Deck 5: Womens Health: Family Planning

Question 1

What issues should the nurse consider when counseling a patient on contraceptive methods?

A) Cultural perspectives on menstruation and pregnancy
B) Efficacy of the method
C) Future childbearing plans
D) Whether the patient is a vegetarian
E) Age at menarche

Answer 1

Cultural perspectives on menstruation and pregnancy
Efficacy of the method
Future childbearing plans

Question 2

The OB-GYN nurse is teaching a patient at the clinic that use of a spermicide has an increased effectiveness if used with:

A) A non-water-based lubricant.
B) A diaphragm.
C) A contraceptive sponge.
D) Prophylactic antibiotics.
E) A condom.

Answer 2

A diaphragm.
A contraceptive sponge.
A condom.

Question 3

A nurse is teaching contraception to a group of college students during a health class. What reason will the nurse include as to why couples might choose to use contraception?

A) Couples use contraception to avoid pregnancy.
B) Couples use contraception to space future pregnancies.
C) Couples use contraception to gain control over the number of children conceived.
D) Couples use contraception to avoid decisions about the number of children to have.
E) Couples use contraception to avoid contracting sexually transmitted diseases.

Answer 3

Couples use contraception to avoid pregnancy.
Couples use contraception to space future pregnancies.
Couples use contraception to gain control over the number of children conceived.
Couples use contraception to avoid contracting sexually transmitted diseases.

Question 4

The nurse instructing a patient in the use combined oral contraceptives knows that additional teaching is required when the patient makes the statement, "Taking combined oral contraceptives will give me a:

A) "Lower risk for breast cancer."
B) "Higher risk for cervical cancer."
C) "Lower risk for ovarian cancer."
D) "Higher risk for uterine cancer."

Question 5

The nurse in the clinic instructs a patient using the natural method of contraception to begin counting the first day of her cycle as:

A) The day her menstrual period ceases.
B) The first day after her menstrual period ceases.
C) The first day of her menstrual period.
D) The day of ovulation.

Question 6

The nurse educator is planning a class about contraception, and includes information about the effects of various contraceptive methods on sexually transmitted diseases. Which statement will the nurse include concerning spermicides?

A) Spermicides are effective against gonorrhea and chlamydia, but not against HIV.
B) Spermicides are not effective against sexually transmitted diseases, and can increase susceptibility to HIV.
C) Spermicides are effective against HIV, but are not effective against the other sexually transmitted diseases.
D) Whether or not spermacides are effective against sexually transmitted diseases depends on where the woman is in her cycle.

Question 7

The nurse is planning an educational session about contraception. What will the nurse emphasize as being the most significant factor in determining the effectiveness of a specific method of contraception to avoid pregnancy?

A) Reliability
B) Ease of use
C) Consistency of use
D) Cost

Question 8

A patient who is 36 years old, weighs 200 pounds, is monogamous, and does not smoke desires birth control. The nurse understands that which contraceptive method is inappropriate for this patient?

A) Intrauterine device
B) Vaginal sponge
C) Combined oral contraceptives
D) Transdermal hormonal contraception

Question 9

When teaching a woman about the use of a diaphragm, it is important to instruct her that the diaphragm should be rechecked for correct size:

A) Every five years routinely.
B) When weight gain or loss beyond five pounds has occurred.
C) After each birth.
D) Only after significant weight loss.

Question 10

A patient in the clinic asks the nurse about available contraceptives. Before responding, the nurse must assess:

A) When menarche occurred.
B) How frequently the patient has intercourse.
C) Whether the patient has a history of thrombophlebitis.
D) What the patient's partner prefers.
E) Whether the patient is in a monogamous relationship.

Question 11

A patient asks the nurse, "Can you explain to us how to use the basal body temperature method to detect ovulation and prevent pregnancy?" What response by the nurse is best?

A) "Take your temperature every evening at the same time and keep a record for a period of several weeks. A noticeable drop in temperature indicates that ovulation has occurred."
B) "Take your temperature every day at the same time and keep a record of the findings. A noticeable rise in temperature indicates ovulation."
C) "Take your temperature each day, immediately upon awakening, and keep a record of each finding. A noticeable drop in temperature indicates that ovulation is about to occur."
D) "This is an unscientific and unproven method of determining ovulation, and is not recognized as a means of birth control."

Question 12

The culturally sensitive nurse will assess cultural attitudes and beliefs about contraception, which can include:

A) Gender inequities
B) Religion
C) Deference to authority figures
D) Devaluation of large families
E) Attitudes about bleeding

Question 13

A patient who wants to use the vaginal sponge method of contraception shows that she understands the appropriate usage when she makes which statement?

A) "I need to use a lubricant prior to insertion."
B) "I need to add spermicidal cream prior to intercourse."
C) "I need to moisten it with water prior to use."
D) "I need to leave it in no longer than 6 hours."

Question 14

A couple asks the nurse what the safest method of sterilization would be. The nurse should reply, "Generally, the safest method of permanent sterilization would be a:

A) "Laparotomy tubal ligation."
B) "Laparoscopy tubal ligation."
C) "Minilaparotomy."
D) "Vasectomy."

Question 15

A woman is asking the nurse about using the calendar method of contraception. She reports that her last six menstrual cycles were 28, 32, 29, 36, 30, and 27 days long, respectively. Based on this information, when should the nurse tell the patient to abstain from intercourse?

A) Days 9-25
B) Days 9-15
C) Days 10-21
D) Days 10-16

Question 16

During a counseling session on natural family planning techniques, the nurse explains that cervical mucus at the time of ovulation should be of what consistency?

A) Thin and elastic
B) Opaque and acidic
C) High in leukocytes
D) Lacking in quantity

Question 17

When assessing a patient asking about birth control, the nurse knows that the patient would not be a good candidate for Depo-Provera (DMPA) if she:

A) Wishes to get pregnant within 3 months.
B) Is a nursing mother.
C) Has a vaginal prolapse.
D) Weighs 200 pounds.

Question 18

A patient in the women's clinic asks the nurse, "How is the cervical mucus method of contraception different from the rhythm method?" The appropriate response by the nurse is that the cervical mucus method:

A) Is more effective for women with irregular cycles.
B) Is not acceptable to women of many different religions.
C) Is harder to work with than is the rhythm method.
D) Requires an artificial substance or device.

Question 19

The nurse teaching a group of new mothers explains that barrier methods of contraception are appropriate if the woman:

A) Just started an oral contraceptive.
B) Is opposed to systemic medications.
C) Is lactating.
D) Is unconcerned about using contraception.
E) Does not smoke and is perimenopausal.

Question 20

A nurse is teaching a group of college students at a Catholic university about natural family planning (NFP). Teaching was successful if the students say "Natural family planning:

A) "Is free, safe, and acceptable according to our religion."
B) "Includes breastfeeding for 1 year."
C) "Is useful in helping us plan pregnancies."
D) "Allows us to safely have intercourse during our fertile days."
E) "Does not involve the use of artifical substances or devices."

Question 21

A patient who was raped is in the emergency department. She asks the nurse what her alternatives are for emergency contraception. The nurse tells her she can:

A) Take levonorgestrel and ethinyl estradiol.
B) Have Essure implanted.
C) Have a laparoscopic tubal ligation.
D) Take levonorgestrel alone, but in a high dose.
E) Take high doses of male hormones.

Question 22

The nurse in the clinic is seeing four patients. Which one is the best candidate for receiving an IUD?

A) An unmarried, 22-year-old college graduate
B) A married 24-year-old who has never been pregnant
C) An unmarried 25-year-old with a history of chlamydia
D) A married 26-year-old who has two children

Question 23

The nurse is preparing educational materials at a family planning clinic. The patient who is an appropriate candidate for using emergency contraception would be one who reports:

A) Forgetting to start her pill pack yesterday.
B) Unprotected intercourse during her menses.
C) That a condom broke yesterday in the middle of her cycle.
D) Increased dysmenorrhea since IUD insertion.

Question 24

A patient who is currently 12 weeks pregnant is seeking information on pregnancy termination. The nurse is teaching the patient about the risks involved if she were to take the medication mifepristone. Which adverse signs would the patient need to know and report immediately to a physician?

A) Fatigue, lack of appetite, and inability to concentrate
B) Nausea, diarrhea, vomiting, and stomach pain
C) Increase in heart rate, inability to sit still, and lack of appetite
D) Headache, fatigue, and hunger

Question 25

The nurse is educating a patient on intrauterine devices (IUDs). The advantages of an IUD that the nurse includes are that:

A) It is effective, continuous contraception.
B) It is relatively inexpensive over time.
C) It does not need to be inserted immediately prior to coitus.
D) Small amounts of estrogen are released daily.
E) It slightly increases the risk of ectopic pregnancy.

Question 26

The nurse is discussing the use of contraception with a patient who has just become sexually active. What factors should the nurse include when educating the patient on contraceptive methods?

A) Contraindications in the patient's health history
B) Religious or moral beliefs
C) Partner's belief in the effectiveness of the choice
D) Personal motivation to use method
E) Future pregnancy plans

Question 27

A patient is being given a new prescription for a low-dose combination birth control pill. The nurse will be giving her advice about taking the pills. What advice will the nurse give the patient if she forgets to take the pill?

A) Take it as soon as she remembers, even if it means taking two pills the same day.
B) Skip that pill and refrain from intercourse for the rest of the month.
C) Wear a pad during the next week, as she will have some light bleeding.
D) Take an at-home pregnancy test at the end of the month to determine whether she has gotten pregnant.

Question 28

A patient is using the contraceptive sponge as a birth control method. What action is important in order to maintain the sponge's effectiveness?

A) Insert the sponge at least 1 hour before intercourse.
B) Thoroughly moisten the sponge with water before inserting.
C) Spermicidal jelly must be inserted at the same time the sponge is inserted.
D) A new sponge must be inserted every time a couple has intercourse.

Question 29

The nurse is developing a teaching plan for a patient undergoing a bilateral tubal ligation. What information should be included in the plan?

A) The surgical procedure is easily reversible.
B) Menstruation will cease after the procedure.
C) Libido should remain the same after the procedure.
D) The incision will be made endocervically.

Question 30

The patient who was raped is extremely upset when a pregnancy test confirms that she is pregnant, and requests information regarding pregnancy termination. Which statement is best for the nurse to include?

A) "Abortion is morally wrong, and should not be undertaken."
B) "You are too late to have a medical abortion."
C) "Surgical abortion can result in uterine perforation."
D) "Both medical and surgical abortions are 100% effective."

Question 31

A nurse is providing contraceptive counseling to a perimenopausal patient in a monogamous relationship. What comment by the patient indicates that further teaching is necessary?

A) "The calendar method is the most reliable method for me to use."
B) "If I use the IUD, I will be at minimal risk for pelvic inflammatory disease."
C) "I should still use birth control, even though I had only three periods last year."
D) "The contraceptive patch contains both estrogen and progesterone."

Question 32

The nurse is providing instructions for a woman who has just had an intrauterine device inserted. What is essential for the nurse to teach the woman?

A) To palpate her lower abdomen each month to check the patency of the device
B) To remain on bed rest for 24 hours after insertion of the device
C) To report any pain during intercourse to the physician
D) To insert spermicidal jelly within 4 hours of every sexual encounter

Question 33

The nurse in the OB-GYN office is explaining the benefits and risks associated with Essure to a patient and her husband. What statement made by the patient indicates that additional education is needed?

A) A stainless steel microinsert is placed into the distal section of one fallopian tube.
B) The Essure method of permanent sterilization requires no surgical incision.
C) Essure is the only sterilization method approved in the United States that will yield no surgical scar.
D) Women allergic to nickel should consult their physician before placement.

Question 34

A woman comes into the emergency department stating she was raped the day before, and requests emergency contraception. She states that she is in the middle of her cycle. The nurse knows that:

A) This patient has waited too long before coming to the emergency department.
B) The patient will have to wait 5 days before she can have emergency contraception.
C) The patient can receive emergency contraception up to 72 hours after the intercourse.
D) The patient will have to wait and see whether she misses a period.