Deck 70: Drugs for Modifying Conception

Question 1

If asked to recommend a delivery method of birth control,for which client would the nurse suggest the use of the depot injection method?

A)A 30-year-old with no children and a family history of breast cancer
B)A 37-year-old with three children and a history of irregular menstrual cycles
C)A 27-year-old with one child and no preexisting conditions
D)A 16-year-old with one child,age 6 months

Answer 1

A 16-year-old with one child,age 6 months

Question 2

A client has decided to terminate a pregnancy using medication.Which medication would not be effective if used for this purpose?

A)Carboprost (Hemabate)
B)Mifepristone (RU-486)
C)Misoprostol (Cytotec)
D)Levonorgestrel (Plan B)

Answer 2

Levonorgestrel (Plan B)

Question 3

A young female client,deciding on which form of birth control to use,tells the nurse she does not want to have to touch "down there." Which form of birth control would be contraindicated for this client?

A)Oral contraceptives
B)Transdermal delivery method
C)Depot injection method
D)Intrauterine device

Answer 3

Intrauterine device

Question 4

A young female client is beginning to use oral contraceptives.What information should be shared with this client that relates to one of the possible adverse effects of these medications?

A)The client should be taught self-examination of the breasts.
B)The client needs to learn how to take her pulse.
C)The client should be instructed to drink 10 glasses of water daily.
D)The client needs to understand how to take the medication correctly.

Question 5

The nurse is discharging a client who gave birth to her first child two days ago.When discussing birth control,which the most important for the nurse to ask this client?

A)"Are you breastfeeding or bottle-feeding your baby?"
B)"What form of birth control does your husband want you to use?"
C)"How much weight did you gain during your pregnancy?"
D)"How soon do you plan to return to work?"

Question 6

A client has decided to use the oral contraceptive norethindrone (Ortha Micronor).How can the nurse most accurately explain the way progestin-only contraceptives help to prevent pregnancy?

A)"Progestin-only pills thicken the cervical mucus and discourage the sperm from entering the uterus."
B)"The pill you have decided to take prevents the egg that is in the ovary from becoming mature."
C)"These pills prevent ovulation just like the combination pills do."
D)"Pills that contain progestin alone prevent pregnancy by preventing the release of follicle-stimulating hormones (FSH)."

Question 7

A client has decided to use the depot injection delivery method of contraception.What information is most important for the nurse to share with this client to ensure consistent contraception?

A)"You must keep your 3-month appointment for your next injection."
B)"You will need to rest for 12 hours after receiving the injection."
C)"Do not rub the injection site immediately after you receive the injection."
D)"You must use sanitary pads instead of tampons when you have your period."

Question 8

A client will be having a second-trimester abortion using misoprostol (Cytotec)and methotrexate.Which statement by the client indicates an understanding of the side effects to be expected with these medications?

A)"I might experience chest pain with these medications."
B)"I know that these medications will most likely cause bleeding when I urinate."
C)"These medications will cause tingling and weakness in my legs."
D)"I will probably run a fever for a few hours after I take these medications."

Question 9

A school nurse is teaching a group of adolescents about oral contraceptives and how they work to prevent pregnancy.The nurse asks the students to name the part of the body that ultimately controls ovulation.Which student gives the nurse the correct answer?

A)The student who answers "The uterus"
B)The student who answers "The ovary"
C)The student who answers "The corpus luteum"
D)The student who answers "The pituitary gland"

Question 10

A client has decided to use a contraceptive sponge for pregnancy prevention.Which statement by the client indicates a need for further instruction?

A)"I can leave the sponge in place for up to 24 hours if I need to."
B)"I can insert the sponge at home before I go out for the evening."
C)"I will moisten the sponge with water before I insert it."
D)"I must remove the sponge as soon as possible after my partner and I have sexual intercourse."

Question 11

A client tells the nurse she wants to use birth control but does not want to have to wait for months before getting pregnant.Which form of birth control would allow a quick return to fertility after it is discontinued?

A)Depot injection method
B)Combination oral contraceptives
C)Transdermal delivery method
D)Mirena (intrauterine device)

Question 12

The school nurse is discussing oral contraceptives with a group of adolescent females.Which factor associated with the use of these medications could prove to be the greatest deterrent to choosing this form of birth control?

A)Clients who use birth control pills need a yearly exam.
B)Clients who use birth control pills might develop high blood pressure.
C)Clients who use birth control pills might experience breast tenderness.
D)Clients who use birth control pills might experience weight gain.

Question 13

A contraceptive that does not contain estrogen has been recommended for a client with a history of deep vein thrombosis,but the client does not know why.Which statement by the nurse best explains the relationship of estrogen to thromboembolic events?

A)"Estrogen causes the bone marrow to form more red blood cells,which then increase the chance of blood cells clumping together and forming a clot."
B)"Estrogen increases vascular vasoconstriction,which restricts blood flow and increases the opportunity for blood clots to form."
C)"Estrogen causes several clotting factors to increase in the blood,which increases the chances of a blood clot occurring."
D)"Estrogen decreases the force of blood flowing through the blood vessels,which increases the chances of blood clot formation."

Question 14

Which statement by a client using the vaginal delivery method of contraception indicates a need for additional instruction?

A)"If the ring comes out,I will wash it off with water and reinsert it."
B)"I have a special waste container where I put the used rings."
C)"I will remove the ring while we have intercourse and then reinsert it."
D)"I will leave the ring in for 3 weeks and then remove it."

Question 15

A client tells the nurse she has had unprotected sexual intercourse and is worried about becoming pregnant.Which the nurse will elicit information most helpful to this client?

A)"When was your last period?"
B)"Have you ever used emergency contraception before?"
C)"How old are you?"
D)"Are you aware how dangerous it is to have unprotected sexual intercourse?"

Question 16

After instruction from the nurse,which statement by the client indicates comprehension of the effectiveness of different birth control methods?

A)"Depot injections are about 95% effective if injections are given weekly."
B)"Combination oral contraceptives are about 100% effective if taken correctly."
C)"Progestin-only oral contraceptives are only about 80% effective in preventing pregnancy."
D)"The Mirena IUD is effective at preventing pregnancy for at least 10 years."

Question 17

A client has decided to use the transdermal delivery method of contraception.What would contraindicate the use of this method?

A)The client has a history of blood clots.
B)The client exercises three times a week.
C)The client takes aspirin 81 mg every day.
D)The client has a history of scarlet fever.

Question 18

A client tells the nurse that since using the vaginal ring for birth control,it always feels like there is something in her vagina.What information should the nurse give this client?

A)"Some women experience this feeling.If it continues,you might want to try another form of birth control."
B)"You must have inserted it incorrectly.I will go over the directions for using the ring again."
C)"You should remove the ring you are using and put a new ring in,and see if the feeling goes away."
D)"You must remove the ring immediately and be checked by the health care provider."

Question 19

Which statement by a client taking oral contraceptives requires immediate intervention by the nurse?

A)"I have started attending a smoking-cessation program."
B)"I forgot to take my pill twice last month,and I haven't started my period yet."
C)"I am only drinking one cup of coffee a day since I started taking birth control pills."
D)"I don't take those last seven pills at the end of my pill pack."

Question 20

A client with four children is asking about options for permanent birth control.Which option would provide the most reliable means of long-term pregnancy prevention for this client?

A)Transdermal delivery method (Ortho-Evra)
B)Mirena IUD
C)Sterilization
D)Vaginal delivery method (NuvaRing)

Question 21

A client being treated for rape asks why ulipristal (Ella)has been prescribed when the "morning after" pill can be obtained without a prescription.How should the nurse respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"Only one dose of the medication needs to be taken."
B)"This medication prevents ovulation."
C)"It works for 5 days after having unprotected sex."
D)"It works better than other morning-after pills."
E)"It will cause an abortion."

Question 22

A client who has been prescribed an estrogen-progestin combination oral contraceptive asks the nurse how the medication works.What can the nurse respond to the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"It prevents ovulation by stopping the secretion of some hormones from the pituitary gland."
B)"It makes the uterine lining less favorable to an embryo."
C)"It makes the cervical mucus thicker to slow the sperm down."
D)"It kills the sperm."
E)"It stops menstruation."

Question 23

The nurse is preparing to instruct a nonpregnant client on the use of misoprostol (Cytotec)for a health problem.For which purposes other than medical abortion can this medication be used? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Prophylaxis for ulcers caused by NSAIDs
B)Kidney transplant rejection prophylaxis
C)Treatment of hemorrhagic cystitis
D)Treatment of hydatidiform mole
E)Treatment for menstrual irregularities

Question 24

A client calls the clinic and reports that her contraceptive transdermal patch (Ortho-Evra)fell off while she was swimming in the ocean,and she is unable to find it.What advice should the nurse give to this client?

A)"Put a new patch on as soon as possible."
B)"You don't need to worry.The medication will remain in your system until it is time for you to put on a new patch."
C)"Use another form of birth control until it is time for you to put your next new patch on."
D)"Cut a new patch in half and put it on your shoulder."

Question 25

A client has been taking estradiol and norethindrone (Ortho-Novum)for birth control for the last 3 years.Which condition might require the client to change to another form of birth control?

A)Complaints of fatigue
B)Gallbladder disease
C)Increased photosensitivity
D)Weight gain of 7 pounds

Question 26

A client asks about the benefits of having a copper intrauterine device (IUD)inserted for birth control.What is the nurse's most accurate response? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"The copper works like a spermicide to slow sperm motility."
B)"Even if an egg becomes fertilized,the device will not let it become implanted in the uterus."
C)"The device can be left in place for up to 10 years."
D)"It is a birth control option for someone who cannot take estrogen or progesterone."
E)"The device has no adverse effects."

Question 27

The nurse instructs a client taking oral combination contraceptives to have periodic serum liver function studies done and to report symptoms of liver dysfunction,including: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)abdominal pain.
B)yellowing of the skin.
C)clay-colored stools.
D)darkened urine.
E)constipation.

Question 28

A client has requested a pregnancy termination using mifepristone (RU-486)and misoprostol (Cytotec).Which statement by the client indicates the need for further instruction about these medications?

A)"I will avoid drinking grapefruit juice while I am taking this medication."
B)"I know that I will probably experience nausea with this medication."
C)"I'll take these medications with me while I am away on vacation."
D)"I will call the clinic if I have excessive bleeding."

Question 29

A client tells the nurse that the ideal form of birth control is something she would not have to take every day and that cannot be seen by others.Which forms of birth control would be appropriate for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Progestin injections
B)Intrauterine device
C)Transdermal patch
D)Combination oral contraceptives
E)Progestin-only oral contraceptives

Question 30

An adolescent client has been taking oral contraceptives for the last 6 months for treatment of an irregular menstrual cycle.Which statement indicates that the client has met the goals of treatment?

A)The client reports that a period occurs every 30 days.
B)The client reports a decrease in premenstrual symptoms.
C)The client reports that acne has improved.
D)The client reports that migraine headaches are better.

Question 31

A client will be starting oral combination contraceptives.What should the nurse instruct the client to report to the health care provider as possible symptoms of a deep vein thrombosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Calf tenderness
B)Pain with walking
C)Dizziness
D)Numbness of an extremity
E)Blurred vision

Question 32

A client is taking oral contraceptives.The nurse instructs her to use another form of birth control when she takes which prescribed medications? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Ampicillin
B)Tetracycline
C)Warfarin
D)Insulin
E)Theophylline

Question 33

The nurse is completing the health assessment of a client who is interested in taking oral contraceptives.Which set of data would indicate that the client should consider another form of birth control?

A)Height 5 feet,7 inches; weight 156 pounds; P-87; R-18; B/P-128/78
B)Height 5 feet,2 inches; weight 102 pounds; P-80; R-14; B/P-121/74
C)Height 5 feet,6 inches; weight 140 pounds; P-86; R-16; B/P-112/79
D)Height 5 feet,3 inches; weight 187 pounds; P-88; R-18; B/P-142/87

Question 34

The nurse teaches a client about contraceptive choices.Which client statement about contraception requires clarification?

A)"If I use the Mirena IUD,I might be able to get pregnant soon after I have it removed."
B)"Birth control pills are very effective,but I must remember to take them every day."
C)"I don't want to use birth control pills because it increases my chances of getting cancer."
D)"If I use the contraceptive sponge,I can't take it out for at least 6 hours after I engage in sexual intercourse."

Question 35

After talking with the nurse,a client has decided to not proceed with the use of an intrauterine device as a contraceptive method because of the possible disadvantages,which include: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)irregular bleeding.
B)pelvic pain.
C)allergic reaction.
D)vaginal dryness.
E)uterine perforation.

Question 36

A client is surprised to learn she is pregnant in spite of using a contraceptive sponge for the last 5 years.Which condition might have altered the contraceptive ability of this form of birth control?

A)Migraine headaches
B)Vaginal yeast infection
C)Strep throat
D)Urinary tract infection

Question 37

A client is prescribed an oral contraceptive that has less progestin than her previous prescription.What assessment findings would support the use of a contraceptive with less progestin? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Increased appetite
B)Weight gain
C)Fatigue
D)Hirsutism
E)Anorexia

Question 38

A client is scheduled to receive mifepristone (Mifeprex)to end a pregnancy and asks the nurse how the medication works.What should the nurse respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"It blocks progesterone,which is needed to maintain the pregnancy."
B)"It sensitizes the uterus to the effects of prostaglandins."
C)"It causes a large amount of prostaglandin to be released and start uterine contractions."
D)"It blocks ovulation from occurring."
E)"It increases the amount of estrogen in your body."