Chapter 4: Common Reproductive Issues-Contraception (Prep U)
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? "This method will help protect me from getting sexually transmitted infections." "I do not have any spermicidal allergies, so this method is OK for me." "I will remove the cap immediately after every intercourse and reinsert it later." "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." Spermicidal allergies are contraindications for the cervical cap. The client should leave the cervical cap in place for at least six hours after intercourse. The cervical cap does not protect against sexually transmitted infections. The woman should have a follow-up Papanicolaou test 3 months after beginning to use the cap.
A client has opted to use an intrauterine device (IUD) for contraception. About which effect of the device on monthly periods should the nurse inform the client? Periods become longer. Periods reduce in number. Periods become more painful. Periods become lighter.
Periods become lighter. The nurse should inform the client that IUDs cause monthly periods to become lighter, shorter, and less painful. Monthly periods reduce in number with use of oral contraceptives, but not with use of IUDs.
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 no longer produce testosterone. The man will continue to ejaculate sperm. The man will still have full erection capacity. The man will no longer ejaculate seminal fluid.
The man will still have full erection capacity. Some men resist the concept of vasectomy because they are not sufficiently aware of their anatomy to know exactly what the procedure will involve. They can be assured vasectomy does not interfere with the production of sperm; the testes continue to produce sperm as always, but the sperm simply do not pass beyond the plugged vas deferens and are absorbed at that point. The man will still have full erection capacity and continue to produce testosterone. Because he also continues to form seminal fluid, he will ejaculate seminal fluid; it will just not contain sperm.
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? an ovulation suppressant a diaphragm and spermicide the rhythm (calendar) method a spermicidal suppository
a diaphragm and spermicide Women over 40 who smoke should not take ovulation suppressants; irregular menstrual cycles make natural methods difficult; women over 40 may have vaginal dryness, so a spermicidal suppository would not be activated.
A woman uses a diaphragm for contraception. The nurse would instruct her to return to the clinic to have her diaphragm fit checked after which occurrence? a vaginal infection cervical infection a weight gain of 10 lb (4.5 kg) six months of nonuse
a weight gain of 10 lb (4.5 kg) A substantial weight gain or weight loss of 10 pounds (4.5 kilograms) or more may shift the relationship of pelvic organs enough that the diaphragm no longer fits correctly.
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? oral contraceptive pills (OCPs) tubal ligation condoms intrauterine device (IUD)
condoms Because the client has multiple sex partners, condoms will help offer protection against sexually transmitted infections (STIs) and are best suited for her needs. The client cannot use an IUD because of her history of various pelvic infections. Although OCPs will help the client as a means of contraception, this method is not the best choice for her because it does not offer protection against STIs. Tubal ligation is a sterilization procedure and does not suit the client's purpose.
After assessing a client, a nurse determines that an IUD as a method of contraceptive would be contraindicated based on a history of which finding? Hypertension Abnormal uterine shape Smoking Thromboembolic disease
Abnormal uterine shape Use of an IUD may be contraindicated for a woman whose uterus is distorted in shape (the device might perforate the uterine wall). The copper IUD use also is not advised for a woman with severe dysmenorrhea (painful menstruation) or menorrhagia (heavy bleeding) because use may increase the incidence of these conditions. Because use of a copper IUD can cause heavier than usual menstrual flow, a woman with anemia also may not be considered a good candidate for a copper IUD. The other findings are not contraindications.
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? as part of foreplay immediately after ejaculation before penile-vulvar contact at least 1 hour prior to coitus
before penile-vulvar contact Some sperm may be released with pre-ejaculation semen, so a condom needs to be used with any penile-vulvar contact. It is best applied when the penis is erect. It is not necessary to apply an hour in advance. Waiting until after ejaculation would not be effective. It can be part of the foreplay; however, the primary goal is to prevent sperm from entering the vagina, so it should be in place before any penile-vulvar contact occurs.
A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her? She has a history of allergy to foreign protein. She has irregular menstrual cycles. She has a family history of thromboembolism. She is 30 years old.
She has a family history of thromboembolism. The estrogen content of birth control pills may lead to increased blood clotting, leading to an increased incidence of thromboembolism. Women who already are prone to this should not increase their risk further.
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? hormonal barrier rhythm transdermal
barrier The nurse should emphasize a barrier method of birth control such as a condom. The condom will help not only with birth control but with the spread of STIs, which is common in this age group. The other methods, such as hormonal, rhythm, and transdermal, will only prevent pregnancy and are more commonly utilized in long-term monogamous relationships.
A nurse is preparing a presentation for a health fair on the topic of vasectomy. Which information should the nurse point out in the presentation? Procedure is effective immediately Birth control measures are not required Regular sperm counts are not essential Relatively easy procedure with few complications
Relatively easy procedure with few complications The nurse should inform the individuals that vasectomy is a relatively easy procedure with few complications. Regular sperm counts following a vasectomy are important, as it will take approximately a month for the remaining sperm to exit the body. The client should use birth control measures until his sperm count remains at zero for 6 weeks.
A male client asks the nurse to explain which structure is cut during a vasectomy. What response should the nurse give the client? the epididymis the ejaculatory ducts the scrotum the vas deferens
the vas deferens The two vas deferens or ductus deferentia are ligated and cut in the male sterilization procedure, called a vasectomy. The epididymis serves as a site for sperm to mature and be stored until ejaculation occurs. The ejaculatory ducts empty into the urethra and receive secretions from the prostate gland to make up semen. The scrotum is a sac-like structure that sits behind the penis and houses the testicles.
When using the contraceptive patch, a client should understand that it: should be applied to the breasts, hips, or back. should be covered when swimming in a pool because of chlorine's effect on the adhesive. is immediately effective after application. should be applied to the abdomen, buttocks, or back.
should be applied to the abdomen, buttocks, or back. The patch should be applied only to the buttocks, back, abdomen, or torso (never the breasts). The patch is safe for wearing during swimming and bathing. The patch requires application for 1 week before becoming effective.
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? 56 active; 5 placebo 70 active; 6 placebo 42 active; 4 placebo 84 active; 7 placebo
84 active; 7 placebo Research has confirmed that the extended use of active OC pills carries the same safety profile as the conventional 28-day regimens. The extended-cycle regimen consists of 84 consecutive days of active combination pills, followed by 7 days of placebo. The woman has four withdrawal-bleeding episodes a year.
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 can help prevent STIs. ECs are more effective than regular birth control. ECs can induce an abortion of a recently implanted embryo. ECs simply prevent embryo creation and uterine implantation from occurring in the first place.
ECs simply prevent embryo creation and uterine implantation from occurring in the first place. ECs prevent the embryo creation and uterine implantation from occurring. There is no evidence that ECs have any effect on an already-implanted ovum or that they induce abortion. They do not protect against STIs and are less effective than regular birth control.
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: potassium. magnesium. silicone. copper.
copper. The implants contain either copper or progesterone to enhance their effectiveness. One or two attached strings protrude into the vagina so that the user can check its placement. Four IUCs are currently available in the United States: the copper ParaGard-TCu-380A, the levonorgestrel-releasing intrauterine systems (LNG-IUSs) marketed as Mirena and Kyleena, and the LNG-IUD marketed as Jaydess. The ParaGard-TCu-380A is approved for 10 years of use and is nonhormonal. Its mechanism of action is based on the release of copper ions, which alone are spermicidal. Additionally, the device causes an inflammatory action leading to a hostile uterine environment.
The nurse is providing contraception counseling to a perimenopausal woman who has had negative reactions to oral contraceptive pills (OCPs) in the past and would like a long-term, nonhormone-based method that has a high rate of success. Neither she nor her husband wants to undergo surgery, however. Which method should the nurse recommend? transdermal patch subdermal progestin implant intrauterine device tubal ligation
intrauterine device Women who are perimenopausal are, overall, good candidates for intrauterine devices (IUDs). In this case, the IUD is the best choice because this method is almost 100% effective, is long-term, and does not involve any hormones. Both the transdermal patch and the subdermal progestin implant involve hormones, which rules each out in this case. Also, tubal ligation is a surgical procedure, which also rules it out for this client.
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? etonogestrel levonorgestrel/ethinyl estradiol norelgestromin/ethinyl estradiol medroxyprogesterone acetate
medroxyprogesterone acetate Medroxyprogesterone acetate is an injectable form of a progesterone-only contraceptive that is given every 12 weeks. It works by suppressing ovulation and the production of FSH and LH by the pituitary gland. Etonogestrel is an implantable form contraceptive. Norelgestromin/ethinyl estradiol is a patch-type contraceptive, and levonorgestrel/ethinyl estradiol is an oral contraceptive that uses a 365-day combination dosing.
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? implantable contraceptives oral contraceptive pills (OCPs) the medroxyprogesterone injection a copper intrauterine device
oral contraceptive pills (OCPs) Considering the client's smoking habit, oral contraceptive pills may be contraindicated. Oral contraceptives are highly effective when taken properly, but can aggravate many medical conditions, especially in women who smoke. The medroxyprogesterone injection or copper intrauterine devices are not contraindicated in this client and can be used with certain precautions. Implantable contraceptives are subdermal time-release implants that deliver synthetic progestin; these are highly effective and are not contraindicated in this client.
A client desires protection from unwanted pregnancies. However, the client does not enjoy sex when her partner wears a male condom. Also, the client experiences breast tenderness, headache, and nausea after taking oral contraceptive pills (OCPs). Which method would be the most likely choice for the couple to help them enhance their sexual experience as well as prevent any side effects? transdermal contraceptive natural membrane condom ethinyl estradiol polyurethane condom
transdermal contraceptive Application of transdermal contraceptive patches to the skin would most likely be the option for this couple. These patches will not hamper the sexual experience nor cause side effects such as those caused by oral contraceptive pills (OCPs). Natural membrane and polyurethane condoms are forms of male condoms, which the client does not like. Ethinyl estradiol is an oral contraceptive pill, which would most likely cause the client to experience breast tenderness, headache, and nausea.
