Question 1

For which patient assessment finding would an intrauterine device (IUD) be contraindicated?&#10;A) Misshapen uterus&#10;B) Multiple sexual partners&#10;C) Diagnosis of hypertension&#10;D) History of thromboembolic disease

Accepted Answer

Use of an IUD may be contraindicated for a woman whose uterus is distorted in shape because the device might perforate the uterine wall. The device is not contraindicated for multiple sexual partners, hypertension, or history of thromboembolic disease.
Infection is no longer a concern because the vaginal string no longer conducts fluid. The device does not impact hormone levels and will not influence blood pressure or blood flow.

Question 2

A male patient is considering a vasectomy. Which information should the nurse instruct the patient about this procedure? (Select all that apply.)&#10;A) Sexual intercourse can resume in a week.&#10;B) The procedure can be done as an outpatient.&#10;C) An opioid analgesic will be prescribed for pain control.&#10;D) Use a birth control method until a negative sperm reports occur.&#10;E) Spermatozoa present in the vas deferens will be viable for 2 weeks.

Accepted Answer

After a vasectomy, sexual intercourse can resume after 1 week. The procedure can be completed as an outpatient. The patient may experience a small amount of local pain afterward, which can be managed by taking a mild analgesic and applying ice to the site. An additional birth control method should be used until two negative sperm reports at about 6 and 10 weeks have been obtained. Spermatozoa, which were present in the vas deferens at the time of surgery, can remain viable for as long as 6 months.

Question 3

A patient comes into the family planning clinic and requests a prescription for birth control pills. Which assessment finding indicates that an ovulation suppressant would not be the best contraceptive method for the patient?

A) Age 30 years
B) Allergy to foreign protein
C) Irregular menstrual cycles
D) History of thromboembolism

History of thromboembolism

Accepted Answer

Combination oral contraceptives are not routinely prescribed for patient with a history of thromboembolic disease. The patients' age would not be a contraindication for this type of contraceptive. An allergy to foreign protein would impact the patient's ability to use condoms. Irregular menstrual cycles would be an indication for combination oral contraceptives.

Question 4

A female patient has forgotten to take an ovulation suppressant for two mornings in a row. What should the nurse advise the patient to do?&#10;A) Take two pills a day for the rest of the month.&#10;B) Take three pills immediately and avoid coitus for the remainder of the month.&#10;C) Start a new cycle of 21 pills immediately plus additional estrogen for the next 3 days.&#10;D) Take two pills now and use a second method of contraception for the remainder of the month.

Accepted Answer

If two consecutive active pills are missed, the patient should be advised to take two pills immediately. Then the patient should continue the following day with the usual schedule. Missing two pills may allow ovulation to occur, so an added contraceptive such as a spermicide should be used for the remainder of the month. The patient does not need to take two pills every day for the rest of the month, take three pills and abstain from coitus, or start a new cycle of 21 pills.

Question 5

The nurse is planning an educational session on contraceptives for a group of adolescent high school students. What does the nurse need to do when planning this session?&#10;A) Argue that encouraging abstinence is unrealistic during the teenage years.&#10;B) Discuss that the application of a condom should occur after penile-vulvar contact.&#10;C) Explain that the combination oral contraceptive approach is the best for adolescents.&#10;D) Teaching about contraceptive options while avoiding indirect encouragement of sexual activity.

Accepted Answer

The nurse can help the nation achieve the 2020 National Health Goals by teaching adolescents about contraceptive options while being cautious to avoid indirectly encouraging sexual activity among teens. A 2020 National Health Goal is to increase the number of adolescents being instructed on abstinence. A condom should be applied before penile-vulvar contact. Oral contraceptives are not the contraceptive of choice for adolescents.

Question 6

The nurse is teaching a patient on the use of a diaphragm for contraception. Which patient statement indicates that instruction has been not been effective?&#10;A) &#34;I need to use my finger to remove the diaphragm.&#34;&#10;B) &#34;I should remove the diaphragm 6 hours after intercourse.&#34;&#10;C) &#34;I should stop using a diaphragm if I get an infection of my cervix.&#34;&#10;D) &#34;I need to have the diaphragm checked if my weight changes by 30 lb.&#34;

Accepted Answer

The patient should be instructed to have the size of the diaphragm checked if weight changes by 15 lb. The patient does need to use the finger to remove the diaphragm. The diaphragm should be removed 6 hours after intercourse. The diaphragm should not be used if the patient is experiencing a cervical infection.

Question 7

A 40-year-old woman who smokes desires a reliable contraceptive method. Which should the nurse recommend to this patient?&#10;A) An ovulation suppressant&#10;B) A condom and spermicide&#10;C) A spermicidal suppository&#10;D) The rhythm (calendar) method

Accepted Answer

Women who are 40 years of age and smoke should not take ovulation suppressants. Irregular menstrual cycles make natural methods difficult. Women older than the age of 40 may have vaginal dryness, so a spermicidal suppository would not be effective. The best option is for the patient to use a condom and spermicide.

Question 8

An adolescent female who has recently started menstruating asks for a highly reliable birth control method. Which method should the nurse discuss with the patient?&#10;A) Postcoital douching&#10;B) An intrauterine device&#10;C) An ovulation suppressant&#10;D) Vaginal foam for her and a condom for her partner

Accepted Answer

For many adolescent couples, use of a dual method, such as a vaginally inserted spermicide by the girl and a condom by her partner, is a preferred method of birth control. Postcoital douching is not a method of birth control. Intrauterine devices are rarely used for early adolescents because the uterus may still be small. Ovulation suppressants are not recommended until a female has been menstruating for at least 2 years.

Question 9

A patient wants to calculate fertile days using the calendar method. What will the nurse instruct the patient to subtract when making this calculation?&#10;A) 14 from 28&#10;B) 18 from the shortest period and 11 from the longest&#10;C) 18 from the longest period and 11 from the shortest&#10;D) The length of the average period from the ideal of 28

Accepted Answer

To calculate "safe" days, the patient should subtract 18 from the shortest cycle. This number predicts the first fertile day. Then subtract 11 from the longest cycle. This represents the last fertile day. The other calculations are incorrect to determine fertile days.

Question 10

The nurse instructs a patient on cervical mucus changes that occur during ovulation. Which statement indicates that teaching has been effective?&#10;A) &#34;During ovulation, the mucus is thick.&#34;&#10;B) &#34;Ovulation makes the mucus more acidic.&#34;&#10;C) &#34;The mucus is white because of more white blood cells.&#34;&#10;D) &#34;When the mucus is thin and watery, then ovulation is occurring.&#34;

Accepted Answer

On the day of ovulation, the cervical mucus becomes copious, thin, watery, and transparent. During ovulation, the mucus is not thick, not acidic, and not white.

Question 11

The nurse is planning instruction for a patient desiring to have a tubal ligation. Which information should the nurse emphasize when teaching the patient?&#10;A) She must think of the procedure as irreversible.&#10;B) The procedure will reduce her menstrual flow in amount.&#10;C) She should schedule it to be done just before a menstrual flow.&#10;D) She will have lessened dysmenorrhea following the procedure.

Accepted Answer

The answer of The nurse is planning instruction for a...

Question 12

A patient asks the nurse if a cervical cap is better than a diaphragm for contraception. What should explain as the advantages of a cervical cap?&#10;A) No initial fitting is required.&#10;B) It can be left in place longer.&#10;C) It needs no spermicidal jelly.&#10;D) It does not need to be refitted after pregnancy.

Accepted Answer

The answer of A patient asks the nurse if a...

Question 13

The nurse instructs a patient on the use of a vaginal estrogen/progestin rings (NuvaRing) for contraception. Which patient statement indicates that additional instruction is needed?&#10;A) &#34;I am to take the ring out overnight.&#34;&#10;B) &#34;I will leave the ring in place for 3 weeks.&#34;&#10;C) &#34;I leave the ring in place during intercourse.&#34;&#10;D) &#34;I am to use other birth control if I take the ring out for 4 hours.&#34;

Accepted Answer

The answer of The nurse instructs a patient on the...

Question 14

When should the nurse instruct a female patient using the basal body temperature method of contraception to refrain from having sexual intercourse?&#10;A) Four days after noticing a temperature rise&#10;B) Fourteen days after the last day of the menstrual period&#10;C) Three days after recording a slight drop in temperature followed by an increase&#10;D) Three to 4 days after recording a slight increase followed by a dip in the temperature

Accepted Answer

The answer of When should the nurse instruct a female...

Question 15

The nurse completes instructing a patient on the use of the contraceptive patch. Which patient response indicates that teaching has been effective?&#10;A) The patch is immediately effective after application.&#10;B) The patch should be applied to the breasts, hips, or back.&#10;C) The patch should be applied to the abdomen, buttocks, or back.&#10;D) The patch should be covered when swimming because of chlorine's effect on the adhesive.

Accepted Answer

The answer of The nurse completes instructing a patient on...

Question 16

A patient who has unprotected intercourse has obtained the morning after pill but has not yet taken the prescribed dosage. What nursing diagnosis should the nurse identify as appropriate for the patient at this time?

A) Powerlessness
B) Spiritual distress
C) Decisional conflict
D) Readiness for enhanced knowledge

Accepted Answer

The answer of A patient who has unprotected intercourse has...

Question 17

An Rh-negative patient of 6 weeks gestation is scheduled for a medically induced termination. Which outcomes should the nurse identify as appropriate for this patient? (Select all that apply.) A) Attended contraceptive counseling B) Received Rh_o (D) immune globulin C) Scheduled postprocedure sonogram D) Avoided strenuous activity for 3 weeks E) Experienced menstrual cycle in 2 months

Accepted Answer

The answer of An Rh-negative patient of 6 weeks gestation...

Question 18

A patient recovering from a surgical pregnancy termination returns for a postprocedure examination. The patient tells the nurse that she is relieved that the procedure is over however is feeling sad. What should the nurse do to assist the patient at this time?

A) Suggest the patient talk with a counselor.
B) Ask the patient to identify the source of the sadness.
C) Recommend the patient attend contraceptive counseling sessions.
D) Discuss the need for an antidepressant with the health care provider.

Accepted Answer

The answer of A patient recovering from a surgical pregnancy...

Question 19

A patient received a scheduled dose of depot medroxyprogesterone acetate (DMPA) 6 weeks ago. Today, the patient reports that a regular menstrual cycle is 2 weeks late. What is the first thing that should be done for this patient?

A) Perform a pregnancy test.
B) Provide prenatal counseling.
C) Discuss pregnancy termination options.
D) Explain side effects of the contraceptive.

Accepted Answer

The answer of A patient received a scheduled dose of...

Question 20

A postpartum patient asks the nurse when the subdermal hormone implant for contraception can be inserted. What should the nurse respond to this patient?&#10;A) In 6 weeks&#10;B) In 1 month&#10;C) 1 week after your next menstrual cycle&#10;D) Before being discharged after this delivery

Accepted Answer

The answer of A postpartum patient asks the nurse when...

Deck 6: Nursing Care for the Family in Need of Reproductive Life Planning