STI & Contraception
A couple is inquiring about vasectomy as a permanent method of contraception. Which teaching statement would the nurse include in the teaching plan?
"Another method of contraception is needed until the sperm count is 0."
A client has obtained levonorgestrel as emergency contraception. After unprotected intercourse, the client calls the clinic to ask questions about taking the contraceptives. The nurse realizes the client needs further explanation when she makes which statement?
"I can wait up to 4 days after intercourse to start taking these to prevent pregnancy."
A nurse is teaching a female client, who is positive for human immunodeficiency virus, about pregnancy. The nurse should know more teaching is necessary when the client says:
"I'll need to have a cesarean birth if I become pregnant and have a baby."
A client taking oral contraceptives is placed on a 10-day course of antibiotics for an infection. Which instruction should the nurse include in the teaching plan?
"Use a barrier method of birth control for the rest of your cycle."
A 17-year-old high school senior calls the clinic because she thinks she might have gonorrhea. She wants to be seen but wants assurances that no one will know. Which is the most appropriate response by the nurse?
"We can see you without your parents' consent but have to report any positive results to the public health department."
A client who has received a new prescription for oral contraceptives asks the nurse how to take them. Which symptom should the nurse instruct the client to report to her primary caregiver?
Blurred vision and headache
The nurse should inform a young female client that the barrier method providing the best protection against sexually transmitted infections (STIs) is:
Condoms.
The nurse is completing a sexual history on a client. The client reports a history of having a sexually transmitted infection (STI) which lies dormant in the body and can reoccur, but does not remember the name. Which STI matches the client's description?
Herpes infection
As she tries to decide on a birth control method, a client requests information about medroxyprogesterone. Which statement represents the nurse's best response?
Medroxyprogesterone needs to be administered every 12 weeks.
A school nurse is teaching a class about sexually transmitted infections (STIs). Which statement is correct regarding STIs?
STIs are most prevalent among teenagers and young adults.
Which instructions should the nurse include in the teaching plan for a 30-year-old multiparous client who will be using an intrauterine device (IUD) for family planning?
Severe cramping may occur when the IUD is inserted.
Under which circumstance may a nurse communicate medical information without the client's consent?
When treating the client with a sexually transmitted disease
A 30-year-old multiparous client has been prescribed oral contraceptives as a method of birth control. The nurse instructs the client that decreased effectiveness may occur if the client is prescribed which drug?
ampicillin
When developing a teaching plan for an 18-year-old client who asks about treatments for sexually transmitted infections, the nurse should explain that:
ceftriaxone sodium may be used to treat Neisseria gonorrhoeae infections.
Examination of a primigravid client having increased vaginal secretions since becoming pregnant reveals clear, highly acidic vaginal secretions. The client denies any perineal itching or burning. The nurse interprets these findings as a response related to which factor?
control of the growth of pathologic bacteria
A 24-year-old client admitted to the hospital is suspected of having an ectopic pregnancy. On admission, which factor would be most important to assess?
date of last menstrual period
The nurse should caution sexually active female clients taking isoniazid (INH) that the drug:
decreases the effectiveness of hormonal contraceptives.
What should the nurse include in a community health program designed to control sexually transmitted infections (STIs)?
location of the possible sources of infection
A nurse is caring for a client after evacuation of a hydatidiform mole. The nurse should tell the woman to:
use birth control for at least 1 year.
A primigravid client at 8 weeks' gestation tells the nurse that since having had sexual relations with a new partner 2 weeks ago, she has noticed flu-like symptoms, enlarged lymph nodes, and clusters of vesicles on her vagina. The nurse refers the client to a primary health care provider because the nurse suspects which sexually transmitted infection?
herpes genitalis
A nurse is conducting a healthy-living workshop with a group of female college students. Which of the following methods of contraception should the nurse recommend as a means of preventing both pregnancy and sexually transmitted infections?
Condoms
A woman with chronic acquired immunodeficiency disorder (AIDS) tells the nurse at the women's health center that she is sexually active but has not had a gynecological exam for over three years. What important information is essential to include in providing health education for the client?
Safe sex education to prevent the risk of infection
An 18-year-old female client who is sexually active with her boyfriend has a purulent vaginal discharge that is sometimes frothy. The nurse interprets this as suggesting a:
sexually transmitted infection.
A nulligravid client calls the clinic and tells the nurse that she forgot to take her oral contraceptive this morning. The nurse should tell the client to:
take the medication immediately.
The nurse is caring for a client newly diagnosed with human immunodeficiency virus (HIV) obtained from unprotected sex. The nurse is in the room when the client is explaining the disease to another person. Which statement by the client would the nurse clarify? Select all that apply.
- "I am afraid that I will give this disease to my nephew." - "Medications can cure the disease."
A 30-year-old client is being treated for epididymitis. Teaching for this client should include the fact that epididymitis is commonly a result of a:
sexually transmitted infection.
The nurse is developing a community health education program about sexually transmitted infections. Which information about women who acquire gonorrhea should be included?
Women with gonorrhea are usually asymptomatic.
A sexually active male client has burning on urination and a milky discharge from the urethral meatus. What documentation should be included on the client's medical record? Select all that apply.
- presence of any enlarged lymph nodes on examination - allergies to any medications - history of unprotected sex (sex without a condom) - history of fever or chills - length of time since symptoms presented
A woman is taking oral contraceptives. The nurse teaches the client that medications that may interfere with oral contraceptive efficacy include:
antibiotics.
A client is 6 months postpartum and asks the nurse about an effective method of birth control. Which of the following is the most appropriate response from the nurse?
"Condoms protect against sexually transmitted diseases and pregnancy."
The mother of a 17-year-old girl with Down syndrome tells the nurse that her daughter recently stated that she has a boyfriend. The mother is concerned that her daughter might become pregnant. Which is the most appropriate suggestion by the nurse?
"I understand your concern; you may want to start your daughter on long-acting contraception."
The nurse is evaluating a female client's understanding of how to prevent sexually transmitted infections (STIs). Which statement indicates that the client understands how to protect herself?
"I will be sure my partner uses a condom."
A woman is using progestin injections for contraception. The nurse instructs the client to return for an appointment in:
3 months.
A nurse is preparing to provide contraceptive counseling for a client. What should the nurse plan to do first?
Explore her own personal beliefs and feelings about contraception.
The nurse is assessing a 16-year-old nulligravida, who asks for information on natural family planning methods of contraception and reports that her menstrual cycle occurs every 28 days. Which information would be important to include in the teaching plan for this client?
Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle.
A multiparous client tells the nurse that she is using medroxyprogesterone for contraception. The nurse should instruct the client to increase her intake of which nutrient?
calcium
The nurse is teaching a young woman about using oxcarbazepine to control seizures. The nurse determines teaching is effective when the client states:
"I will use one of the barrier methods of contraception."
A public health nurse is responsible for contact tracing of individuals identified in confirmed cases of sexually transmitted infections. The nurse telephones an individual named by a client as a contact. The individual demands the name of the person who identified the individual as a contact. Which of the following is the most appropriate response from the nurse?
"Just as I will protect your privacy, I must protect the privacy of the other people involved."
A client who tells the nurse that she would like to use the basal body temperature method for family planning receives instructions about the method. Which client statement indicates to the nurse that the teaching has been successful?
"It is important to take my temperature at about the same time every morning before arising."
Students in a health class are discussing birth control and prevention of sexually transmitted disease. The school nurse would know that teaching has been effective if the students state which of the following?
"Responsible sex involves using condoms and spermicides for protection and birth control."
A 22-year-old single female is discussing contraceptive methods with her health care provider and specifically asking about the ethinyl estradiol and etonogestrel vaginal insert. The nurse realizes the client needs further instruction when she makes which statement?
"This ring contains only progesterone for birth control."
A client scheduled for a vasectomy asks the nurse how soon after the procedure he can have sexual intercourse without using an alternative birth control method. How should the nurse respond?
"You can safely have unprotected intercourse when your sperm count indicates sterilization."
The nurse is reviewing discharge instructions with a postpartum breastfeeding client who is going home. She has chosen depot medroxyprogesterone acetate (DMPA) as birth control. Which statement by the client identifies that she needs further instruction concerning birth control?
"You will give me my first DMPA inection before I leave today."
A nurse is reviewing a client's medical record and notes the Papanicolaou smear laboratory report indicates visualization of clue cells and a vaginal pH of 3.8. What should the nurse teach this client? Select all that apply.
- Do not douche unless instructed by a health care provider (HCP). - Seek care if experiencing white, adherent vaginal discharge. - Seek care if the vaginal discharge has a fishy odor.
After receiving information on various forms of birth control, a young couple decides to use a barrier method because they would like to try and conceive in 1 to 2 years. Which barrier method uses a rubber barrier to hold spermicide against the cervix?
A diaphragm.
A postpartum client visits her physician to discuss contraception. After a thorough discussion, the client decides to use hormonal contraceptives. The physician orders ethinyl estradiol-ethynodiol diacetate, one tablet by mouth daily, followed by 7 days without a dose before beginning the next cycle of tablets. Which type of combination hormonal contraceptive is ethinyl estradiol-ethynodiol diacetate?
Monophasic
A nurse is teaching a group of clients about birth control methods. When providing instruction about subdermal contraceptive implants, the nurse should cite which feature as the main advantage of this method?
The implants provide effective, continuous contraception that isn't user dependent.
An antenatal G2, T1, P0, A0, L1 client is discussing her postpartum plans for birth control with her health care provider. In analyzing the available choices, which factor has the greatest impact on her birth control options?
breast- or bottle-feeding plan
A client wants to avoid methods of birth control that contain estrogen. Which method would be the nurse recommend?
depot medroxyprogesterone acetate injection
An adolescent female is prescribed amoxicillin for an ear infection. The nurse should teach the adolescent about the risks associated with her concurrent use of:
oral contraceptives.
A 32-year-old female client visits the family planning clinic and requests an intrauterine device for contraception. When assessing the client, a history of which problem would be most important to determine?
pelvic inflammatory disease
A client has just begun taking an oral contraceptive that contains estrogen and progestin. The nurse should instruct the client to use additional methods of contraception for at least:
7 days.
A 17-year-old client confides in the school nurse that he/she is interested in understanding safe sex practices. In instructing the client on how to correctly use a condom, which information would be stressed? Select all that apply.
- The condom would be applied on an erect penis. - Leave a 1/2 inch space at the end of the condom. - Never reuse a condom. - Condoms should be stored in a cool, dry place to prevent damage
The nurse is assessing a multigravid client at 12 weeks' gestation who has been admitted to the emergency department with sharp right-sided abdominal pain and vaginal spotting. Which information should the nurse obtain about the client's history? Select all that apply.
- contraceptive use - number of sexual partners - history of sexually - transmitted infections - last menstrual period
When developing a teaching plan about contraception with a 37-year-old woman during her annual gynecologic examination, which should the nurse identify as contraindications to combined oral contraceptive use? Select all that apply.
- smoking 1 pack of cigarettes per day - healing of a currently casted fractured femur. - use of phenytoin for a seizure disorder
The nurse is witnessing the client's signature on the informed surgical consent for an abdominal hysterectomy. It is important to ascertain that the client understands that with this surgical procedure she will have:
infertility.
A young female client is receiving chemotherapy and mentions to the nurse that she and her husband are using a diaphragm for birth control. Which information is most important for the nurse to discuss?
infection control
The nurse is caring for a client who is 12 weeks pregnant and speaks Spanish only. Which interventions should the nurse include in the plan of care at the client's initial visit? Select all that apply
- Review dietary intake and discuss nutrition. - Provide brochures in the client's native language. - Arrange for an interpreter for her appointments.
