Chapter 8: Contraception and Abortion

1. A woman is 16 weeks pregnant and has elected to terminate her pregnancy. Which is the most common technique used for the termination of a pregnancy in the second trimester? a. Dilation and evacuation (D&E) b. Methotrexate administration c. Prostaglandin administration d. Vacuum aspiration

a. Dilation and evacuation (D&E)

1. Which statement regarding emergency contraception is correct? a. Emergency contraception requires that the first dose be taken within 72 hours of unprotected intercourse. b. Emergency contraception may be taken right after ovulation. c. Emergency contraception has an effectiveness rate in preventing pregnancy of approximately 50%. d. Emergency contraception is commonly associated with the side effect of menorrhagia.

a. Emergency contraception requires that the first dose be taken within 72 hours of unprotected intercourse.

1. Which term best describes the conscious decision concerning when to conceive or avoid pregnancy as opposed to the intentional prevention of pregnancy during intercourse? a. Family planning b. Birth control c. Contraception d. Assisted reproductive therapy

a. Family planning

1. Nurses should be cognizant of what information with regard to the noncontraceptive medical effects of combination oral contraceptives (COCs)? a. COCs can cause TSS if the prescription is wrong. b. Hormonal withdrawal bleeding is usually a little more profuse than in normal menstruation and lasts a week for those who use COCs. c. COCs increase the risk of endometrial and ovarian cancers. d. Effectiveness of COCs can be altered by some over-the-counter medications and herbal supplements.

d. Effectiveness of COCs can be altered by some over-the-counter medications and herbal supplements.

1. What is the importance of obtaining informed consent for a number of contraceptive methods? a. Contraception is an invasive procedure that requires hospitalization. b. The method may require a surgical procedure to insert a device. c. The contraception method chosen may be unreliable. d. The method chosen has potentially dangerous side effects.

d. The method chosen has potentially dangerous side effects.

1. The nurse is responsible for providing health teaching regarding the side effects of COCs. These side effects are attributed to estrogen, progesterone, or both. Which side effects are related to the use of COCs? (Select all that apply.) a. Gallbladder disease b. Myocardial infarction and stroke c. Hypotension d. Breast tenderness and fluid retention e. Dry skin and scalp

a. Gallbladder disease b. Myocardial infarction and stroke d. Breast tenderness and fluid retention

1. The nurse is reviewing the educational packet provided to a client about tubal ligation. Which information regarding this procedure is important for the nurse to share? (Select all that apply.) a. It is highly unlikely that you will become pregnant after the procedure. b. Tubal ligation is an effective form of 100% permanent sterilization. You wont be able to get pregnant. c. Sterilization offers some form of protection against STIs. d. Sterilization offers no protection against STIs. e. Your menstrual cycle will greatly increase after your sterilization.

a. It is highly unlikely that you will become pregnant after the procedure. d. Sterilization offers no protection against STIs.

1. A woman has chosen the calendar method of conception control. Which is the most important action the nurse should perform during the assessment process? a. Obtain a history of the womans menstrual cycle lengths for the past 6 to 12 months. b. Determine the clients weight gain and loss pattern for the previous year. c. Examine skin pigmentation and hair texture for hormonal changes. d. Explore the clients previous experiences with conception control.

a. Obtain a history of the womans menstrual cycle lengths for the past 6 to 12 months.

1. Which nonpharmacologic contraceptive method has a failure rate of less than 25%? a. Standard days variation b. Periodic abstinence c. Postovulation d. Coitus interruptus

a. Standard days variation

1. Although reported in small numbers, toxic shock syndrome (TSS) can occur with the use of a diaphragm. If a client is interested in this form of conception control, then the nurse must instruct the woman on how best to reduce her risk of TSS. Which comment by the nurse would be most helpful in achieving this goal? a. You should always remove your diaphragm 6 to 8 hours after intercourse. Dont use the diaphragm during menses, and watch for danger signs of TSS, including a sudden onset of fever over 38.4 C, hypotension, and a rash. b. You should remove your diaphragm right after intercourse to prevent TSS. c. Its okay to use your diaphragm during your menstrual cycle. Just be sure to wash it thoroughly first to prevent TSS. d. Make sure you dont leave your diaphragm in for longer than 24 hours, or you may get TSS.

a. You should always remove your diaphragm 6 to 8 hours after intercourse. Dont use the diaphragm during menses, and watch for danger signs of TSS, including a sudden onset of fever over 38.4 C, hypotension, and a rash.

1. Which benefit regarding FAMs makes it an appealing choice for some women? a. Adherence to strict recordkeeping b. Absence of chemicals and hormones c. Decreased involvement and intimacy of partner d. Increased spontaneity of coitus

b. Absence of chemicals and hormones

1. Which contraceptive method best protects against STIs and the HIV? a. Periodic abstinence b. Barrier methods c. Hormonal methods d. Same protection with all methods

b. Barrier methods

1. Postabortion instructions may differ among providers regarding tampon use and the resumption of intercourse. However, education should be provided regarding serious complications. When should the woman who has undergone an induced abortion be instructed to return to the emergency department? (Select all that apply.) a. Fever higher than 39 C b. Chills c. Foul-smelling vaginal discharge d. Bleeding greater than four pads in 2 hours e. Severe abdominal pain

b. Chills c. Foul-smelling vaginal discharge e. Severe abdominal pain

1. 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 womans social, cultural, and interpersonal needs are met. Which action should the nurse first take when meeting with a new client to discuss contraception? a. Obtain data about the frequency of coitus. b. Determine the womans level of knowledge concerning contraception and her commitment to any particular method. c. Assess the womans willingness to touch her genitals and cervical mucus. d. Evaluate the womans contraceptive life plan.

b. Determine the womans level of knowledge concerning contraception and her commitment to any particular method.

1. A married couple is discussing alternatives for pregnancy prevention and has asked about fertility awareness methods (FAMs). Which response by the nurse is most appropriate? a. Theyre not very effective, and it is very likely that youll get pregnant. b. FAMs can be effective for many couples; however, they require motivation. c. These methods have a few advantages and several health risks. d. You would be much safer going on the pill and not having to worry.

b. FAMs can be effective for many couples; however, they require motivation.

1. Importantly, the nurse must be aware of which information related to the use of IUDs? a. Return to fertility can take several weeks after the device is removed. b. IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse. c. IUDs offer the same protection against STIs as the diaphragm. d. Consent forms are not needed for IUD insertion

b. IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse.

1. A male client asks the nurse why it is better to purchase condoms that are not lubricated with nonoxynol-9 (a common spermicide). Which response by the nurse is the most accurate? a. The lubricant prevents vaginal irritation. b. Nonoxynol-9 does not provide protection against STIs as originally thought; it has also been linked to an increase in the transmission of the HIV and can cause genital lesions. c. The additional lubrication improves sex. d. Nonoxynol-9 improves penile sensitivity.

b. Nonoxynol-9 does not provide protection against STIs as originally thought; it has also been linked to an increase in the transmission of the HIV and can cause genital lesions.

1. The client and her partner are considering male sterilization as a form of permanent birth control. While educating the client regarding the risks and benefits of the procedure, which information should the nurse include? (Select all that apply.) a. Sterilization should be performed under general anesthesia. b. Pain, bleeding, and infection are possible complications. c. Pregnancy may still be possible. d. Vasectomy may affect potency. e. Secondary sex characteristics are unaffected.

b. Pain, bleeding, and infection are possible complications. c. Pregnancy may still be possible. e. Secondary sex characteristics are unaffected.

1. An unmarried young woman describes her sex life as active and involving many partners. She wants a contraceptive method that is reliable and does not interfere with sex. She requests an intrauterine device (IUD). Which information is most important for the nurse to share? a. The IUD does not interfere with sex. b. The risk of pelvic inflammatory disease will be higher with the IUD. c. The IUD will protect you from sexually transmitted infections. d. Pregnancy rates are high with the IUD.

b. The risk of pelvic inflammatory disease will be higher with the IUD.

1. The lactational amenorrhea method (LAM) of birth control is popular in developing countries and has had limited use in the United States. As breastfeeding rates increase, more women may rely upon this method for birth control. Which information is most important to provide to the client interested in using the LAM for contraception? a. LAM is effective until the infant is 9 months of age. b. This popular method of birth control works best if the mother is exclusively breastfeeding. c. Its typical failure rate is 5%. d. Feeding intervals should be 6 hours during the day.

b. This popular method of birth control works best if the mother is exclusively breastfeeding.

1. A woman who has a seizure disorder and takes barbiturates and phenytoin sodium daily asks the nurse about the pill as a contraceptive choice. What is the nurses best response? a. Oral contraceptives are a highly effective method, but they have some side effects. b. Your current medications will reduce the effectiveness of the pill. c. Oral contraceptives will reduce the effectiveness of your seizure medication. d. The pill is a good choice for a woman of your age and with your personal history.

b. Your current medications will reduce the effectiveness of the pill.

1. In the acronym BRAIDED, which letter is used to identify the key components of informed consent that the nurse must document? a. B stands for birth control. b. R stands for reproduction. c. A stands for alternatives. d. I stands for ineffective.

c. A stands for alternatives.

1. If consistently and correctly used, which of the barrier methods of contraception has the lowest failure rate? a. Spermicides b. Female condoms c. Male condoms d. Diaphragms

c. Male condoms

1. A woman will be taking oral contraceptives using a 28-day pack. What advice should the nurse provide to protect this client from an unintended pregnancy? a. Limit sexual contact for one cycle after starting the pill. b. Use condoms and foam instead of the pill for as long as the client takes an antibiotic. c. Take one pill at the same time every day. d. Throw away the pack and use a backup method if two pills are missed during week 1 of her cycle.

c. Take one pill at the same time every day

1. Which client would be an ideal candidate for injectable progestins such as Depo-Provera (DMPA) as a contraceptive choice? a. The ideal candidate for DMPA wants menstrual regularity and predictability. b. The client has a history of thrombotic problems or breast cancer. c. The ideal candidate has difficulty remembering to take oral contraceptives daily. d. The client is homeless or mobile and rarely receives health care.

c. The ideal candidate has difficulty remembering to take oral contraceptives daily.

1. The nurse is providing contraceptive instruction to a young couple who are eager to learn. The nurse should be cognizant of which information regarding the natural family planning method? a. The natural family planning method is the same as coitus interruptus or pulling out. b. This contraception method uses the calendar method to align the womans cycle with the natural phases of the moon. c. This practice is the only contraceptive method acceptable to the Roman Catholic Church. d. The natural family planning method relies on barrier methods during the fertility phases.

c. This practice is the only contraceptive method acceptable to the Roman Catholic Church.

1. A woman who has just undergone a first-trimester abortion will be using oral contraceptives. To protect against pregnancy, the client should be advised to do what? a. Avoid sexual contact for at least 10 days after starting the pill. b. Use condoms and foam for the first few weeks as a backup. c. Use another method of contraception for 1 week after starting the pill. d. Begin sexual relations once vaginal bleeding has ended.

c. Use another method of contraception for 1 week after starting the pill.

1. Which statement regarding the term contraceptive failure rate is the most accurate? a. The contraceptive failure rate refers to the percentage of users expected to have an accidental pregnancy over a 5-year span. b. It refers to the minimum rate that must be achieved to receive a government license. c. The contraceptive failure rate increases over time as couples become more careless. d. It varies from couple to couple, depending on the method and the users.

d. It varies from couple to couple, depending on the method and the users.

1. A client currently uses a diaphragm and spermicide for contraception. She asks the nurse to explain the major differences between the cervical cap and the diaphragm. What is the most appropriate response by the nurse? a. No spermicide is used with the cervical cap, so its less messy. b. The diaphragm can be left in place longer after intercourse. c. Repeated intercourse with the diaphragm is more convenient. d. The cervical cap can be safely used for repeated acts of intercourse without adding more spermicide later.

d. The cervical cap can be safely used for repeated acts of intercourse without adding more spermicide later.

1. Which statement is the most complete and accurate description of medical abortions? a. Medical abortions are performed only for maternal health. b. They can be achieved through surgical procedures or with drugs. c. Medical abortions are mostly performed in the second trimester. d. They can be either elective or therapeutic.

d. They can be either elective or therapeutic.

1. A woman is using the basal body temperature (BBT) method of contraception. She calls the clinic and tells the nurse, My period is due in a few days, and my temperature has not gone up. What is the nurses mostappropriate response? a. This probably means that youre pregnant. b. Dont worry; its probably nothing. c. Have you been sick this month? d. You probably didnt ovulate during this cycle.

d. You probably didnt ovulate during this cycle.