Family Planning
Ectopic pregnancy
A pregnancy outside of the womb, usually in a fallopian tube
After reviewing the various types of contraception available and discussing the pros and cons about each with the nurse, a young woman decides to use a spermicidal cream. When teaching the woman about this type of contraception, the nurse would instruct the woman to insert the cream at which time frame before intercourse? A 1 hour B 1.5 hours C 2 hours D 3 hours
A. Spermicidal gels or creams are easily inserted into the vagina before sex with the provided applicator. The woman should do this no more than 1 hour before sex.
The hormone ________________ is contraindicated in a woman with a current breast cancer diagnosis or acute viral hepatitis
progestin
coitus interruptus method
pul out method
The safest and most cost-effective method of permanent sterilization is the ________________.
vasectomy
What important information should the nurse give a client about the use of a diaphragm during menstruation? 1 Toxic shock syndrome is possible. 2 Vaginal discharges may occur. 3 It may cause genital burning. 4 Use during menstruation can lead to abdominal pain.
1 The nurse should inform the client that using a diaphragm during menstruation can lead to toxic shock syndrome. NOT 2 Vaginal discharge is associated with the use of a vaginal contraceptive ring. 3 Genital burning may occur when spermicidal products are used along with the barrier methods of contraception. 4 Abdominal pain is a side effect reported during the use of oral contraceptive pills (OCPs) and intrauterine devices (IUDs).
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? 1 cervical infection 2 a weight gain of 10 lb (4.5 kg) 3 a vaginal infection 4 six months of nonuse
2 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 woman is using depot medroxyprogesterone acetate (Depo-Provera) as a method of birth control. Which side effect would the nurse most likely include as common? 1 constipation 2 nausea 3 irregular menstruation 4 pregnancy
3 Depo-Provera is a progestin-only hormonal birth control system. One injection can prevent pregnancy for 12 weeks and is 99.7% effective. Irregular bleeding is the most common side effect
A woman telephones the nurse after taking an ovulation suppressant for 3 months to state that she has forgotten to take her pill two mornings in a row. What would be the best advice to give her regarding this? 1 Start a new cycle of 21 pills immediately plus additional estrogen for the next 3 days. 2 Take three pills immediately and avoid sex for the remainder of the month. 3 Take two pills now and use a second method of contraception for the remainder of the month. 4 Take two pills a day for the rest of the month.
3 Failure to take two pills could have resulted in ovulation, so additional protection should be used for the remainder of the cycle.
A client is desiring to start birth control and is questioning the nurse concerning the best options. Which option should the nurse point out is the most reliable? 1 diaphragms 2 condoms 3 oral contraceptive pills (OCPs) 4 hormonal implant
4 Hormonal implant is a small, flexible, plastic rod implanted into the arm of the client. This method requires replacement only every 3 years and has a high success rate for pregnancy prevention. The client does not have to remember to do anything. NOT 3 Oral contraceptive pills, although highly effective, depend on the individual remembering to take the pill every day at the same time without fail. 1.2. Diaphragms and condoms can have structural failures (a hole) and would be less reliable.
diaphragm contraception
A barrier method of contraception. It fits inside your vagina and prevents sperm passing through the cervix (the entrance of your womb). You need to use it with a gel that kills sperm (spermicide).
Sterilization
Both men and women may be sterilized. The sterilization of a woman is called BTL (Bilateral Tubal Ligation). The sterilization of a man is referred to as a vasectomy. Contraception failure is rare with sterilization.
Symptothermal method
The symptothermal method requires a combination of evaluating cervical secretions several times a day and taking a daily temperature prior to rising with a basal body thermometer. A woman's temperature dips slightly on the day of ovulation and then rises sharply after ovulation has occurred
The nurse is planning instruction for a client desiring to have a tubal ligation. Which information should the nurse emphasize when teaching the client? 1 She must think of the procedure as irreversible. 2 The procedure will reduce her menstrual flow in amount. 3 She should schedule it to be done just before a menstrual flow. 4 She will have less dysmenorrhea following the procedure.
1 People considering tubal ligation should think of this procedure as permanent before having it done. Although reversal of the procedure can be done, the success rate is only between 70% and 80%. NOT 2.4. Tubal ligation does not alter the menstrual flow or affect dysmenorrhea. 3 Ectopic pregnancy could result if it is done following ovulation.
A female client who has been trying to conceive for 1 year comes to the fertility clinic and will be undergoing a subfertility evaluation. When discussing the components involved, which information would the nurse most likely include? Select all that apply. 1 semen analysis of the partner 2 ovulation monitoring 3 hormone injections 4 tubal patency assessment 5 medication regimen
1.2.4. Subfertility assessment used to require many months and numerous tests. Today, a subfertility investigation is usually limited to three assessments: semen analysis, ovulation monitoring, and evaluation of tubal patency. NOT 3.5. Medications (including hormone injections) are part of the treatment depending on what was revealed in the assessment.
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? 1 intrauterine device (IUD) 2 condoms 3 oral contraceptive pills (OCPs) 4 tubal ligation
2 Because the client has multiple sex partners, condoms will help offer protection against sexually transmitted infections (STIs) and are best suited for her needs. NOT 1 The client cannot use an IUD because of her history of various pelvic infections. 3 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. 4 Tubal ligation is a sterilization procedure and does not suit the client's purpose.
The nurse in a primary care clinic and a client have come to see the primary care provider because the client is getting married and wants to have a prenuptial gynecologic examination. After the exam, the nurse asks about the woman's plan to have a family. The woman responds, "Why do I have to plan for a family?" What would be the nurse's best response? 1 Families are always best when pregnancies are not planned. 2 The couple can control the time between births when they plan their family. 3 An unwanted pregnancy can always be aborted. 4 The couple can decide on a method of birth control.
2 Women and couples can avoid unwanted pregnancies, bring about wanted births, and control the intervals between births with family planning.
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? 1 natural membrane condom 2 polyurethane condom 3 transdermal contraceptive 4 ethinyl estradiol
3 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). NOT 1.2. Natural membrane and polyurethane condoms are forms of male condoms, which the client does not like. 4 Ethinyl estradiol is an oral contraceptive pill, which would most likely cause the client to experience breast tenderness, headache, and nausea.
A nurse is instructing a client on the use of home-use ovulation determination kits. What is most appropriate for the nurse to tell the client? 1 "These are not reliable; you should just monitor your temperature." 2 "You will need a prescription for these kits." 3 "The kit will help determine when your body is preparing for ovulation." 4 "The results of the kit will have to be sent in to the clinic on a daily basis."
3 The home-use ovulation determination kit monitors LH or FSH hormone in a urine sample. In LH kits it monitors for a surge in the hormone that would indicate ovulation is getting ready to occur.
The nurse has finished teaching a client about the use of a contraceptive patch. Which client response indicates that teaching has been effective? 1 The patch is immediately effective after application. 2 The patch should be applied to the breasts, hips, or back. 3 The patch should be applied to the abdomen, buttocks, or back. 4 The patch should be covered when swimming because of chlorine's effect on the adhesive.
3 The patch should be applied only to the buttocks, back, abdomen, or torso and never on the breasts. NOT 4 The patch is safe for wearing during swimming and bathing. 1 The patch requires application for 1 week before becoming effective.
________________ of the uterus, though rare, is one of the risks of IUD insertion
Perforation
A nursing instructor is teaching about fertility and realizes a need for further instruction when a student states: 1 "Sterility is the inability to conceive because of a known condition, such as absence of a uterus." 2 "In most couples with a subfertility problem, it is the man who is subfertile." 3 "In primary subfertility, there have been no previous conceptions." 4 "In secondary subfertility, there has been a previous viable pregnancy."
2 In approximately 30% of couples, the man is subfertile
The nurse discusses various contraceptive methods with a client and her partner. Which method would the nurse explain as being available only by prescription? 1 condom 2 spermicide 3 diaphragm 4 basal body temperature
3 The diaphragm is available only by prescription and must be professionally fitted by a health care provider. NOT 1.2. Condoms and spermicides are available over the counter. 4 Basal body temperature requires the use of a special thermometer that is available over the counter.
Hysterosalpingography
Is a radiologic examination with radiopaque contrast of the fallopian tubes. It is widely used to assess the patency of the fallopian tubes in women who are subfertile.
A client is beginning to take oral contraceptive pills (OCPs). Which side effects will the nurse caution might be expected? Select all that apply. 1 nausea 2 weight loss 3 headache 4 breast tenderness 5 frequent urinary tract infections
The main side effects that women may experience are nausea, weight gain, headache, breast tenderness, breakthrough bleeding, monilial vaginal infections (yeastlike parasitic fungus), mild hypertension, and depression.
A nurse is asked to teach a woman to take her basal body temperature daily to assess the time of ovulation. She can detect her day of ovulation, following ovulation, because her temperature will: 1 increase a degree. 2 decrease a degree. 3 fluctuate a degree daily. 4 no longer reflect basal body temperature.
1 The effect of progesterone, released with ovulation, is to increase body temperature.
A 45-year-old client and her spouse are present in the clinic. Results of fertility testing indicate that the client has damage to her fallopian tubes. Which would be the most appropriate infertility option for this client? 1 Gamete intrafallopian transfer 2 In vitro fertilization 3 Surrogate mother 4 Ovulation stimulation
2 This client has damage to her fallopian tubes, so any procedure would need to bypass this structure. In vitro fertilization fertilizes an ovum and then inserts it into a women's uterus.
Which description best explains the hysterosalpingogram procedure? 1 insertion of an endoscope through the posterior fornix to visualize the reproductive organs 2 instillation of carbon dioxide through the cervix into the uterus and fallopian tubes 3 passage of an endoscope through a small abdominal incision to inspect the reproductive organs 4 radiograph of the uterus and fallopian tubes following introduction of a radiopaque medium through the cervix
4 Hysterosalpingogram is a procedure to document the patency of the fallopian tubes through the use of a radiopaque medium.
The nurse is teaching a group of adolescents about contraceptive use. One of the adolescents asks if contraceptives prevent sexually transmitted infections (STIs). The nurse identifies which of the following as a method of birth control that also prevents the spread of STIs? 1 oral contraceptive pills (OCPs) 2 diaphragm 3 sterilization 4 male condoms 5 spermicides
4 a male condom is the only one that will also prevent STIs.
The teaching guidelines for proper condom use include:
Ensure the condom has been stored in a cool, dry place away from direct sunlight. Do not store condoms in wallet; put the condom on before any genital contact; put the condom on when penis is erect; ensure adequate lubrication during intercourse. If external lubricants are used, use only water-based lubricants. Oil-based or petroleum-based lubricants, such as body lotion or massage oil, can weaken latex condoms. Withdraw while penis is still erect, and hold condom firmly against base of penis. Remove carefully to ensure no semen spills out.
Should a subfertile couple to have intercourse daily?
No. Couples who engage in sex daily hoping to cause impregnation may actually have more difficulty conceiving than those who space sex to every other day. This is because sex that occurs too frequently can lower a man's sperm count to a level below optimal fertility.
A 30-year-old client would like to try using basal body temperature (BBT) as a fertility awareness method. Which instruction should the nurse provide the client? 1 Avoid unprotected intercourse until BBT has been elevated for 6 days. 2 Avoid using other fertility awareness methods along with BBT. 3 Use the axillary method of taking the temperature. 4 Take temperature before rising, and record it on a chart.
4 The client should be instructed to take her temperature before rising and record it on a chart. NOT 1 If using this method by itself, the client should avoid unprotected intercourse until the BBT has been elevated for 3 days. 2 The client should be informed that other fertility awareness methods should be used along with BBT for better results. 3 The oral method is better suited than the axillary method for taking the temperature in this case.
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? 1 Oral contraceptive pills (OCPs) 2 Subdermal hormone implant 3 Intramuscular injections 4 Vaginal estrogen/progestin (contraceptive) ring
4 The nurse should recognize that the vaginal estrogen/progestin ring releases hormones into the mucous membranes of the vagina and avoids the "first pass" through the liver.
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? A 84 active; 7 placebo B 70 active; 6 placebo C 56 active; 5 placebo D 42 active; 4 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.
cervical mucus ovulation method
Tracks changes in the viscosity (stickiness) of the cervical mucus. After menstruation the vagina is rather dry. Dry days are relatively safe. The mucus discharge appears in the vagina that is first thick and sticky and white or cloudy in color. Sex should be avoided at the first sign of mucus. The mucus thins and clears, becoming slippery or stringy like raw egg whites. These are the peak days. Ovulation takes place after the ovulatory mucus appears. Sex may resume 4 days after the last peak day. Very hard to tell changes.
A woman comes to the clinic because she has been unable to conceive. When reviewing the woman's history, the nurse would least likely identify which factor as a possible risk? 1 age of 25 years 2 history of smoking 3 diabetes since age 15 years 4 weight below standard for height and age
1 Female risk factors for infertility include increased age, smoking and alcohol consumption, history of chronic illness such as diabetes, and overweight or underweight, which can disrupt hormonal function.
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? 1 rhythm method 2 diaphragm 3 intrauterine device 4 hormonal method
1 Fertility awareness methods (FAMs) include the rhythm method, which involves limiting sexual intercourse to the time during the woman's menstrual cycle when she is most likely to be infertile. This method does not involve contraceptive devices. NOT 2.3. Barrier methods such as diaphragms and IUDs interfere with conception by physically preventing sperm from fertilizing ova. Barriers work through mechanical and chemical means. 4 Hormonal methods of birth control alter a woman's normal hormone level to prevent ovulation and thus the chances for conception.
The public health nurse is teaching a community class of couples on fertility awareness-based methods. The nurse determines that additional teaching is needed when one of the couples states that they will be using which method? 1 coitus interruptus method 2 cervical mucus ovulation method 3 basal body temperature method 4 symptothermal method
1 Fertility awareness refers to any natural contraceptive method that does not require hormones, pharmaceutical compounds, physical barriers, or surgery to prevent pregnancy. Techniques used to determine fertility include the cervical mucus ovulation method, the basal body temperature (BBT) method, the symptothermal method, standard days method, and 2-day method. Coitus interruptus or withdrawal is not considered a fertility awareness based method.
A woman is going to have in vitro fertilization. When preparing her for this, the nurse would make which statement? 1 "It can be done with frozen donor sperm." 2 "You will need to select a surrogate mother." 3 "Most procedures are effective the first time tried." 4 "This is dangerous if there is ovarian cancer in your family."
1 Fresh or frozen sperm may be used. NOT 4 The success of in vitro fertilization is not related to the incidence of ovarian cancer in the family. 3 Quite often, more than one attempt is needed before successful implantation.
A client is questioning the nurse about the various options for contraception. When explaining the implantable form, the nurse should point out it contains which form of contraception? 1 progestin 2 estrogen and progestin 3 concentrated spermicide 4 concentrated estrogen
1 Implantable contraceptives deliver synthetic progestin that act by inhibiting ovulation and thickening cervical mucus so sperm cannot penetrate. NOT 2 Various options that combine estrogen and progestin include the transdermal patch and a vaginal estrogen/progestin (contraceptive) ring. 3 Concentrated spermicide is inserted directly into the vagina. 4 There are no concentrated estrogen products available for contraceptive measures.
A nurse is helping a couple choose a contraception method that is right for them. Which is the least likely factor the nurse should consider? 1 the popularity of the method among the couple's friends 2 ability to use a method correctly 3 financial factors 4 whether the method will affect sexual enjoyment
1 Important things to consider when helping a couple to choose a method that will be right for them include the following: personal values, ability to use a method correctly, whether the method will affect sexual enjoyment, financial factors, whether a couple's relationship is short-term or long-term, prior experiences with contraception, and future plans. The popularity of the method is the least likely factor the nurse should consider.
A young woman is newly married and is seeking advice on contraception. She is in a monogamous relationship and would like a temporary contraceptive, as she plans to have children in the future. Her husband dislikes the feel of condoms. Also, she mentions that she typically experiences dysmenorrhea and has a history of recurrent urinary tract infections. Which method should the nurse recommend? 1 oral contraceptive pills (OCPs) 2 postcoital douching 3 diaphragm 4 vasectomy
1 Oral contraceptive pills would be the best choice of those listed for this client, as it is a temporary contraceptive that also can help relieve dysmenorrhea. NOT 2 Postcoital douching is ineffective as a contraceptive measure as sperm may be present in cervical mucus as quickly as 90 seconds after ejaculation. 3 Diaphragms are contraindicated for women with a history of recurrent UTI. 4 Vasectomy is a permanent measure and thus inappropriate in this situation.
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? 1 transdermal contraception 2 sterilization 3 cervical cap 4 diaphragm
1 The best choice for her is transdermal contraception, which involves wearing a patch for a week at a time and does not require taking pills daily. NOT 3.4. The fact that this woman has a latex allergy rules out the cervical cap and diaphragm. Moreover, the diaphragm is contraindicated in her case due to her papillomavirus infection.
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? 1 when it is thin, watery, and copious 2 when it is thick 3 Cervical mucus is not a reliable indicator. 4 when it does not stretch
1 The cervical mucus method relies on the changes that occur naturally with ovulation. Before ovulation, cervical mucus is thick and does not stretch when pulled. With ovulation, the mucus becomes thin, copious, watery, transparent, and stretchy. During ovulation, the mucus is NOT thick, NOT acidic, and NOT white. Ovulation occurs after a slight drop in temperature followed by an increase
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: 1 copper. 2 magnesium. 3 silicone. 4 potassium.
1 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. 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. 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.
The nurse is conducting a well-visit physical assessment on a 29-year-old female. The nurse determines the client is probably ovulating based on which condition of the cervical mucus? 1 Thin, slippery, and stretchy 2 Cloudy, thick, and watery 3 Clear and of large quantity 4 Thin and red-tinged
1 The mucus at the time of ovulation is thin, slippery, and stretchy to allow for the passage of sperm into the uterus. This is called spinnbarkeit fiber. If the mucus is too thick, it will inhibit fertilization. Before ovulation, the mucus is thick and does not stretch easily.
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? 1 Relatively easy procedure with few complications 2 Regular sperm counts are not essential 3 Procedure is effective immediately 4 Birth control measures are not required
1 The nurse should inform the individuals that vasectomy is a relatively easy procedure with few complications. not 2.3. Regular sperm counts following a vasectomy are important, as it will take approximately a month for the remaining sperm to exit the body. 4 The client should use birth control measures until his sperm count remains at zero for 6 weeks.
The nurse instructs a client on the use of a vaginal estrogen/progestin (contraceptive) ring. Which client statement indicates that additional instruction is needed? 1 "I am to take the ring out overnight." 2 "I will leave the ring in place for 3 weeks." 3 "I leave the ring in place during intercourse." 4 "I am to use other birth control if I take the ring out for 4 hours."
1 The ring is not removed overnight. NOT 4 If the ring is removed for 4 hours for any purpose, it should be replaced with a new ring and a form of barrier protection is to be used for the next 7 days. 2 The ring is left in place for 3 weeks and then removed for menstruation during the ring-free week. 3 The ring does not need to be removed for intercourse.
When teaching the client how to use a contraceptive sponge, the nurse must tell the client that leaving the sponge in place longer than 30 hours may lead to: 1 toxic shock syndrome. 2 pelvic inflammatory disorder. 3 sexually transmitted infections. 4 cervical inflammation.
1 The sponge provides protection for up to 12 hours but should not be left in place for more than 30 hours after insertion to avoid the risk of toxic shock syndrome.
A woman has opted to use the basal body temperature method for contraception. The nurse instructs the client that a rise in basal body temperature indicates which event? 1 onset of menses 2 ovulation 3 pregnancy 4 safe period for intercourse
2 Basal body temperatures typically rise within a day or two after ovulation and remain elevated for approximately 2 weeks, at which point bleeding usually begins. NOT 3 Basal body temperature is not a means for determining pregnancy. 4 Having intercourse while the temperature is elevated would increase the risk of pregnancy.
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? 1 the medroxyprogesterone injection 2 oral contraceptive pills (OCPs) 3 a copper intrauterine device 4 implantable contraceptives
2 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. NOT 1.3. The medroxyprogesterone injection or copper intrauterine devices are not contraindicated in this client and can be used with certain precautions. 4 Implantable contraceptives are subdermal time-release implants that deliver synthetic progestin; these are highly effective and are not contraindicated in this client.
A nurse is reviewing the medical record of several couples who have attempted to conceive but have been unsuccessful. Which couple would the nurse most likely identify as benefitting from in vitro fertilization (IVF)? Select all that apply. 1 a woman who has had a hysterectomy 2 a woman who has blocked or damaged fallopian tubes 3 a man who has oligospermia 4 a woman who lacks cervical mucus 5 a couple with unexplained subfertility of long duration
2 IVF is most often used for couples who have not been able to conceive because a woman has blocked or damaged fallopian tubes. 3 It is also used when the man has oligospermia, or a very low sperm count, because the controlled, concentrated conditions in the laboratory require only one sperm. 4 IVF may be helpful to couples when an absence of cervical mucus prevents sperm from traveling to or entering the cervix, or antisperm antibodies cause immobilization of sperm. 5 In addition, IVF may help couples with unexplained subfertility of long duration.
Which definition best explains the term "subfertility/infertility"? 1 failure to achieve pregnancy after 6 months of unprotected intercourse 2 failure to achieve pregnancy after 1 year of unprotected intercourse 3 inability to achieve pregnancy because of a known factor that prevents conception 4 inability to achieve pregnancy following a previous viable pregnancy
2 Infertility is the failure to achieve conception after 1 year of unprotected intercourse. Because most couples have the potential to conceive but are just less able to conceive without additional help, the term subfertility is more often used today.
Prevention of pregnancy is a major factor in the sex lives of many couples. One method of contraception is the female condom. It is a thin tube made of polyurethane, with flexible rings at both ends. What is a disadvantage of the female condom? 1 needs an erection to remain in place 2 makes noise during intercourse 3 cannot be used by people sensitive to latex 4 decreases stimulation to the clitoris
2 Reported disadvantages are that the condom may be difficult to apply, makes noise during intercourse, causes vaginal or penile irritation, and is more expensive. NOT 1 An erection is not needed for one to be used. 3 It is a good alternative for individuals allergic to latex. 4 It assists with stimulation of the clitoris due to the placement of the rings.
A 40-year-old woman who smokes desires a reliable contraceptive method. Which should the nurse recommend to this client? 1 an ovulation suppressant 2 a condom and spermicide 3 a spermicidal suppository 4 the rhythm (calendar) method
2 The best option is for the client to use a condom and spermicide. NOT 1 Women who are 40 years of age and smoke should not take ovulation suppressants. 4 Irregular menstrual cycles make natural methods difficult. 3 Women older than the age of 40 may have vaginal dryness, so a spermicidal suppository would not be effective.
A nurse is teaching a female client about fertility awareness as a method of contraception. The nurse should mention to the client that this method relies on which assumption? 1 Sperm can live up to 24 hours after intercourse. 2 The "unsafe period" is approximately 6 days. 3 The exact time of ovulation can be determined. 4 The "safe period" is 3 days after ovulation.
2 The nurse should explain to the client that the fertility awareness method relies on the assumption that the "unsafe period" is approximately 6 days—3 days before and 3 days after ovulation. NOT 1 The method also assumes that sperm can live up to 5 days, not just 24 hours after intercourse. An ovum lives up to 24 hours after being released from the ovary. 3 The exact time of ovulation cannot be determined, so 2 to 3 days are added to the beginning and end to avoid pregnancy.
A 25-year-old having a yearly check-up informs the nurse that she has stopped taking oral contraceptive pills (OCPs) because she and her husband want to start a family. She states, "I know I will get pregnant right away because my mother was very fertile." What is the nurse's best response? 1 "The chance of subfertility increases with age, especially after the age of 20." 2 "Women who used oral birth control pills may have difficulty becoming pregnant for several months after discontinuing them." 3 "Based on your history, you probably won't experience a problem getting pregnant." 4 "It seems that everybody is different when it comes to getting pregnant."
2 The nurse should inform her that after stopping oral contraceptive pills it may take several months for the body to restore normal functioning, so it may take time to conceive. NOT 1 Although the chance of subfertility increases with age, this client is 25 years old, so that issue does not apply. The other statements are not appropriate. 4 Although each person is an individual, the statement about everybody being different offers false reassurance and does not address the client described in the scenario.
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? 1 "These strips are often not reliable and end up being a waste of money." 2 "It is a lot more accurate if you come to the clinic routinely to get tested." 3 "You can also test your vaginal discharge to determine if you are ovulating." 4 "I am sure these strips will help you become pregnant faster."
3 The appropriate statement for the nurse to make is regarding testing vaginal or cervical discharge (spinnbarkeit test). This testing and basal body temperature monitoring are free methods clients can use at home to test for ovulation. NOT 1 The home-use ovulation kit monitors luteinizing hormone (LH) levels in a urine sample. The home-use kit monitors for a surge in LH that would indicate ovulation is getting ready to occur. They are typically effective; however, they can be expensive to use repeatedly. 2 Although being tested in the clinic would be most accurate, this is not feasible for most clients financially nor easy to fit into daily schedules. 4 The nurse would not provide false assurance that usage will lead to a quick pregnancy as other factors could be present.
A client 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 client at this time? 1 Powerlessness 2 Spiritual distress 3 Decisional conflict 4 Readiness for enhanced knowledge
3 The client has the "morning after" pill but has not yet taken the prescribed dosage. This indicates that the client has not yet made a decision. NOT 1 Powerlessness would be applicable if the client's planned contraceptive was ineffective. 2 Spiritual distress would be appropriate if there were a conflict regarding contraceptive methods. 4 Readiness for enhanced knowledge would be applicable if the client was asking about different contraceptive types.
A female client has been trying to conceive for 3 months. She tells the nurse, "I just know something is wrong with me." Which response by the nurse is best? 1 "It is time to talk to your health care provider about hormone testing." 2 "Do you or your partner have a family history of subfertility?" 3 "The problem can be with the man, woman, or both. We will explore all possibilities." 4 "It can take up to 1 year of regular, unprotected intercourse to conceive."
4 The nurse would first provide accurate information by informing the client that 3 months is not an adequate time frame to indicate a problem is present. Most couples conceive within 1 year when they have regular intercourse without the use of contraceptives. NOT 1.2. There is no reason to assess for infertility issues with the female or with the couple's families. 3 It is true that subfertility issues can be related to the man, woman, or both; however, it is not appropriate to indicate there is concern by stating "we will explore all possibilities."
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: 1 ECs simply prevent embryo creation and uterine implantation from occurring in the first place. 2 ECs can induce an abortion (elective termination of pregnancy) of a recently implanted embryo. 3 ECs can help prevent STIs. 4 ECs are more effective than regular birth control.
1 ECs prevent the embryo creation and uterine implantation from occurring. NOT 2. There is no evidence that ECs have any effect on an already-implanted ovum or that they induce abortion (elective termination of pregnancy). 3.4. They do not protect against STIs and are less effective than regular birth control.
basal body temperature (BBT) method
natural family planning method that relies on monitoring decreases and increases in basal body temperature during the menstrual cycle
