Prep U Chapter 6: Nursing Care for the Family in Need of Reproductive Life Planning

A pregnant client states they are interested in having a tubal ligation following the birth of the child. Which statement by the nurse is a priority at this time? "There are risks and complications associated with having this procedure." "A tubal ligation is an effective method for permanent sterilization." "Your partner needs to understand the permanence of this procedure as well." "You should discuss other forms of birth control with your health care provider first."

"A tubal ligation is an effective method for permanent sterilization."

An 18-year-old female client who is sexually active asks the nurse for information on barrier contraceptives. Which statement is appropriate for the nurse to include in the response? "Cervical caps are most effective when used along with a spermicidal agent." "The use of a diaphragm is a good choice if you have frequent urinary tract infections." "A diaphragm must be inserted 1 hour prior to sexual intercourse." "A cervical cap is a barrier contraceptive that you can purchase over the counter."

"Cervical caps are most effective when used along with a spermicidal agent."

A nurse is preparing a client for intrauterine device (IUD) insertion. Which education will the nurse provide to the client? "The insertion procedure for an IUD is painless." "Checking the strings is recommended following insertion." "An IUD will prevent sexually transmitted infections (STIs)." "Expect to have continuous uterine cramps after insertion."

"Checking the strings is recommended following insertion."

Depot medroxyprogesterone acetate (Depo-Provera) has been suggested to a postpartum client as a method of birth control. Which statement by the client reveals to the nurse an accurate understanding and benefit to using this type of birth control? "I like that this is only a yearly injection." "My acne should diminish within 30 days of birth control use." "Weight loss of 5 to 10 lb (2.3 to 4.6 kg) is expected." "I am able to breastfeed while using this type of birth control."

"I am able to breastfeed while using this type of birth control."

Depot medroxyprogesterone acetate (Depo-Provera) has been suggested to a postpartum client as a method of birth control. Which statement by the client reveals to the nurse an accurate understanding and benefit to using this type of birth control? "Weight loss of 5 to 10 lb (2.3 to 4.6 kg) is expected." "I like that this is only a yearly injection." "My acne should diminish within 30 days of birth control use." "I am able to breastfeed while using this type of birth control."

"I am able to breastfeed while using this type of birth control."

The nurse is providing education about barrier contraceptives. Which statement by the client indicates a need for further education? "I have to wash my cervical caps after each use." "I can insert my female condoms up to 8 hours before intercourse." "Male latex condoms when used correctly are an effective means of contraception." "I can leave my diaphragm in for up to 48 hours."

"I can leave my diaphragm in for up to 48 hours."

After teaching a woman who has chosen the vaginal ring as her method of contraception, the nurse determines that the client needs additional teaching when she makes which statement? "If I do not get the ring centered on my cervix, it will still be effective." "I will compress the ring, inserting it as far back as possible." "Once I remove the ring, I will discard it." "I will insert a new ring at the same time and day of every week."

"I will insert a new ring at the same time and day of every week."

After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing abnormal uterine bleeding. Which statement by the client would support the nurse's suspicions? "I get really irritable and moody about a week before my period." "I've been having bleeding off and on that's irregular and sometimes heavy." "I get sharp pain in my lower abdomen usually starting soon after my period comes." "My periods have been unusually long and heavy lately."

"I've been having bleeding off and on that's irregular and sometimes heavy."

A couple in their early 30s is concerned because they have been trying to get pregnant for 4 months without success. The woman says that she had been on oral contraceptives before they began trying. Which of the following should the nurse say to the couple? "You are experiencing subfertility related to your age. I recommend beginning fertility testing next week." "You are experiencing subfertility. Increase your frequency of coitus to every day." "You are experiencing sterility. Have you considered adoption or child-free living?" "Oral contraceptives may delay conception for a few months. Give it another 6 to 8 months."

"Oral contraceptives may delay conception for a few months. Give it another 6 to 8 months."

A woman is diagnosed with primary dysmenorrhea and is prescribed ibuprofen as part of her treatment plan. When teaching the woman about using this medication, which instruction would be important for the nurse to emphasize? "Add an aspirin to the regimen if you do not get relief right away." "It is normal for your bowel movements to be black." "Start taking the medication when you first get your period." "Take the medication on an empty stomach."

"Start taking the medication when you first get your period."

A female client calls the clinic and tells the nurse, "I have forgotten to take my birth control pill the past 2 mornings in a row. What should I do?" After further discussion, the nurse determines that the client is using a combined oral contraceptive. Which response by the nurse would be most appropriate? "Take three pills now and do not have sex for the rest of the month." "Start a new pack of pills tomorrow morning and double up on tomorrow's dose." "Take two pills a day for the rest of the month." "Take two pills now and use a second method of contraception for the rest of the month."

"Take two pills now and use a second method of contraception for the rest of the month."

A newly married couple asks the nurse which "natural" way of family planning would be most effective in preventing pregnancy. What is the most appropriate response by the nurse? "Coitus interruptus is the easiest method and most reliable." "By checking your cervical mucus you will know when to abstain." "The basal body temperature method is simple and has a low failure rate." "I believe that abstinence would work best for your life choices."

"The basal body temperature method is simple and has a low failure rate."

A client is seen in the clinic requesting an emergency postcoital contraception pill levonorgestrel (Plan B). The client states that she had unprotected sex 3 ½ days ago. What is the most appropriate response by the nurse? "The pill will cause you to begin menstruating within a day." "Unfortunately you are past the time frame to take that prescription." "You will need to also be treated with antibiotics for an STI." "You should contact the local abortion clinic to set up an appointment."

"Unfortunately you are past the time frame to take that prescription."

A client states she has purchased home-use ovulation strips to help her know when she is ovulating. Which response by the nurse is most appropriate? "You can also test your vaginal discharge to determine if you are ovulating." "It is a lot more accurate if you come to the clinic routinely to get tested." "These strips are often not reliable and end up being a waste of money." "I am sure these strips will help you become pregnant faster."

"You can also test your vaginal discharge to determine if you are ovulating."

The nurse is caring for a client requesting oral contraceptive pills (OCPs). She has multiple sexual partners. The nurse recommends condoms to the client, but the client states, "I cannot use condoms because I am allergic to latex." Which response by the nurse is appropriate? "You can still use condoms because they make latex-free condoms." "Do you understand the potential ramifications of having multiple sexual partners?" "We can have you allergy tested to see if certain condoms may work for you." "I will let the health care provider know you desire oral contraceptive pills."

"You can still use condoms because they make latex-free condoms."

A nurse is reviewing sperm count results for a couple trying to conceive. Which results would concern the nurse? 20 million per ml of seminal fluid 10 million per ml of seminal fluid 30 million per ml of seminal fluid 40 million per ml of seminal fluid

10 million per ml of seminal fluid

The nurse is caring for four female clients, all prescribed oral contraceptive pills (OCPs). The nurse will question giving an oral contraceptive pill to which client? 37-year-old client who has migraines with aura several times a week and smokes 40-year-old client who has a history of asthma and a total cholesterol level of 170 mg/dl (4.40 mmol/L) 25-year-old client who has had three miscarriages and leads a sedentary lifestyle 30-year-old client who drinks a glass of wine daily and whose aunt had breast cancer

37-year-old client who has migraines with aura several times a week and smokes

The nurse is caring for four female clients, all prescribed oral contraceptive pills (OCPs). The nurse will question giving an oral contraceptive pill to which client? 40-year-old client who has a history of asthma and a total cholesterol level of 170 mg/dl (4.40 mmol/L) 37-year-old client who has migraines with aura several times a week and smokes 30-year-old client who drinks a glass of wine daily and whose aunt had breast cancer 25-year-old client who has had three miscarriages and leads a sedentary lifestyle

37-year-old client who has migraines with aura several times a week and smokes

A client who delivered her baby 3 months ago is seen in the clinic and tells the nurse that she and her husband have yet to resume a sexual relationship. The nurse notes that no contraception is currently being used. What is the most appropriate nursing diagnosis for this client? Decisional conflict related to unintended pregnancy Powerlessness related to failure of chosen contraceptive Spiritual distress related to partner's preference for contraception Altered sexual pattern related to fear of pregnancy

Altered sexual pattern related to fear of pregnancy

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? Dysmenorrhea Sexually active since 16 G1P0 Bicornuate uterus

Bicornuate uterus

A nurse is receiving a client from the postanesthesia unit to the recovery unit at the ambulatory surgery center. The client just had a laparoscopic tubal ligation. Which is the nurse's priority assessment? Depression Abdominal bloating Pain Bleeding

Bleeding

A nurse is receiving a client from the postanesthesia unit to the recovery unit at the ambulatory surgery center. The client just had a laparoscopic tubal ligation. Which is the nurse's priority assessment? Depression Pain Abdominal bloating Bleeding

Bleeding

The nurse is teaching a male client how to properly apply a male condom. Place the actions in the correct sequence for condom application. Use all options. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1Carefully open the condom wrapper. 2After sex but before removing the penis, hold the base of the condom. 3Remove the condom and dispose properly. 4Pinch air out of the tip of the condom. 5Place the condom over the head of the erect penis. 6Unroll the condom completely down the erect penis.

Carefully open the condom wrapper. Place the condom over the head of the erect penis. Pinch air out of the tip of the condom. Unroll the condom completely down the erect penis. After sex but before removing the penis, hold the base of the condom. Remove the condom and dispose properly

A client asks the nurse, "What would be the best way to get pregnant." The nurse would incorporate which information in the response? Conception is more likely in the presence of orgasm. Conception is more likely when intercourse occurs within 72 hours of ovulation. The timing of intercourse and conception affects the sex of the pregnancy. Conception is more likely if the sperm has just been ejaculated.

Conception is more likely when intercourse occurs within 72 hours of ovulation.

A client is requesting information on the various available contraceptives. When explaining a vaginal spermicide, which information should the nurse prioritize? Apply the spermicide directly to the glans penis to kill the sperm when they exit the penis. Leave the product in place for 24 hours after intercourse. Wash with clean water and soap after intercourse. Insert the product by applicator in the vagina prior to intercourse.

Insert the product by applicator in the vagina prior to intercourse.

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 Relatively easy procedure with few complications Birth control measures are not required Regular sperm counts are not essential

Relatively easy procedure with few complications

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? Relatively easy procedure with few complications Regular sperm counts are not essential Procedure is effective immediately Birth control measures are not required

Relatively easy procedure with few complications

A nurse supervisor observes a nurse massage a client's injection site after giving a dose of depot medroxyprogesterone acetate (Depo-Provera). What is the priority response by the nurse supervisor? Remind the nurse that this injection should absorb slowly. Thank the nurse for excellent client care. Call the health care provider immediately. Write up an incident report for the medication error.

Remind the nurse that this injection should absorb slowly.

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 continue to ejaculate sperm. The man will no longer produce testosterone. The man will still have full erection capacity. The man will no longer ejaculate seminal fluid.

The man will still have full erection capacity.

What important information should the nurse give a client about the use of a diaphragm during menstruation? Toxic shock syndrome is possible. It may cause genital burning. Vaginal discharges may occur. Use during menstruation can lead to abdominal pain.

Toxic shock syndrome is possible.

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? Vaginal estrogen/progestin (contraceptive) ring Subdermal hormone implant Intramuscular injections Oral contraceptive pills (OCPs)

Vaginal estrogen/progestin (contraceptive) ring

The nurse has assessed several clients who have arrived for routine appointments. The nurse predicts the health care provider will prioritize a bone density scan for which client? a 40-year-old black client, 5 ft 4 in (1.62 m) tall, 172 lbs (78 kg), inactive lifestyle a 45-year-old Hispanic client with a vitamin D deficiency a 25-year-old Asian client, 5 ft 7 in (1.7 m) tall, 129 lbs (58.5 kg), with two children a 55-year-old white client who smokes and has family history of osteoporosis

a 55-year-old white client who smokes and has family history of osteoporosis

A young client has just received a progesterone intrauterine contraceptive (IUC) and the nurse is doing postprocedural teaching. The nurse stresses to the client to report which finding(s) because it is a possible complication of the IUC? Select all that apply. discomfort from the string spotting leg cramping unscheduled bleeding amenorrhea

amenorrhea unscheduled bleeding spotting discomfort from the string

The nurse is teaching a young couple who desire to start their family the various methods for determining fertility. After discovering the woman regularly travels internationally for work, deals with a lot of job anxiety, and frequently uses an electric blanket at home, the nurse will discourage the use of which method? basal body temperature method cervical mucus method symptothermal method calendar method

basal body temperature method

The nurse is teaching a young couple who desire to start their family the various methods for determining fertility. After discovering the woman regularly travels internationally for work, deals with a lot of job anxiety, and frequently uses an electric blanket at home, the nurse will discourage the use of which method? calendar method cervical mucus method basal body temperature method symptothermal method

basal body temperature method

A woman is to receive methotrexate and misoprostol to terminate a first-trimester pregnancy. When preparing the teaching plan for this client, the nurse understands that misoprostol works by: dilating the cervix. acting as a toxin to the trophoblastic tissue. causing uterine contractions to expel the uterine contents. blocking the action of progesterone on the endometrium.

causing uterine contractions to expel the uterine contents.

The nurse should carefully screen a client who insists on using only oral contraceptive pills (OCPs) for which contraindication? impaired absorption gastrointestinal disease deep vein thrombosis use of alcohol

deep vein thrombosis

A woman in the 15th week of gestation is planning on terminating the pregnancy. The procedure done for second-trimester terminations is which of the following? hysterotomy menstrual extraction dilatation and curettage dilatation and extraction

dilatation and extraction

A woman in the 15th week of gestation is planning on terminating the pregnancy. The procedure done for second-trimester terminations is which of the following? hysterotomy menstrual extraction dilatation and extraction dilatation and curettage

dilatation and extraction

A client comes to the clinic for termination of pregnancy via medication. Which potential complication(s) will the nurse point out as possible with this type of procedure? Select all that apply. incomplete abortion prolonged bleeding hypoglycemia pneumonia infection

incomplete abortion prolonged bleeding infection

A client comes to the clinic for termination of pregnancy via medication. Which potential complication(s) will the nurse point out as possible with this type of procedure? Select all that apply. pneumonia hypoglycemia incomplete abortion infection prolonged bleeding

incomplete abortion prolonged bleeding infection

The nurse is providing contraception counseling to a perimenopausal woman who has had negative reactions to oral contraceptives (OCs) 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? subdermal progestin implant tubal ligation intrauterine device transdermal patch

intrauterine device

A middle-aged woman with a history of hypertension and high cholesterol levels asks the nurse about ways to reduce her risk for heart disease as she approaches menopause. Which area would the nurse emphasize as most important? lifestyle modification medications stress management screening

lifestyle modification

A client is beginning to take oral contraceptive pills (OCPs). Which side effects will the nurse caution might be expected? Select all that apply. weight loss headache breast tenderness frequent urinary tract infections nausea

nausea headache breast tenderness

The nurse is meeting with a 36-year-old client who wishes to begin using contraceptives. The client reports being in a long-term, monogamous relationship, runs 2 miles per day, and smokes a pack of cigarettes each day. Which method will the nurse be least likely to suggest to the client? coitus interruptus condoms spermicides oral contraceptive pills (OCPs)

oral contraceptive pills (OCPs)

The nurse is meeting with a 36-year-old client who wishes to begin using contraceptives. The client reports being in a long-term, monogamous relationship, runs 2 miles per day, and smokes a pack of cigarettes each day. Which method will the nurse be least likely to suggest to the client? oral contraceptive pills (OCPs) condoms coitus interruptus spermicides

oral contraceptive pills (OCPs)

The nurse is meeting with a 36-year-old client who wishes to begin using contraceptives. The client reports being in a long-term, monogamous relationship, runs 2 miles per day, and smokes a pack of cigarettes each day. Which method will the nurse be least likely to suggest to the client? oral contraceptive pills (OCPs) condoms spermicides coitus interruptus

oral contraceptive pills (OCPs)

A nurse is teaching a class about natural methods of birth control. Which group would the nurse identify as a good candidate for these methods of family planning? Select all that apply. young executives perimenopausal women postpartal women adolescents college students

perimenopausal women postpartal women

A 26-year old mother of three children tells the nurse at her annual check-up that she does not want to have any more children; however, her religion forbids the use of contraceptive devices. Which of the following methods would be the best option for this client? diaphragm hormonal method intrauterine device rhythm method

rhythm method

A 26-year old mother of three children tells the nurse at her annual check-up that she does not want to have any more children; however, her religion forbids the use of contraceptive devices. Which of the following methods would be the best option for this client? diaphragm hormonal method intrauterine device rhythm method

rhythm method

A woman who is using an intrauterine system for contraception comes to the clinic. When assessing the woman, which finding(s) would alert the nurse to a possible complication? Select all that apply. reports of abdominal pain string length shorter than on initial visit menstrual flow lighter and shorter absence of pain with intercourse oral temperature of 101°F (38.3°C)

string length shorter than on initial visit reports of abdominal pain oral temperature of 101°F (38.3°C)

A couple has chosen fertility awareness as their method of contraception. The nurse explains that the unsafe period for them during the menstrual cycle would be at which time? five days after the first day of the menstrual cycle three days before and three days after ovulation six days before the onset of menstruation midway between the normal menstrual cycle

three days before and three days after ovulation

A couple has chosen fertility awareness as their method of contraception. The nurse explains that the unsafe period for them during the menstrual cycle would be at which time? midway between the normal menstrual cycle six days before the onset of menstruation three days before and three days after ovulation five days after the first day of the menstrual cycle

three days before and three days after ovulation

A young woman says she needs a temporary contraceptive but has a latex allergy. She mentions that she has had a papillomavirus infection. Also, she says she is terrible about remembering to take pills. Which method should the nurse recommend? transdermal contraception cervical cap diaphragm sterilization

transdermal contraception

A young woman says she needs a temporary contraceptive but has a latex allergy. She mentions that she has had a papillomavirus infection. Also, she says she is terrible about remembering to take pills. Which method should the nurse recommend? transdermal contraception sterilization diaphragm cervical cap

transdermal contraception

A 22-year-old female client asks about forms of chemical barrier contraception. The nurse tells the client that which is a form of a chemical barrier contraceptive? female condom cervical cap vaginal foam diaphragm

vaginal foam

A nurse is providing medication education to an adolescent who is being prescribed an oral contraceptive pill (OCP). Which side effect(s) is important for the nurse to discuss with this client? Select all that apply. weight gain depression breakthrough bleeding breast tenderness nausea

weight gain breakthrough bleeding depression

A nurse is instructing a client on birth control methods. The client asks about the cervical mucus method. When should the nurse tell the client she is fertile in relation to her mucus? when it is thick when it does not stretch when it is thin, watery, and copious Cervical mucus is not a reliable indicator.

when it is thin, watery, and copious