Deck 71: Drugs for Modifying Conception

Question 1

A client calls the clinic to report that since she began using the vaginal ring for birth control, she always feels like there is something in her vagina.What information should the nurse give this client?
1)"You should remove the ring you are using and put a new ring in, and see if the feeling goes away."
2)"You must remove the ring immediately and come to the clinic to be checked by the health care provider."
3)"You must have inserted it incorrectly.Please come to the clinic and I will go over the directions for using the ring again."
4)"Some women experience this feeling.If it continues, you might want to try another form of birth control."

Answer 1

4

Question 2

A client has decided to use a contraceptive sponge for pregnancy prevention.Which statement by the client indicates a need for further instruction?
1)"I can insert the sponge at home before I go out for the evening."
2)"I must remove the sponge as soon as possible after my partner and I have sexual intercourse."
3)"I can leave the sponge in place for up to 24 hours if I need to."
4)"I will moisten the sponge with water before I insert it."

Answer 2

2

Question 3

A 32-year-old client is seeking information about various birth control methods.The client has a history of deep vein thrombosis, and the health care provider has recommended that she use a contraceptive that does not contain estrogen.Which statement by the nurse best explains the relationship of estrogen to thromboembolic events?
1)"Estrogen causes several clotting factors to increase in the blood, which increases the chances of a blood clot occurring."
2)"Estrogen decreases the force of blood flowing through the blood vessels, which increases the chances of blood clot formation."
3)"Estrogen increases vascular vasoconstriction which restricts blood flow and increases the opportunity for blood clots to form."
4)"Estrogen causes the bone marrow to form more red blood cells, which can then increase the chance of blood cells clumping together and forming a clot."

Answer 3

1

Question 4

For which of the following clients would the nurse recommend the use of the depo-injection for birth control?
1)A 27-year-old with one child and no preexisting conditions
2)A 16-year-old with one child, age 6 months
3)A 37-year-old with three children and a history of irregular menstrual cycles
4)A 30-year-old with no children and a family history of breast cancer

Question 5

A 19-year-old woman with no children is trying to decide which form of birth control to use.The client states that she doesn't care what she uses but she doesn't want to have to "touch herself, down there" in the process.Which of the following forms of birth control would be contraindicated for this client?
1)Intrauterine device
2)Transdermal delivery method
3)Depot injection method
4)Oral contraceptives

Question 6

A client has decided to terminate a pregnancy using medication.Which of the following medications would not be effective if used for this purpose?
1)Mifepristone (RU-486)
2)Carboprost (Hemabate)
3)Misoprostol (Cytotec)
4)Levonorgestrel (Plan B)

Question 7

A young woman calls the clinic and asks to speak to a nurse.She states that she had unprotected sexual intercourse, and she is worried about becoming pregnancy.Which question by the nurse will elicit information helpful to this client?
1)"Have you ever used emergency contraception before?"
2)"Are you aware how dangerous it is to have unprotected sexual intercourse?"
3)"When was your last period?"
4)"How old are you?"

Question 8

A 41-year-old woman has had four children.She has come to the clinic to discuss her options for permanent birth control.Which of the following options would provide the most reliable means of long-term pregnancy prevention for this client?
1)Mirena IUD
2)Tubal ligation
3)Vaginal delivery method (NuvaRing)
4)Transdermal delivery method (Ortho-Evra)

Question 9

The nurse is discharging a client who gave birth to her first child two days ago.When discussing birth control, which of the following questions is most important for the nurse to ask this client?
1)"How soon do you plan on returning to work?"
2)"How much weight did you gain with your pregnancy?"
3)"What form of birth control does your husband want you to use?"
4)"Are you breastfeeding or bottle-feeding your baby?"

Question 10

A 20-year-old woman 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?
1)The client should be taught self-breast examination.
2)The client should be instructed to drink ten glasses of water daily.
3)The client needs to understand how to correctly take the medication.
4)The client needs to learn how to take her pulse.

Question 11

A school nurse is teaching a group of high school students about oral contraceptives, and how these medications 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?
1)The student who answers "The ovary."
2)The student who answers "The uterus."
3)The student who answers "The pituitary gland."
4)The student who answers "The corpus luteum."

Question 12

Which statement by a client taking oral contraceptives requires immediate intervention by the nurse?
1)"I forgot to take my pill twice last month, and I haven't started my period yet."
2)"I don't take those last seven pills at the end of my pill pack."
3)"I am only drinking one cup of coffee a day since I started taking birth control pills."
4)"I have started attending a smoking-cessation program."

Question 13

A school nurse is discussing oral contraceptives with a group of adolescent girls.Which of the following factors associated with the use of these medications could prove to be the greatest deterrent to choosing this form of birth control?
1)Clients who use birth control pills will need a yearly exam.
2)Clients who use birth control pills might experience breast tenderness.
3)Clients who use birth control pills might experience weight gain.
4)Clients who use birth control pills might develop high blood pressure.

Question 14

Which of the following statements by a client using the vaginal delivery method of contraception indicates a need for additional instruction?
1)"I will leave the ring in for three weeks and then remove it."
2)"If the ring comes out, I will wash it off with water and reinsert it."
3)"I will remove the ring while we have intercourse and then reinsert it."
4)"I have a special waste container where I put the used rings."

Question 15

A client has decided to use oral contraceptives that contain only norethindrone (Ortha-Micronor).Which statement by the nurse indicates the way the progestin-only contraceptives help to prevent pregnancy?
1)"These pills prevent ovulation just like the combination pills do."
2)"Progestin-only pills thicken the cervical mucus and discourage the sperm from entering the uterus."
3)"Pills that contain progestin alone prevent pregnancy by preventing the release of follicle-stimulating hormones (FSH)."
4)"The pill you have decided to take prevents the egg that is in the ovary from becoming mature."

Question 16

Which of the following statements by a client indicates a good understanding of the effectiveness of different birth control methods?
1)"Progestin-only oral contraceptives are only about 80% effective in preventing pregnancy."
2)"Depot injections are about 95% effective if injections are given weekly."
3)"Combination oral contraceptives are 100% effective if taken correctly."
4)"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 for contraception.Which of the following conditions would not contraindicate the use of this method?
1)The client has a history of blood clots.
2)The client has a history of eczema.
3)The client has a history of seizures
4)The client has a history of scarlet fever.

Question 18

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?
1)"I know that this medication will most likely cause me to have bleeding when I urinate."
2)"I will probably run a fever for a few hours after I take these medications."
3)"These medications will cause me to have tingling and weakness in my legs."
4)"I might experience chest pain with these medications."

Question 19

A woman has decided to use the depot injection delivery method.What information is most important for the nurse to share with this client to ensure consistent contraception?
1)"Do not rub the injection site immediately after you receive the injection."
2)"You will need to rest for 12 hours after receiving the injection."
3)"You must keep your 3-month appointment for your next injection."
4)"You must use sanitary pads instead of tampons when you have your period."

Question 20

A client makes the following statement: "I want to use birth control until I am ready to get pregnant again." Which of the following forms of birth control would allow a client to have a quick return to fertility after it is discontinued?
1)Combination oral contraceptives
2)Intrauterine device Mirena
3)Depot injection method
4)Transdermal delivery method

Question 21

A client has requested a pregnancy termination using medication.The health care provider has prescribed mifepristone (RU-486)in conjunction with misoprostol (Cytotec).Which statement by the client indicates the need for further instruction?
1)"I know that I will probably experience nausea with this medication."
2)"I'll take these medications with me while I am away on vacation."
3)"I will call the clinic if I have excessive bleeding."
4)"I will avoid drinking grapefruit juice while I am taking this medication."

Question 22

A client calls the clinic and reports that her transdermal patch (Ortho-Evra)fell off while she was swimming in the ocean.She reports that she can't find it.What advice should the nurse give to this client?
1)"Put a new patch on as soon as possible."
2)"Use another form of birth control until it is time for you to put your next new patch on."
3)"Cut a new patch in half and put it on your shoulder."
4)"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."

Question 23

The nurse is completing the health assessment of a client who is interested in taking oral contraceptives.Which set of data would require the nurse to suggest another form of birth control for this client?
1)Height 5 feet, 6 inches; weight 140 pounds; P-86; R-16; B/P-112/79
2)Height 5 feet, 2 inches; weight 102 pounds; P-80; R-14; B/P-121/74
3)Height 5 feet, 3 inches; weight 187 pounds; P-88; R-18; B/P 142/87
4)Height 5 feet, 7 inches; weight 156 pounds; P-87; R-18; B/P 128/78

Question 24

A client has been taking estradiol and norethindrone (Ortho-Novum)for birth control for the last three years.Which of the following conditions might require the client to change to another form of birth control?
1)Weight gain of seven pounds
2)Complaints of fatigue
3)Increased photosensitivity
4)Gallbladder disease

Question 25

A 16-year-old female has been taking oral contraceptives for the last six months for treatment of an irregular menstrual cycle.Which of the following statements indicates that the client has met the goals of treatment?
1)The client reports a decrease in premenstrual symptoms.
2)The client reports that her period starts every 30 days.
3)The client reports that her migraine headaches are better.
4)The client reports that her acne has improved.

Question 26

Which of the following statements by a client seeking information about contraception requires clarification?
1)"Birth control pills are very effective, but I must remember to take them every day."
2)"If I use the Mirena IUD, I might be able to get pregnant soon after I have it removed."
3)"I don't want to use birth control pills, because it increases my chances of getting cancer."
4)"If I use the contraceptive sponge, I can't take it out for at least six hours after I engage in sexual intercourse."

Question 27

A client has just received a positive pregnancy test at the clinic.She is surprised that she is pregnant because she has been successfully using a contraceptive sponge for the last five years.Which condition, if reported by the client, might have altered the contraceptive ability of this form of birth control?
1)The client reports she was treated for a vaginal yeast infection.
2)The client reports she was treated for a urinary tract infection.
3)The client reports she was treated for migraine headaches.
4)The client reports she was treated for strep throat.