Chapter 29: PrepU - Contraception and Unplanned Pregnancies
The client is interested in using an injectable contraceptive that works by suppressing pituitary secretions. The nurse provides the client with literature and discusses which contraceptive with her? medroxyprogesterone acetate etonogestrel norelgestromin/ethinyl estradiol levonorgestrel/ethinyl estradiol
1
What are methods for delivering hormonal contraception? Select all that apply. orally transdermally vaginally rectally implantation injection
1,2,3,5,6
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? the medroxyprogesterone injection combination oral contraceptives a copper intrauterine device implantable contraceptives
2
A woman calls the clinic to report that she has had some cramping and spotting since the insertion of her IUD three days ago. Which instruction would be most appropriate? "Come to the clinic as soon as possible." "Consider this normal, because your IUD is newly inserted." "Take your blood pressure daily for the rest of the month." "You'll have to change your method of birth control."
2
The nurse instructs a patient on cervical mucus changes that occur during ovulation. Which statement indicates that teaching has been effective? "During ovulation, the mucus is thick." "Ovulation makes the mucus more acidic." "The mucus is white because of more white blood cells." "When the mucus is thin and watery, then ovulation is occurring."
4
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? Epispadias Erectile dysfunction Cryptorchidism Hypospadias
4
A newly married couple is meeting with the nurse to discuss a temporary method of birth control that is both a natural form and does not employ birth control pills/devices, in keeping with their religious beliefs. Which fertility awareness method should the nurse point out will best meet their request to delay conception until they are ready? CycleBeads lactation amenorrhea method vasectomy coitus interruptus
1
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 21 pills COCs packaged with 28 pills COCs packaged with 30 pills COCs packaged with 14 pills
2
A 35-year-old female client who is unable to conceive is scheduled for a hysterosalpingogram to assess tubal patency. Which of the following would the nurse ensure before the client undergoes the hysterosalpingogram? Client has been administered general anesthesia Client is in second phase of menstrual cycle Client's basal body temperature is recorded Client has just completed her menses
4
Which laboratory result would be most important for a nurse to monitor for a client who has recently started letrozole? hCG CBC TSH FSH
4
A female client who has chosen the cervical cap as her method of contraception states that she knows how to use it. Which statement by the client would indicate to the nurse that the client does understand this method of contraception? "I will remove the cap immediately after every intercourse and reinsert it later." "This method will help protect me from getting sexually transmitted infections." "I do not need any follow-up procedures for this method." "I do not have any spermicidal allergies, so this method is OK for me."
4
Which statement best indicates that a client has taken self-care measures to reduce her risk for cervical cancer? "I've really cut down on the amount of caffeine I drink everyday." "I've thrown out all my bubble baths and just use soap and water now." "Every time I have sexual intercourse, I douche." "My partner always uses a condom when we have sexual intercourse."
4
The nurse is planning an educational session on contraceptives for a group of adolescent high school students. What does the nurse need to do when planning this session? Argue that encouraging abstinence is unrealistic during the teenage years. Discuss that the application of a condom should occur after penile-vulvar contact. Explain that the combination oral contraceptive approach is the best for adolescents. Teaching about contraceptive options while avoiding indirect encouragement of sexual activity.`
3
The nurse is providing education about barrier contraceptives. Which statement by the patient indicates a need for further education? "I have to wash my cervical caps after each use." "I can leave my diaphragm in for up to 48 hours." "I can insert my female condoms up to 8 hours before intercourse." "Male latex condoms when used correctly are an effective means of contraceptive and very effective at preventing transmission of STDs."
2
The nurse has been working with a subfertile couple through the process of determining their best plan of action to conceive a child. Which action should the nurse prioritize to provide emotional support to this couple? Speak only with both partners present so they will feel more comfortable. Speak separately with each partner so both will feel more free to talk. Speak both separately and together with both partners. Only speak with the woman, who is the client.
3
A patient recovering from a surgical pregnancy termination returns for a postprocedure examination. The patient tells the nurse that she is relieved that the procedure is over but that she is feeling sad. What should the nurse do to assist the patient at this time? Suggest the patient talk with a counselor. Ask the patient to identify the source of the sadness. Recommend the patient attend contraceptive counseling sessions. Discuss the need for an antidepressant with the health care provider.
1
The nurse discusses various contraceptive methods with a client and her partner. After the discussion, the nurse determines that the couple understood the information when they identify which method as being available only with a prescription? cervical cap cervical sponge condom spermicide
1
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? When do you expect your next menstrual flow? Are you allergic to any sedatives? What is your blood type and Rh factor? When did you have coitus last?
1
The nurse is explaining the various evaluations used to determine infertility to a young couple who have been trying to get pregnant for 5 years. Which instruction should the nurse prioritize when teaching about the postcoital test? Should douche before the test Can be combined with a sperm count Is performed close to time of ovulation Will use a prescribed lubricant during vaginal intercourse
3
A client expresses interest in having an intrauterine device (IUD) placed for contraception. Which finding noted in the health history would indicate to the nurse that this would not be an appropriate contraceptive option? Sexually active since 16 Dysmenorrhea G1P0 Bicornate uterus
4
A client with liver disease is seen in the clinic wanting to begin contraception. The nurse recognizes that which type of contraception is best for this client? Oral combination contraception Subdermal hormone implant Intramuscular injections Vaginal estrogen/progestin ring
4
A clinic nurse is interviewing a young client during a subfertility work up. When the client asks the nurse what causes infertility, the nurse informs the client that the problem can rest with the man, the woman, or both. What does the nurse tell the client are common problem areas related to the woman? Select all that apply. ovulation tubal transport diabetes impaired implantation lack of exercise
1,2,4
A nurse is conducting education classes at the local high school on reproductive life planning. Which would be appropriate for the nurse to implement during the teaching? Select all that apply. Encouragement of abstinence Proper condom application Various religious viewpoints Sexual transmitted infection statistics
1,2,4
A client is beginning to take a combined oral contraceptive. Which of the following side effects will the nurse caution the client might be expected? Select all that apply. Nausea Weight loss Headache Breast tenderness Frequent urinary tract infections
1,3,4
A nurse is providing education to a client with infertility concerns. Which statement by the client indicates appropriate understanding of the Spinnbarkeit Test? "I will need to purchase a microscope and look for a fern-like pattern from a sample of my cervical mucus to indicate when I am ovulating." "I will need to purchase an over-the-counter ovulation kit that will tell me when I am currently ovulating." "Halfway in my cycle I will need to check my cervical mucus to see if I can stretch it in to long strands, indicating I am close to ovulating." "At midpoint in my menstrual cycle, I need to come to the clinic for a cervical exam looking for color changes to my cervical mucus."
2
The nurse is assessing the health history of a male partner. Which data is most likely to be related to an infertility problem? 30 years of age employment as a taxi driver intercourse approximately every third day immunization against mumps as a child
2
The nurse was teaching a college student how to properly take the prescribed combination oral contraceptive (COC). The nurse determines the session is successful when the client correctly chooses which instruction to follow when taking the COC? empty stomach, full glass of water same time of day, each day take with a meal same day of the week, once a week
2
A couple comes in and tells the nurse that they have been trying diligently to conceive for the last 3 months and are subfertile. What should the nurse explain to the couple about the definition of subfertility? Subfertility is said to exist when a pregnancy has not occurred after at least 3 months of engaging in unprotected coitus. Subfertility is said to exist when a pregnancy has not occurred after at least 6 months of engaging in unprotected coitus. Subfertility is said to exist when a pregnancy has not occurred after at least 1 year of engaging in unprotected coitus. Subfertility is said to exist when a pregnancy has not occurred after at least 2 years of engaging in unprotected coitus.
3
A couple is undergoing fertility testing. The male partner is scheduled for semen analysis. When teaching the male partner about this procedure, the nurse would instruct him to refrain from sexual intercourse for which time frame before the analysis? 4 to 8 hours 12 to 24 hours 2 to 4 days at least 1 week
3