OB Pillitteri 7th Edition Chapter 6
A patient received a scheduled dose of depot medroxyprogesterone acetate (DMPA) 6 weeks ago. Today, the patient reports that a regular menstrual cycle is 2 weeks late. What is the first thing that should be done for this patient? A) Perform a pregnancy test. B) Provide prenatal counseling. C) Discuss pregnancy termination options. D) Explain side effects of the contraceptive.
A
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 however is feeling sad. What should the nurse do to assist the patient at this time? A) Suggest the patient talk with a counselor. B) Ask the patient to identify the source of the sadness. C) Recommend the patient attend contraceptive counseling sessions. D) Discuss the need for an antidepressant with the health care provider.
A
A postpartum patient asks the nurse when the subdermal hormone implant for contraception can be inserted. What should the nurse respond to this patient? A) In 6 weeks B) In 1 month C) 1 week after your next menstrual cycle D) Before being discharged after this delivery
A
For which patient assessment finding would an intrauterine device (IUD) be contraindicated? A) Misshapen uterus B) Multiple sex partners C) Diagnosis of hypertension D) History of thromboembolic disease
A
The nurse instructs a patient on the use of a vaginal estrogen/progestin rings (NuvaRing) for contraception. Which patient statement indicates that additional instruction is needed? A) "I am to take the ring out overnight." B) "I will leave the ring in place for 3 weeks." C) "I leave the ring in place during intercourse." D) "I am to use other birth control if I take the ring out for 4 hours."
A
The nurse is planning instruction for a patient desiring to have a tubal ligation. Which information should the nurse emphasize when teaching the patient? A) She must think of the procedure as irreversible. B) The procedure will reduce her menstrual flow in amount. C) She should schedule it to be done just before a menstrual flow. D) She will have lessened dysmenorrhea following the procedure.
A
An Rh-negative patient of 6 weeks gestation is scheduled for a medically induced termination. Which outcomes should the nurse identify as appropriate for this patient? (Select all that apply.) A) Attended contraceptive counseling B) Received Rho (D) immune globulin C) Scheduled postprocedure sonogram D) Avoided strenuous activity for 3 weeks E) Experienced menstrual cycle in 2 months
A B C
A male patient is considering a vasectomy. Which information should the nurse instruct the patient about this procedure? (Select all that apply.) A) Sexual intercourse can resume in a week. B) The procedure can be done as an outpatient. C) An opioid analgesic will be prescribed for pain control. D) Use a birth control method until a negative sperm reports occur. E) Spermatozoa present in the vas deferens will be viable for 2 weeks.
A B D
A 40-year-old woman who smokes desires a reliable contraceptive method. Which should the nurse recommend to this patient? A) An ovulation suppressant B) A condom and spermicide C) A spermicidal suppository D) The rhythm (calendar) method
B
A patient asks the nurse if a cervical cap is better than a diaphragm for contraception. What should explain as the advantages of a cervical cap? A) No initial fitting is required. B) It can be left in place longer. C) It needs no spermicidal jelly. D) It does not need to be refitted after pregnancy.
B
A patient wants to calculate fertile days using the calendar method. What will the nurse instruct the patient to subtract when making this calculation? A) 14 from 28 B) 18 from the shortest period and 11 from the longest C) 18 from the longest period and 11 from the shortest D) The length of the average period from the ideal of 28
B
A patient who has unprotected intercourse has obtained the morning after pill but has not yet taken the prescribed dosage. What nursing diagnosis should the nurse identify as appropriate for the patient at this time? A) Powerlessness B) Spiritual distress C) Decisional conflict D) Readiness for enhanced knowledge
C
The nurse completes instructing a patient on the use of the contraceptive patch. Which patient response indicates that teaching has been effective? A) The patch is immediately effective after application. B) The patch should be applied to the breasts, hips, or back. C) The patch should be applied to the abdomen, buttocks, or back. D) The patch should be covered when swimming because of chlorine's effect on the adhesive.
C
When should the nurse instruct a female patient using the basal body temperature method of contraception to refrain from having sexual intercourse? A) Four days after noticing a temperature rise B) Fourteen days after the last day of the menstrual period C) Three days after recording a slight drop in temperature followed by an increase D) Three to 4 days after recording a slight increase followed by a dip in the temperature
C
A female patient has forgotten to take an ovulation suppressant for two mornings in a row. What should the nurse advise the patient to do? A) Take two pills a day for the rest of the month. B) Take three pills immediately and avoid coitus for the remainder of the month. C) Start a new cycle of 21 pills immediately plus additional estrogen for the next 3 days. D) Take two pills now and use a second method of contraception for the remainder of the month.
D
A patient comes into the family planning clinic and requests a prescription for birth control pills. Which assessment finding indicates that an ovulation suppressant would not be the best contraceptive method for the patient? A) Age 30 years B) Allergy to foreign protein C) Irregular menstrual cycles D) History of thromboembolism
D
An adolescent female who has recently started menstruating asks for a highly reliable birth control method. Which method should the nurse discuss with the patient? A) Postcoital douching B) An intrauterine device C) An ovulation suppressant D) Vaginal foam for her and a condom for her partner
D
The nurse instructs a patient on cervical mucus changes that occur during ovulation. Which statement indicates that teaching has been effective? A) "During ovulation, the mucus is thick." B) "Ovulation makes the mucus more acidic." C) "The mucus is white because of more white blood cells." D) "When the mucus is thin and watery, then ovulation is occurring."
D
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? A) Argue that encouraging abstinence is unrealistic during the teenage years. B) Discuss that the application of a condom should occur after penile-vulvar contact. C) Explain that the combination oral contraceptive approach is the best for adolescents. D) Teaching about contraceptive options while avoiding indirect encouragement of sexual activity.
D
The nurse is teaching a patient on the use of a diaphragm for contraception. Which patient statement indicates that instruction has been not been effective? A) "I need to use my finger to remove the diaphragm." B) "I should remove the diaphragm 6 hours after intercourse." C) "I should stop using a diaphragm if I get an infection of my cervix." D) "I need to have the diaphragm checked if my weight changes by 30 lb."
D