Contraceptive Quiz set using questions from FNP Nurse Mastery

Which of the following is not an absolute contraindication for use of oral contraceptive pills? A. Active hepatitis A infection B. Thrombosis related to an IV needle C. Undiagnosed vaginal bleeding D. Transient ischemic attack (TIA)

B

Which of the following is true about therapy with Depo-Provera? A. It is not appropriate for adolescents. B. Return of fertility may be delayed after discontinuing the drug. C. It may be prescribed up until age 35. D. It may be prescribed only for 2 years due to decreased bone mineral density.

B

With DMPA in depot injection (Depo-Provera), the recommended length of use is usually: A. less than 1 year. B. no more than 2 years. C. as long as the woman desires this form of contraception. D. as determined by her lipid response to the medication.

B

You see a 34-year-old woman who reports having unprotected sexual intercourse 4 days ago and requests emergency contraception. She has a recent history of gonorrhea that was treated successfully. The most acceptable and effective option in this clinical scenario is: A. progestin-only emergency contraception B. ulipristal C. copper-containing IUD D. nothing, as 4 days is too long for emergency contraception to be effective.

B

Which of the following statements should the Nurse Practitioner include in medication teaching about oral contraceptives? A. Progestin-only pills are as effective as the combined pill with typical use. B. Progestin-only pills may be less effective than the combined pill. C. Progestin-only contraceptive pills thicken the endocervical mucus, alter the endometrium, and suppress ovulation. D. Benefits of combined oral contraceptives may include decreased menstrual cramps and PMS. E. Benefits of progestin-only pills include a daily schedule that's easy to remember and less nausea than with combined oral contraceptives.

B,C,D

When assessing the need for emergency contraception. Your patient tells you it is been 5 days since she had unprotected sex. What form of emergency contraception would be indicated for this patient? A. Oral contraception - Levonorgestrel (Plan B) B. Depo-Provera (DMPA) C. Copper-releasing Intrauterine Device (IUD) D. Spermicide Douche

C

Which of the following is considered a relative contraindication for combined oral contraceptive pills? A. Undiagnosed vaginal bleeding B. Hepatoma of the liver C. Suspected history of transient ischemic attacks (TIAs) D. Depression

D

Which of the following statements is false? A. Progestin-only emergency contraception can be taken as one dose or two doses. B. Ulipristal is available by prescription only C. Progestin-only emergency contraception is available OTC for women 17 years old and older D. Ulipristal is taken in two doses 12 hours apart.

D

With the use of a levonorgestrel intrauterine system (Mirena), which one of the following is normally noted? A. endometrial hyperplasia B. hypermenorrhea C. increase in PID rates D. reduction in menstrual flow

D

Your 27-year-old patient who is suffering from chronic migraine headaches visits your clinic for contraceptives. She is otherwise healthy and does not smoke. You advise that the best option for her is: A. Ortho Evra patch B. NuvaRing C. Combined estrogen and progestin pills D. Progestin-only pills

D

Your 32-year-old patient has been using Depo-Provera and recently received her shot before getting married. She would like to start planning to have a family. She visits your clinic hoping to get pregnant within the next three months. Your response to her is that: A. She should have an immediate return to fertility. B. She will have an immediate return to fertility after three months since she just received a shot. C. She will have an immediate return to fertility as soon as her period is regular again. D. She may have a delay in her return to fertility for up to one year or longer.

D

Your patient is currently menstruating and forgot to take her combined oral contraceptive pill yesterday. She calls the clinic. You advise her of which of the following? A. Resume taking her pills as scheduled again tomorrow B. Take two today and get back on schedule tomorrow by taking one again C. Discard this pack and start a new pack D. If she missed a nonactive, nonhormonal pill, that is okay. She should resume taking her pills as scheduled again tomorrow.

D

Which of the following is commonly found after 1 year of using DMPA (Depo-Provera)? A. weight gain. B. hypermenorrhea. C. acne. D. rapid return of fertility when discontinued

A

Tier 1 is the most effective contraceptive methods and the rate of failure is less than 1% in one year. What are those methods?

IUD, sterilization, and implantation

When can a woman safely conceive after discontinuing COC use? A. immediately B. after 1 to 2 months C. after 3 to 4 months D. after 5 to 6 months

A

True or False? According to the U. S. Medical Eligibility Criteria for Contraception Use, a 29-year-old with PID a category 1 or 2 COC candidate.

?

A 22-year-old woman taking a 35-mcg ethinyl estradiol COC calls after forgetting to take her pills for 2 consecutive days. She is 2 weeks into the pack. You advise her to: A. take the last pill missed immediately, even if this means taking 2 pills today. B. discard two pills and take two pills today. C. discard the rest of the pack and start a new pack with the first day of her next menses. D. continue taking one pill daily for the rest of the cycle.

A

In contrast to progestin-only emergency contraception, a possible mechanism of action of ulipristal (Ella) is: A. inhibiting embryo implantation B. impairing sperm transport C. through spontaneous abortion D. impairing ovum transport

A

In contrast to progestin-only emergency contraception, a possible mechanism of action of ulipristal (Ella) is: A. inhibiting embryo implantation B. impairing sperm transport. C. through spontaneous abortion. D. impairing ovum transport

A

Irregular bleeding associated with DMPA (Depo-Provera) can be minimized with the use of all of the following except: A. acetaminophen. B. ibuprofen. C. naproxen sodium. D. estrogen supplements.

A

Sydney, age 21, is taking an oral contraceptive (OC). She complains of acne. How should you adjust the estrogen in the OC? A. Increase the estrogen content. B. Decrease the estrogen content. C. Delete the estrogen content. D. No adjustment should be made to the estrogen content.

A

Which of the following is false regarding usage of the Ortho Evra patch? A. If the patch falls off and stays off for greater than 12 hours, restart a new four-week cycle and use a backup method of protection. B. After three applications, the patch is removed for seven days, allowing for menstruation. C. The patch may be applied to the arm, buttocks, or abdomen. D. The patch is removed every seven days and another one is applied.

A

Your patient asks you to prescribe her the most effective method of contraception. Which method has the highest failure rate? A. Spermicides B. Diaphragm C. Oral contraceptives D. Depo-Provera

A

The Nurse Practitioner is providing teaching to a postpartum Catholic client who wishes to use natural family planning. Which of the following would the NP include in teaching about how to utilize this method? Select all that apply. A. Calendar charting B. Cervical mucous observation C. Extended breastfeeding D. Basal body temperature graphing E. The use of condoms with no spermicide

A,B,C,D

Which of the following contraceptive options are progestin-only? Choose three answers. Select all that apply. A. Depo-Provera B. Mirena intrauterine device C. NuvaRing D. Implanon E. Paraguard intrauterine device

A,B,D

Your patient is worried about which contraceptive option would be best for her. She states that she often forgets to take her vitamins. For this particular candidate, you would discuss which of the following? Select all that apply. A. NuvaRing B. Depot medroxyprogesterone C. Progestin-only pills D. An intrauterine device

A,B,D

26-year-old mother who breastfeeds her 10-month-old child queries about contraceptives. In counseling her on the use of the progestin-only pill (POP), you mention all of the following except: A. the pill is taken every day B. POP is a more effective contraceptive than COC C. POP does not alter the quality or quantity of breast milk. D. POP is associated with bleeding irregularity, ranging from prolonged flow to amenorrhea.

B

A 20-year-old G0P0 woman with no significant medical history presents to your office reporting that she is concerned about becoming pregnant. She had sexual intercourse with her boyfriend last night and usually uses a cervical diaphragm for contraception. However, she forgot to place her diaphragm last night and is now seeking emergency contraception. She also wants to prevent this situation from happening again. Which of the following is the best option for this patient for emergency contraception? A- Implanon B- Copper intrauterine device C- Medroxyprogesterone D- Oral contraceptive pills

B

A 23-year-old woman is breastfeeding her healthy newborn. She wishes to start using hormonal contraception. Which of the following represents the best regimen? A. combined oral contraception initiated at 2 weeks B. progesterone-only oral contraception initiated at 3 weeks C. medroxyprogesterone acetate (Depo-Provera) given day 1 postpartum D. use of all forms of hormonal contraception is discouraged during lactation

B

A 26-year-old mother who breastfeeds her 10-month-old child queries about contraceptives. In counseling her on the use of the progestin-only pill (POP), you mention all of the following except: A. the pill is taken every day B. POP is a more effective contraceptive than COC C. POP does not alter the quality or quantity of breast milk. D. POP is associated with bleeding irregularity, ranging from prolonged flow to amenorrhea.

B

A 48-year-old woman presents with a monthly 4-day premenstrual migraine headache, poorly responsive to triptans and analgesics, and accompanied by vasomotor symptoms (hot flashes). The clinician considers prescribing all of the following except: A. continuous monophasic oral contraceptive. B. phasic combined oral contraceptive with a 7-day-per-month withdrawal period. C. low-dose estrogen patch use during the premenstrual week. D. triptan prophylaxis.

B

A college freshman who is using oral contraceptives calls the nurse practitioner's office asking for advice. She forgot to take her pills 2 days in a row during the second week of the pill cycle and wants to know what to do. What is the best advice? A. Start a new pack of pills and dispose of the old one B. Take two pills today and two pills tomorrow, and have your partner use condoms for the rest of the pill cycle C. Stop taking the pills right away, and start a new pill cycle in 2 weeks D. Take one pill today and two pills tomorrow, and have your partner use

B

According to the U. S. Medical Eligibility Criteria for Contraception Use, which of the following is a clinical condition in which use of a copper-containing IUD should be approached with caution? A. uncomplicated valvular heart disease B. AIDS-defining illness C. hypertension D. dysmenorrhea

B

All of the following are examples of excessive progesterone except: A. Increased appetite B. Increased libido C. Breast tenderness D. Depression

B

By using a diaphragm with spermicide nonoxynol-9 during sexual intercourse, a woman is likely at increased risk for: A. cervical stenosis B. urinary tract infection C. increased perivaginal lactobacilli colonization D. ovarian malignancy.

B

Due to an increased risk of blood clots, an alternative to the contraceptive ring (NuvaRing) or patch (Ortho Evra) is preferred in all of the following women except: A. a 42-year-old nulliparous woman B. 31-year-old woman with a history of naturally occurring multiple gestation pregnancy. C. 28-year-old who smokes one pack per day D. 33-year-old woman with a family history of venous thrombosis.

B

Due to an increased risk of blood clots, an alternative to the contraceptive ring (NuvaRing) or patch (Ortho Evra) is preferred in all of the following women except: A. a 42-year-old nulliparous woman B. 31-year-old woman with history of naturally occurring multiple gestation pregnancy. C. 28-year-old who smokes one pack per day D. 33-year-old woman with a family history of venous thrombosis.

B

The most common reasons for discontinuing oral contraception use is breakthrough bleeding and: A. nausea/vomiting B. inconvenience of use. C. cost D. high failure rate.

B

The nurse practitioner receives a phone call from an 18-year-old female patient on combined oral contraceptive pills, stating that she missed the previous two days of her birth control pill. She is inquiring as to what she should do now, as these are the "active pills". The NP advises her to: A. Take two active pills today and two active pills tomorrow, then resume the regular schedule. B. Take the most recent missed active pill as soon as possible, discard other missed pills, and continue with the regular schedule, even if it means taking two pills in one day. Use backup contraception or avoid intercourse for 7 days. C. Discard the current pack and begin with a new one the following day. D. Resume taking the pills as scheduled the following day.

B

The reduction in free androgens noted in a woman using COC can yield an improvement in: A. cycle control B. acne vulgaris C. breast tenderness. D. rheumatoid arthritis

B

When counseling a patient on the risks associated with an intrauterine device, you include all of the following except: A. Intrauterine device strings may migrate due to poor positioning and become difficult to find B. Intrauterine device use increases the risk for pelvic inflammatory disease C. Intrauterine device use increases the risk for candidiasis D. Risk of expulsion of the intrauterine device is 10% the first year of use E. All of the answer choices are true

B

When prescribing the contraceptive patch (Ortho Evra) or vaginal ring (NuvaRing), the NP considers that: A. these are progestin-only products. B. candidates include women who have difficulty remembering to take a daily pill. C. there is significant drug interactions with both products D. contraceptive efficacy is less than with COC.

B

Your 30-year-old patient has been taking oral contraceptives for over ten years. She has recently stopped taking them and wonders how quickly she can safely conceive. How do you respond? A. She may conceive after one month off of the oral contraceptives. B. She can safely conceive immediately. C. She may have over one year to return to safe fertility. D. She will only be able to safely conceive after three months off of the hormones.

B

Your patient is currently menstruating and forgot to take her combined contraceptives yesterday. You advise her A.Discard the pack and start a new park B. If she missed a non active pill, she should resume the pills as scheduled the next day C. Resume her pills as scheduled tomorrow D. Take two pills today and get on schedule tomorrow by taking one again

B

A 19-year-old student who is on a prescription of combined oral contraceptive pills is being seen for an annual gynecological exam in the college health center. The nurse practitioner has obtained the Pap smear and is about to perform the bimanual exam. She gently removes the plastic speculum from the vagina. While the NP is performing the bimanual vaginal exam, the patient complains of slight discomfort during deep palpation of the ovaries. Which of the following is a true statement? A. The uterus and the ovaries are both very sensitive to any type of palpation B. The fallopian tubes and ovaries are not sensitive to light or deep palpation C. The ovaries are sensitive to deep palpation but they should not be painful D. The uterus and the ovaries are not important organs of reproduction

C

A 26-year-old female comes to your office to discuss birth control options. Her history includes migraine headaches with aura while on combination oral contraceptives in the past. She does not want to become pregnant. Which of the following birth control options would be the best choice for her? A. Combined hormonal contraceptive pills. B. Ortho Evra Patch C. Mirena intrauterine device (IUD) D. Vaginal NuvaRing

C

A patient visits the clinic with complaints of oral contraceptive side effects. Which one of the following is NOT a sign of excessive estrogen? A. Breast tenderness B. Increased blood pressure C. Decreased blood pressure D. Headache E. Melasma

C

A woman who has used emergency contraception pills should be advised that if she does not have a normal menstrual period within _____ weeks, a pregnancy test should be obtained. A. 1 to 2 B. 2 to 3 C. 3 to 4 D. 4 to 5

C

All of the following are examples of excessive androgens except: A. Increased libido B. Hirsutism C. Syncope D. Acne and oily skin E. Weight gain and edema

C

As you prescribe COC containing the progestin drospirenone (Loryna, Ocella, Vestura, Yasmin, Yaz), you offer the following advice: A. "Always take this pill on a full stomach. " B. "You should not take acetaminophen when using this birth control pill. " C. "Avoid using potassium-containing salt substitutes. " D. "You will likely notice that premenstrual syndrome symptoms might become worse.

C

At what point after childbirth can a combined oral contraceptive be started without other risk factors for venous thrombosis in a woman who is not breastfeeding? A. 1 day B. 1 week C. 3 weeks D. 6 weeks

C

Guidelines recommend that a breastfeeding mother waits until breastfeeding is well established for approximately 6 months before using combined oral contraceptives (COC) because: A. in early breastfeeding, the amount of hormone in COC could cause significant harm to the nursing infant. B. efficacy of COC could be compromised by breastfeeding. C. milk flow could be compromised by COC. D. COC oral contraceptive use could affect mother's sleep patterns.

C

Noncontraceptive benefits of COC use include a decrease in all of the following except: A. iron-deficiency anemia. B. pelvic inflammatory disease (PID). C. cervicitis. D. ovarian cancer.

C

One of the nurse practitioner's patients plans on using a diaphragm for contraception. While counseling her on how to use it, she asks when she should remove the diaphragm following intercourse. What would be the most appropriate answer to her question? A. 1 hour following intercourse B. Whenever is most convenient C. 6 hours following intercourse D. Immediately following intercourse

C

The following conditions are absolute contraindications for the use of oral contraceptives except: A. Sexually active patient with amenorrhea B. History of emboli that resolved with heparin therapy 15 years ago C. Cigarette smoking at the age of 30 years D. Hepatitis C infection

C

The incidence of which of the following cancers are reduced with the use of oral contraceptives? A. Ovarian and breast B. Endometrial and breast C. Ovarian and endometrial D. Lung and ovarian

C

Which of the following is the most appropriate response to a 27-year-old woman who is taking phenytoin (Dilantin) for the treatment of a seizure disorder and is requesting hormonal contraception? A. "A barrier method would be the preferable choice." B. "COC is the best option." C. "Depo-Provera (medroxyprogesterone acetate in a depot injection [DMPA]) use will likely not interact with your seizure medication." D. "Copper-containing IUD use is contraindicated."

C

Which of the following statements is true concerning vaginal diaphragm use? A. When in place, the woman is aware that the diaphragm fits snugly against the vaginal walls. B. This is a suitable form of contraception for women with recurrent urinary tract infection. C. After insertion, the cervix should be smoothly covered. D. The device should be removed within 2 hours of coitus to minimize the risk of infection.

C

Which of the following women is the best candidate for progestin-only pill (POP) use? A. an 18-year-old woman who frequently forgets to take prescribed medications B. a 28-year-old woman with multiple sexual partners C. a 32-year-old woman with adequately-controlled hypertension D. a 26-year-old woman who wants to use the pill to help "regulate" her menstrual cycle

C

Which of these emergency contraceptives are contraindicated in migraine and CVD? A. Copper IUD B. levonogestrel C. ethinyl estradiol and levonogestrel combination D. all are acceptable E. none are acceptable

C

Which statement is false regarding the usage of NuvaRing? A. It is vaginally inserted. B. It is left in place for 21 days and then removed to allow for menstruation. C. If the ring falls out, it should be reinserted within 24 hours. D. It is a combination of synthetic estrogen and progestin.

C

Women 5. A woman who has used emergency contraception pills should be advised that if she does not have a normal menstrual period within _____ weeks, a pregnancy test should be obtained. A. 1 to 2 B. 2 to 3 C. 3 to 4 D. 4 to 5

C

True or False? Calcium and vitamin D supplementation is recommended for those taking DMPA (Depo-Provera) injections to minimize the risk of a loss in bone density.

True

True or False? The use of combined oral contraception (COC) reduces menstrual volume by approximately 60%, thereby reducing the risk of iron deficiency anemia.

True

All of the following are correct statements regarding oral contraceptives except: A. The actual failure rate of oral contraceptives is 3% B. Desogestrel belongs to the progesterone family of drugs C. The newer low-dose birth control pills do not require backup during the first 2 weeks of use D. Oral contraceptives are contraindicated for women 35 years of age or older who smoke

C?

A 24-year-old woman who requests emergency contraception pills wants to know the effects if pregnancy does occur. You respond that there is the risk of increased rate of: A. spontaneous abortion B. birth defects C. placental abruption D. none of the above.

D

Which of the following factors is considered a relative contraindication for combined oral contraceptive pills? A. Undiagnosed vaginal bleeding B. Hepatoma of the liver C. Suspected history of transient ischemic attacks D. Smoking

D

A 25-year-old female patient has been using Depo-Provera, but has experienced an 8-lb weight gain in the past year and is already significantly overweight. She asks if the weight gain is common. How should the NP respond? A. "This is, unfortunately, common with the use of Depo-Provera. If your weight has normalized and this is tolerable for you, you can continue it." B. "This is an abnormal side effect associated with the use of this drug, but if this weight is tolerable for you, you can continue it." C. "This is a very abnormal side effect associated with the use of this drug." The NP should advise that she switch to a different form of contraception. D. "This is, unfortunately, common with the use of Depo-Provera." As she is already overweight, the NP should offer a switch to a different form of contraception like the nonhormone intrauterine device.

D

A 38-year-old nulliparous woman who smokes two and a half packs a day is in an "on-and-off" relationship. The woman presents seeking contraception. Which of the following represents the most appropriate method? A. contraceptive ring (NuvaRing). B. COC. C. contraceptive patch (Ortho Evra). D. vaginal diaphragm

D

An 18-year-old woman requests emergency contraception after having unprotected vaginal intercourse approximately 18 hours ago. Today is day 12 of her normally 27- to 29-day menstrual cycle and she has no contraindications to the use of any currently available forms of emergency contraception. You advise her that: A. emergency hormonal contraception use reduces the risk of pregnancy by approximately 33%. B. all forms of emergency contraception must be used within 12 hours after unprotected intercourse. C. the likelihood of conception is minimal. D. insertion of a copper-containing IUD offers an effective form of emergency and ongoing contraception.

D

Concerning selective estrogen receptor modulator therapy such as raloxifene (Evista), which of the following statements is correct? A. Concurrent progestin opposition is needed B. Hot flashes are reduced in frequency and severity. C. Use is contraindicated when a woman has a history of breast cancer D. Osteoporosis risk is reduced with use.

D

Emergency contraception refers to: A. An induced abortion in an emergency room (ER). B. Quickly starting on birth control pills in anticipation of sexual intercourse. C. Having a medroxyprogesterone (Depo Provera) injection in the ER every 12 weeks. D. Taking emergency contraceptive pills.

D

In regards to oral hormonal contraceptives, all are false except? A. Benefits may include minimizing the risk of breast cancer B. Progestin-only pills are as effective as the combined pill with typical use. C. Actual failure rates are between 0.5% and 1% D. Benefits may include reduced dysmenorrhea

D

The NP is seeing an adult female patient with 2 school-aged children in a monogamous relationship. She is asking about non-oral contraceptive methods but does not want to consider permanent sterilization for herself or her partner. This patient has no significant medical history but smokes 1 pack of cigarettes daily. Which of the following is the best contraceptive option for this patient? A. Transdermal Contraceptive Patch B. Etonogestrel Subdermal Implant C. Diaphragm D. Levonorgestrel Intrauterine Device (IUD)

D

When counseling a woman about COC use, you advise that: A. long-term use of COC is discouraged because the body needs a "rest" from birth control pills from time to time. B. fertility is often delayed for many months after discontinuation of COC. C. there is an increase in the rate of breast cancer after protracted use of COC D. premenstrual syndrome symptoms are often improved with use of COC.

D

Which is incorrect regarding the use of a vaginal diaphragm? A. All of the answer choices are true B. It may increase the risk for urinary tract infections C. It must be left in place for at least six hours after intercourse D. It should be refitted if one has a weight gain of greater than 10 lbs

D

When counseling a woman about the use of oral contraceptives, you should provide her with which of the following pieces of information? A. They do not protect against sexually transmitted infections. B. Antibiotics may decrease their effectiveness and she should use a backup method of protection when taking them C. They must be taken every day. D. They may worsen mood. E. All of the answers are correct.

E

True or False? According to the U. S. Medical Eligibility Criteria for Contraception Use, a 32-year-old breastfeeding a 6-month-old infant a category 1 or 2 COC candidate.

False

True or False? According to the U. S. Medical Eligibility Criteria for Contraception Use, a 45-year-old with fibroids with uterine cavity distortion a candidate for a copper-containing IUD

False

True or False? Nausea with oral contraceptive use can be minimized by taking the pill on an empty stomach.

False

True or False? According to the U. S. Medical Eligibility Criteria for Contraception Use, a 33-year-old with low-grade squamous intraepithelial lesions noted on Pap test a candidate for a copper-containing IUD.

True

True or False? According to the U. S. Medical Eligibility Criteria for Contraception Use, a 45-year-old with tension-type headache a category 1 or 2 COC candidate.

True

According to the U. S. Medical Eligibility Criteria for Contraception Use, is a 45-year-old with tension-type headache a category 1 or 2 COC candidate? True or False

True

True or False? According to the U. S. Medical Eligibility Criteria for Contraception Use , a 22-year-old who smokes one pack per day a category 1 or 2 COC candidate.

True

True or False? According to the U. S. Medical Eligibility Criteria for Contraception Use, a 25-year-old with hypertension a candidate for a copper-containing IUD

True

True or False? According to the U. S. Medical Eligibility Criteria for Contraception Use, a 28-year-old with type 1 diabetes mellitus a category 1 or 2 COC candidate.

True