a lower dose of griseofulvin (Fulvicin P/G.)" 4 "Take both medications simultaneously."
1 Griseofulvin (Fulvicin P/G) reduces the efficacy of oral contraceptives. Therefore, to prevent pregnancy, the nurse should advise the patient to use other contraceptive methods while taking griseofulvin (Fulvicin P/G). The patient should not take a double dose of oral contraceptives, because it may cause drug overdose and may cause adverse effects in the patient. Lowering the dose of griseofulvin (Fulvicin P/G) may not eliminate the ringworm infection. Griseofulvin (Fulvicin P/G) diminishes the action of oral contraceptives. Therefore, the patient should not take oral contraceptives and griseofulvin (Fulvicin P/G) simultaneously.
A female patient who experiences metrorrhagia has been taking oral contraceptive pills (OCPs). The patient is instructed to take the pills at the same time each day to alleviate breakthrough bleeding. On assessment, after a week, the patient is prescribed a different contraceptive pill with an increased progestin component. Which condition does the nurse expect led to the change? 1 The breakthrough bleeding continued. 2 The patient had osteoporosis. 3 The patient experienced nausea. 4 The patient experienced gastrointestinal bleeding.
1 Metrorrhagia is an episode of bleeding that occurs at a time other than the normal menses. Metrorrhagia may occur if the patient takes OCPs. The problem can be resolved if the patient takes the OCPs at the same time each day. However, if the bleeding continues, the patient is prescribed a different formulation of the OCP that increases either the estrogen or progestin component of the pill. An increase in calcium intake is usually prescribed for a patient who develops osteoporosis. Nausea is a side effect of estrogen use. Nausea occurs if the progestin component in the pills is increased. Gastrointestinal bleeding is a side effect of nonsteroidal antiinflammatory drugs (NSAIDs).
The nurse must evaluate a male patient's knowledge regarding the use of a condom. The nurse recognizes the need for additional instruction if the patient states that he does what? 1 Lubricates the condom with a spermicide containing nonoxynol-9 2 Leaves an empty space at the tip of the condom 3 Removes any air remaining in the tip 4 Removes his still-erect penis from the vagina while holding onto the base of the condom
1 Nonoxynol-9 is no longer recommended. Recent data suggest that frequent use of nonoxynol-9 may increase human immunodeficiency virus transmission and can cause genital lesions. An empty space at the tip of the condom is the correct instruction. Removing any air in the tip of the condom is the correct instruction. Removing the condom while holding the base is the correct instruction.
The nurse is assessing a patient who is taking oral contraceptives and reports severe pain in the legs. What symptoms should the nurse primarily assess for in the patient? 1 Thrombus formation 2 Severe muscle spasms 3 High creatinine levels 4 Hyperglycemic events
1 Patients who take oral contraceptives are at a high risk of developing thromboembolism or blood clots. Therefore, the nurse would primarily assess for calf pain warmth and tenderness, which indicate thromboembolism. Muscle spasms are not side effects that develop with oral contraceptives. Though the pain is severe in the case of muscle spasms, it can be resolved easily with the help of analgesics. Creatinine levels increase when the kidneys fail to function properly. Oral contraceptives have no effect on kidney function. Oral contraceptives have no effect on blood glucose levels.
What does the nurse tell a patient who is using the ParaGard Copper T 380A? 1 "Report immediately if rashes occur." 2 "Drink warm water if you experience cramping." 3 "Irregular spotting is a serious side effect and needs prompt treatment." 4 "Use a condom to increase contraceptive effectiveness."
1 The nurse should inform the patient to report immediately if there are rashes because it indicates an allergy to copper, and the device needs to be removed immediately. Cramping and bleeding are side effects of the copper intrauterine device (IUD) that can cause pain. The patient needs to take nonsteroidal antiinflammatory drugs, not warm water, to reduce pain. The ParaGard Copper T 380A is an effective contraceptive method that does not require the need of an alternative contraception method to prevent pregnancy.
After having a discussion with a patient, the nurse finds that the patient has regular menstrual cycles every 28 days. What instructions should the nurse give to the patient to prevent conception? 1 The couple should abstain from sexual intercourse from days 10 through 17. 2 The couple should abstain from sexual intercourse from days 6 through 19. 3 It is safe to have unprotected sexual intercourse from days 11 through 17. 4 It is safe to have unprotected sexual intercourse from days 12 through 16
1 The patient has regular menstrual cycles of 28 days. The beginning of the fertile period is estimated by subtracting 18 days from the length of the shortest cycle. The end of the fertile period is determined by subtracting 11 days from the length of the longest cycle. Therefore, according to the formula, the fertile days are from day 10 through day 17 (shortest cycle, 28 - 18 = day 10, and longest cycle, 38 - 11 = day 17). Therefore, the nurse should advise the patient to abstain from sexual intercourse between days 10 and 17. If the woman has a shortest cycle of 24 days and a longest cycle of 30 days, then the couple should abstain from sexual intercourse from days 6 through 19. As per the calculation, women who have regular cycles of 28 days should not have unprotected sexual intercourse between days 11 and 17, because it is a fertile period.
The nurse is caring for a female patient. The patient is 26 years old, has no known allergies, is 5 feet 9 inches, and weighs 108 kg. The patient states, "I need another method of birth control. I have had an intrauterine device (IUD) before, but I experienced too much bleeding and cramping with it. I also do not want to take a pill every day." Which method of birth control will be most effective in meeting the patient's needs? 1 Progestin implants 2 Progestin injections 3 Vaginal contraceptive ring 4 Transdermal contraceptive patch
1 The progestin implant will offer the patient the most protection against pregnancy with the least amount of effort on the patient's part. Progestin implants provide 3 years of protection and require injections every 12 weeks. The vaginal contraceptive ring can stay in place for 3 weeks, but the patient must remember when to remove and reinsert a new one. The transdermal contraceptive patch is less effective for women over 90 kg and requires weekly application.
The nurse is obtaining a medical history from a patient who would like to begin oral contraceptives. The use of oral contraception is contraindicated if the patient has which conditions? Select all that apply. 1 Breast cancer 2 Thrombophlebitis 3 Renal impairment 4 Migraines with auras 5 Impaired liver function
1,2,4,5 The use of oral contraception is contraindicated for patients with breast cancer, a history of or active thrombophlebitis, migraines with an aura, and impaired liver function. Oral contraception in not contraindicated with renal impairment.
The nurse is educating a patient on contraceptive reliability. Which method of contraception will the nurse inform the patient is the least reliable form of birth control? 1 Condoms 2 Coitus interruptus 3 Natural family planning 4 Vaginal contraceptive ring
2 Coitus interruptus is the least reliable birth control method. Condoms, natural family planning, and the vaginal contraceptive ring are statistically more reliable methods. The natural family planning method is only marginally more reliable, and the vaginal contraceptive ring is the most reliable of these options.
Nurses, certified nurse-midwives, and other advanced practice nurses have the knowledge and expertise to assist women in making informed choices regarding contraception. A multidisciplinary approach should ensure that the woman's social, cultural, and interpersonal needs are met. Which action should the nurse take first when meeting with a new patient to discuss contraception? 1 Obtain data about the frequency of coitus. 2 Determine the woman's level of knowledge about contraception and commitment to any particular method. 3 Assess the woman's willingness to touch her genitals and cervical mucus. 4 Evaluate the woman's contraceptive life plan.
2 Determination of the woman's level of knowledge regarding contraception and her commitment to a method is the primary step of this nursing assessment and necessary before completing the process and moving on to a nursing diagnosis. Once the patient's level of knowledge is determined, the nurse can interact with the woman to compare options, reliability, cost, comfort level, protection from sexually transmitted infections (STIs), and a partner's willingness to participate. Although important, obtaining data about the frequency of coitus is not the first action that the nurse should undertake when completing an assessment. Data should include not only the frequency of coitus but also the number of sexual partners, level of contraceptive involvement, and the partner's objections. A woman's willingness to touch her genitals and cervical mucus is a key factor for the nurse to discuss should the patient express interest in using one of the fertility awareness methods of contraception, but is not the first action taken by the nurse. The nurse must be aware of whether the patient is attempting to prevent conception, delay conception, or conceive.
A male patient asks the nurse why it is better to purchase condoms that are not lubricated with nonoxynol-9 (a common spermicide). The nurse's most appropriate response is what? 1 "The lubricant prevents vaginal irritation." 2 "Nonoxynol-9 does not provide protection against sexually transmitted infections, as originally thought; also, it has been linked to an increase in the transmission of human immunodeficiency virus (HIV) and can cause genital lesions." 3 "The additional lubrication improves sex." 4 "Nonoxynol-9 improves penile sensitivity."
2 Nonoxynol-9 does not provide protection against sexually transmitted infections, as originally thought; also, it has been linked to an increase in the transmission of human immunodeficiency virus (HIV) and can cause genital lesions" is a true statement. Nonoxynol-9 may cause vaginal irritation. Nonoxynol-9 has no effect on the quality of sexual activity. Nonoxynol-9 has no effect on penile sensitivity.
Which symptom in a woman who is using oral contraceptives should be reported to the physician immediately? 1 5-pound weight gain in a month 2 Leg pain and edema 3 Decreased menstrual flow 4 Increased pigmentation of the face
2 Oral contraceptives increase clotting factors that may place the woman at risk for thrombophlebitis. Leg pain and edema are symptoms of thrombophlebitis. A 5-lb weight gain in the first month is a common finding. A decrease in menstrual flow is an expected finding. An increased pigmentation of the face is a common finding.
Which patient is a probable candidate for the Essure system of transcervical sterilization? 1 A patient who has a history of ectopic pregnancy 2 An obese patient with abdominal adhesion 3 A patient who had a vaginal delivery a week ago 4 A patient who wants more children
2 The Essure system of transcervical sterilization is more beneficial for an obese patient with abdominal adhesions, because it eliminates the need for abdominal surgery. The device works by stimulating the woman's own scar tissue formation to occlude the uterine tubes and prevent conception. The Essure system is intended to prevent pregnancy, and so a history of ectopic pregnancy is irrelevant to this method of sterilization. The device is not intended for postpartum patients and may cause complications. The Essure system is a permanent form of birth control and is not intended for women who want children.
Which statement by the student nurse about spermicides indicates effective learning? 1 "Spermicides are inserted 3 hours before sexual intercourse." 2 "Spermicides are reapplied for each additional act of intercourse." 3 "Spermicides are added to male condoms to prevent pregnancy." 4 "Spermicides are used to prevent sexually transmitted infections."
2 The patient needs to apply spermicide before each additional act of intercourse, because there is an increased chance of pregnancy if the spermicide is used only once. Spermicides are inserted no more than 1 hour before intercourse. The spermicide is inserted high into the vagina in order to make contact with the cervix. The use of spermicides in male condoms does not prevent pregnancy. Spermicides cannot prevent sexually transmitted infections. The couple needs to use barrier contraception along with spermicides to prevent sexually transmitted infections.
A patient is worried about pregnancy after unprotected sex. Within how many days can the patient use emergency contraception to prevent pregnancy? 1 10 days 2 3 days 3 12 days 4 21 days
2 The patient should take emergency contraception within 72 hours of unprotected sex to prevent pregnancy. The patient may be already pregnant 10, 12, or 21 days after unprotected sex. Therefore, the use of emergency contraception is ineffective, because the pill does not affect an implanted pregnancy.
The nurse is educating a patient on the use of the symptothermal method for natural family planning. Which statement made by the patient demonstrates an understanding of the teaching? 1 "I understand intercourse is safe on days 5 through 10 and from day 15 to the end of the cycle." 2 "I will make sure I take my temperature when I am resting, and check my cervical mucus daily." 3 "I will check my cervical mucus every day, and when the cervical mucus is present I know I am fertile." 4 "To determine my fertility, I will subtract 11 days from my shortest cycle and 18 days from my longest cycle."
2 The statement made by the patient that demonstrates an understanding of the teaching for the symptothermal method of natural family planning is, "I will make sure I take my temperature when I am resting, and check my cervical mucus daily." The symptothermal method combines all the natural family planning methods and assesses weight gain, libido, bloating, and mittelschmerz. Using the application of the standard days method, intercourse is safe only on days 1 through 7 and day 20 to the end of the cycle. It is recommended that the barrier method be used, or to abstain from intercourse, on days 8 through 19. Using the two-day method, not the symptothermal method, the patient is instructed to check for mucus each day. Fertility is determined by the presence of cervical mucus on the current or previous day. When using the calendar method, not the symptothermal method, subtracting 18 days from the shortest cycle and 11 days from longest cycle is used to determine the fertile period.
A married woman has made the decision to use a diaphragm as her primary method of birth control. What instructions should the clinic nurse provide regarding care of, insertion, and removal of the diaphragm? Select all that apply. 1 "Remove the diaphragm by catching the rim from below the dome." 2 "Avoid using mineral oil body products." 3 "On insertion, direct the diaphragm down toward the space below cervix." 4 "Wash diaphragm after each use with mild soap and water." 5 "A dusting of cornstarch is appropriate after drying the diaphragm."
2,3,4,5 Oil-based products can cause the breakdown of the rubber. The diaphragm should be inserted into the vagina, directing it inward and downward as far as it will go to the space behind and below the cervix. The diaphragm should be washed after each use with mild soap and water. Cornstarch may be used. Avoid use of scented talc, body powder, and baby powder, because they can weaken the rubber. The diaphragm should not be removed by trying to catch the rim from below the dome.
The nurse is providing education for a patient prescribed oral contraceptives. What warning signs will the nurse teach the patient to immediately report? Select all that apply. 1 Nausea 2 Headache 3 Chest pain 4 Severe leg pain 5 Severe abdominal pain
2,3,4,5 The patient should be instructed to immediately report headaches, chest pain, severe leg pain, and severe abdominal pain. Headaches could be due to a migraine or a stroke; chest pain may indicate a pulmonary embolus or myocardial infarction; severe leg pain may be an indication of deep vein thrombosis; and severe abdominal pain is an indication of mesenteric or pelvic vein thrombosis. These are all potentially life-threatening conditions. Nausea is not a symptom that needs to be immediately reported.
If used consistently and correctly, which of the barrier methods of contraception has the lowest failure rate? 1 Spermicides 2 Female condoms 3 Male condoms 4 Diaphragms
3
The nurse is assessing a patient who has an unplanned pregnancy even after using contraceptives. The patient uses a barrier technique and lubricants. Which lubricant used by the patient would have reduced the contraceptive effect? 1 Nonoxynol-9 lubricant 2 Silicon-based lubricant 3 Suntan oil as lubricant 4 Water-soluble lubricant
3 Barrier methods such as latex condoms are one among many effective contraceptives. However, the latex condom might break when it is used with lubricants like suntan oil. This would allow the sperm to reach the female cervix and may cause pregnancy. Nonoxynol-9 is a spermicidal lubricant that would reduce sperm activity. The effectiveness of Nonoxynol-9 in preventing pregnancy is high. Silicon-based and water-soluble lubricants are suggested to be used along with condoms. Some of them
Which contraceptive method provides protection against sexually transmitted infections? 1 Oral contraceptives 2 Tubal ligation 3 Male or female condoms 4 Intrauterine device (IUD)
3 Because condoms provide the best protection available, they should be used during any potential exposure to a sexually transmitted infection. Only the barrier methods provide some protection from sexually transmitted infections. A tubal ligation is considered a permanent contraceptive method but does not offer any protection against sexually transmitted infections. IUDs are inserted in the uterus but do not block or inhibit sexually transmitted infections.
The nurse is teaching a group of women about contraception and child spacing. Which statement by the women indicates the need for additional teaching? 1 Condoms can help prevent HIV infection. 2 Different methods of contraception vary in their effectiveness. 3 Barrier methods help prevent pregnancy but not sexually transmitted infections (STIs). 4 Oral contraceptives may help prevent the later development of ovarian cancer.
3 Effective use of contraception promotes desirable child spacing, quality maternity care and future patient health. Barrier methods can prevent both unwanted pregnancy and sexually transmitted infections that may further develop into pelvic inflammatory disease and result in infertility. An individual's risk for contracting an STI can vary depending on choice of contraception. Many researchers believe that combined oral contraceptive pills may prevent the later development of ovarian cancer
A patient is planning to use the calendar rhythm method for contraception. On assessment, the nurse finds that the patient has regular menstrual cycles of 28 days each. When should the couple abstain from sexual activity to avoid pregnancy? 1 On the 9th day 2 On the 16th day 3 From days 10 through 17 4 From days 2 through 10
3 In the calendar rhythm method, the patient is taught to subtract 18 days from the length of the shortest cycle to determine the beginning of the fertile period. The patient is instructed to subtract 11 days from the length of the longest cycle to determine the end of the fertile period. Accordingly in this case, the couple will have to abstain from sexual activity from day 10 through day 17, because ovulation occurs on day 14 plus or minus 2 days. The patient may become pregnant if she engages in sexual activity after the 10th day.
A patient who is taking combined oral contraceptives (COCs) complains of increased appetite and postpill amenorrhea. What does the nurse inform the patient? 1 "Take herbal supplements to prevent these side effects." 2 "Take the pills at the same time each day." 3 "The primary health care provider can prescribe a COC with a low dose of hormone." 4 "These side effects are temporary and will diminish soon."
3 Increased appetite and postpill amenorrhea are symptoms of progestin excess in a patient who takes COCs. If the patient finds these side effects bothersome, the primary health care provider can prescribe a COC with a low dose of hormones that have few side effects, and also prevent ovulation. The nurse should instruct the patient to avoid herbal supplements, because they can reduce the effectiveness of COCs. Taking the pill at the same time each day helps to maintain adequate hormonal levels for contraception. However, this will not reduce the side effects of the COC. The side effects of COCs do not diminish, because the COCs bring about a change in the progestin and estrogen levels.
Which contraceptive method is contraindicated in a woman with a history of toxic shock syndrome? 1 Condom 2 Spermicide 3 Cervical cap 4 Oral contraceptives
3 The cervical cap may increase the risk of toxic shock syndrome because it may be left in the vagina for a prolonged period. A condom is not contraindicated with a history of toxic shock syndrome. Spermicide is not contraindicated with a history of toxic shock syndrome. Oral contraceptives are not contraindicated with a history of toxic shock syndrome.
The nurse is educating a patient about how to use a condom. Which statement by the patient indicates effective learning? 1 "Sticky and brittle condoms are effective for use." 2 "Condoms should be stored in warm, humid locations." 3 "Condoms should be worn before the penis is erect." 4 "Water-based lubricants should be used with condoms."
4 A water-based lubricant is the only lubricant that should be used with condoms, because it reduces the risk of the condom breaking. Petroleum-based lubricants should not be used, because they may break the condom. Sticky and brittle condoms should not be used, because they are not effective. Storing condoms in warm, humid conditions may decrease the effectiveness of the spermicide in the condom. Condoms should be stored in cool, dry locations. Condoms should be worn after the penis is erect, because it is difficult to put on a condom before the penis is erect.
Which statement is true about the term contraceptive failure rate? 1 It refers to the percentage of users expected to have an accidental pregnancy over a 5-year span. 2 It refers to the minimum level that must be achieved to receive a government license. 3 It increases over time as couples become more careless. 4 It varies from couple to couple, depending on the method and the users.
4 Contraceptive effectiveness varies from couple to couple, depending on how well a contraceptive method is used and how well it suits the couple. The contraceptive failure rate measures the likelihood of accidental pregnancy in the first year only. Failure rates decline over time because users gain experience.
A patient is prescribed a single-rod etonogestrel implant (Implanon) for contraception. The patient informs the nurse, "I'm sure I can have multiple sexual partners now." What does the nurse tell the patient? 1 "Your partners will have to use a condom lubricated with N-9." 2 "Encourage your partners to use a natural skin condom." 3 "It is better to use a condom, because there may be a risk for pregnancy." 4 "You must avoid multiple sexual partners and use a condom to prevent sexually transmitted infections."
4 Implanon is a contraceptive implant that is inserted under the skin of a woman's arm. It contains a progestin hormone and is effective for contraception for 3 years. However, an implant does not ensure protection from sexually transmitted infections. Therefore, the nurse instructs the patient to avoid multiple sexual partners and use barrier contraceptives such as condoms. N-9 is a spermicide which helps avoid pregnancy. However, it is not needed if the patient has a contraceptive implant. Natural skin condoms increase the risk for sexually transmitted infections and are not recommended. There is no risk for pregnancy with a contraceptive implant.
On interacting with a patient, the nurse finds that the patient uses lubricants that contain nonoxynol-9 (N-9) at least twice a day. The nurse instructs the patient to not use N-9. What is the reason for giving such advice to the patient? 1 Frequent use can cause a significant decrease in the patient's libido. 2 Frequent use increases the patient's progesterone and estrogen levels. 3 Frequent use reduces bone mineral density and causes osteoporosis. 4 Frequent use raises the patient's risk of sexually transmitted infections.
4 Nonoxynol-9 is a surfactant and is used as a lubricant. This chemical has spermicidal properties and reduces the mobility of sperm. This chemical attacks the flagella and body of the sperm, thereby preventing the sperm from reaching the cervical os. Frequent use of nonoxynol-9 places the patient at a higher risk for sexually transmitted infections, because it decreases immunity and can cause lesions in the anus. Nonoxynol-9 does not decrease libido and does not increase progesterone or estrogen levels. Nonoxynol-9 does not decrease bone mineral density. Depot medroxyprogesterone acetate, used as a contraceptive, decreases bone mineral density in women and increases the risk of osteoporosis.
A patient reports to the nurse that she had her menses on May 11 and again had some light bleeding on May 26. The patient had her next menses on June 8. What does the nurse inform the patient? 1 "Please come again after your next menses." 2 "Your menstrual cycle has a duration of 15 days." 3 "You may need to undergo an ultrasound of the uterus." 4 "Having bleeding in the middle of your cycle is a normal finding."
4 Ovulation usually occurs on the 14th day of the menstrual cycle in a woman who has a 28-day menstrual cycle. After ovulation, there is drop in the estrogen levels, which may result in some light bleeding. This is also referred to as midcycle bleeding. The patient had bleeding after 15 days of the first menstrual period, which indicates that the patient had midcycle bleeding. Therefore, in this case the nurse should assure the patient that it is a normal finding. The patient has the first menstrual cycle on May 11 and the next one on June 8. This indicates that the patient has a normal 28-day menstrual cycle. The patient is normal and therefore does not need to come for a followup appointment after the next menses. The patient's findings do not indicate a uterine pathology; thus, the patient need not undergo an ultrasound.
A married couple is discussing male and female sterilization with the nurse. Which statement is most appropriate for the nurse to make? 1 "Male and female sterilization methods are 100% effective." 2 "A vasectomy may have a slight effect on sexual performance." 3 "Tubal ligation can be easily reversed if you change your mind in the future." 4 "Major complications after sterilization are rare
4 Sterilization procedures can be safely done on an outpatient basis. Complications are uncommon and usually not serious. The average failure rate for female sterilization is 0.5%. The average failure rate for male sterilization is 0.15%. A vasectomy has no effect on potency or volume of ejaculate. Sterilization reversal is costly, difficult, and uncertain.
Which response by the nurse is most appropriate when a woman asks, "What contraceptive do you think I should use?" 1 "Your health care provider will know what is best for you." 2 "The male condom is probably the easiest for you to use." 3 "Because you are younger than 40, you should use oral contraceptives." 4 "I can discuss the various methods so you can decide what is best for you."
4 The nurse should provide the woman with all the necessary information to make an informed decision, but should not make the decision for her. The nurse can educate the woman about contraception; she does not have to ask the doctor. The nurse should provide information about contraception, not tell her which one to choose. The nurse should educate the woman about different types of contraception, not make the choice for her.
What is the role of the nurse in initial family planning? 1 Refer the couple to a reliable health care provider. 2 Decide on the best method for the couple. 3 Advise couples on which contraceptive to use. 4 Educate couples on the various methods of contraception.
4 The nurse's role is to provide information to the couple so that they can make an informed decision about family planning. The nurse can help the couple initially; they do not need to be sent to a health care provider unless it is warranted. The nurse's role is to educate, not to decide for the couple which is the best method. The nurse's role is to educate, not to advise couples on which contraceptive to use.
A female patient informs the nurse that she conceived in the 1st month after discontinuing oral contraceptives (COCs). The patient is worried about the effect of possible COC use on this pregnancy. What does the nurse tell the patient? 1 "The child may have a birth defect." 2 "Conception is safe only after 6 months of discontinuing the pill." 3 "The child may have iron deficiency anemia." 4 "There is no evidence that COCs cause maternal or fetal harm
4 There is no evidence that there will be fetal or maternal harm if the patient conceives in the 1st month after discontinuing oral contraceptives. The child will not have any birth defects because of this, and conception is safe even in the 1st month after discontinuing the pills. Iron deficiency anemia occurs in the fetus if the fetal iron supply is decreased and is not related to maternal COC use.
Which are the long-acting reversible contraceptive methods? Select all that apply. 1 Using condoms 2 Using a diaphragm 3 Using spermicides 4 Using contraceptive implants 5 Using an intrauterine device (IUD)
4,5 Contraceptive implants consist of one or more nonbiodegradable flexible tubes or rods that are inserted under the skin of a woman's arm. These implants contain slowly released hormones to prevent pregnancy and are effective for at least 3 years. Intrauterine contraceptive devices prevent pregnancy by adversely affecting sperm motility and irritating the lining of the uterus. The IUD is inserted through the cervix by a health care provider and provides long-term protection from pregnancy. Condoms, diaphragms, and spermicides are barrier methods that involve user intervention and also have lower typical effectiveness rates.
