Deck 4: Contraception, Abortion, and Infertility

Question 1

A woman currently uses a diaphragm and spermicide for contraception. She asks the nurse what the major differences are between the cervical cap and diaphragm. The nurse's most appropriate response is:

A) "No spermicide is used with the cervical cap, so it's less messy."
B) "The diaphragm can be left in place longer after intercourse."
C) "Repeated intercourse with the diaphragm is more convenient."
D) "The cervical cap can safely be used for repeated acts of intercourse without adding more spermicide later."

Answer 1

"The cervical cap can safely be used for repeated acts of intercourse without adding more spermicide later."

Question 2

A woman who has a seizure disorder and takes barbiturates and phenytoin sodium daily asks the nurse about the pill as a contraceptive choice. The nurse's most appropriate response would be:

A) "This is a highly effective method, but it has some side effects."
B) "Your current medications will reduce the effectiveness of the pill."
C) "The pill will reduce the effectiveness of your seizure medication."
D) "This is a good choice for a woman of your age and personal history."

Answer 2

"Your current medications will reduce the effectiveness of the pill."

Question 3

While instructing a couple regarding birth control, the nurse should be aware that the method called natural family planning:

A) Is the same as coitus interruptus, or "pulling out."
B) Uses the calendar method to align the woman's cycle with the natural phases of the moon.
C) Is the only contraceptive practice acceptable to the Roman Catholic church.
D) Relies on barrier methods during fertility phases.

Answer 3

Is the only contraceptive practice acceptable to the Roman Catholic church.

Question 4

With regard to the use of intrauterine devices (IUDs), nurses should be aware that:

A) Return to fertility can take several weeks after the device is removed.
B) IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse.
C) IUDs offer the same protection against sexually transmitted infections as the diaphragm.
D) Consent forms are not needed for IUD insertion.

Question 5

With regard to the noncontraceptive medical effects of combined oral contraceptive pills (COCs), nurses should be aware that:

A) COCs can cause toxic shock syndrome if the prescription is wrong.
B) Hormonal withdrawal bleeding usually is a bit more profuse than in normal menstruation and lasts a week.
C) COCs increase the risk of endometrial and ovarian cancer.
D) The effectiveness of COCs can be altered by some over-the-counter medications and herbal supplements.

Question 6

A married couple is discussing alternatives for pregnancy prevention and has asked about fertility awareness methods (FAMs). The nurse's most appropriate reply is:

A) "They're not very effective, and it's very likely you'll get pregnant."
B) "They can be effective for many couples, but they require motivation."
C) "These methods have a few advantages and several health risks."
D) "You would be much safer going on the pill and not having to worry."

Question 7

Which statement is the most complete and accurate description of medical abortions?

A) They are performed only for maternal health.
B) They can be achieved through surgical procedures or with drugs.
C) They are mostly performed in the second trimester.
D) They can be either elective or therapeutic.

Question 8

A man smokes two packs of cigarettes a day. He wants to know if smoking is contributing to the difficulty he and his wife are having getting pregnant. The nurse's most appropriate response is:

A) "Your sperm count seems to be okay based on the first semen analysis."
B) "Only marijuana cigarettes affect sperm count."
C) "Smoking can give you lung cancer, even though it has no effect on sperm."
D) "Smoking can reduce the quality of your sperm."

Question 9

An unmarried young woman describes her sex life as "active" and involving "many" partners. She wants a contraceptive method that is reliable and does not interfere with sex. She requests an intrauterine device (IUD). The nurse's most appropriate response is:

A) "The IUD does not interfere with sex."
B) "The risk of pelvic inflammatory disease (PID) will be higher for you."
C) "The IUD will protect you from sexually transmitted infections (STIs)."
D) "Pregnancy rates are high with the IUD."

Question 10

Which contraceptive method best protects against sexually transmitted infections (STIs) and human immunodeficiency virus (HIV)?

A) Periodic abstinence
B) Barrier methods
C) Hormonal methods
D) They all offer about the same protection.

Question 11

A woman is 16 weeks pregnant and has elected to terminate her pregnancy. The nurse knows that the most common technique used for medical termination of a pregnancy in the second trimester is:

A) Dilation and evacuation (D&E).
B) Instillation of hypertonic saline into the uterine cavity.
C) Intravenous administration of Pitocin.
D) Vacuum aspiration.

Question 12

The nurse working with a patient who has infertility concerns should be aware that Lupron (Leuprolide acetate, a gonadotropin-releasing hormone [GnRH] agonist) may be prescribed for an infertile woman to treat:

A) Anovulatory cycles.
B) Uterine fibroids.
C) Polycystic ovarian disease (POD).
D) Luteal phase inadequacy.

Question 13

A couple is trying to cope with an infertility problem. They want to know what they can do to preserve their emotional equilibrium. The nurse's most appropriate response is:

A) "Tell your friends and family so they can help you."
B) "Talk only to other friends who are infertile because only they can help."
C) "Get involved with a support group. I'll give you some names."
D) "Start adoption proceedings immediately because it is very difficult to obtain an infant."

Question 14

In vitro fertilization-embryo transfer (IVF-ET) is a common approach for women with blocked fallopian tubes or unexplained infertility and for men with very low sperm counts. A husband and wife have arrived for their preprocedural interview. The husband asks the nurse to explain what the procedure entails. The nurse's most appropriate response is:

A) "IVF is a type of assisted reproductive therapy that involves collecting eggs from your wife's ovaries, fertilizing them in the lab with your sperm, and transferring the embryo to her uterus."
B) "A donor embryo will be transferred into your wife's uterus."
C) "Donor sperm will be used to inseminate your wife."
D) "Don't worry about the technical stuff; that's what we are here for."

Question 15

Which test used to diagnose the basis of infertility is done during the luteal or secretory phase of the menstrual cycle?

A) Hysterosalpingogram
B) Endometrial biopsy
C) Laparoscopy
D) Follicle-stimulating hormone (FSH) level

Question 16

A woman has chosen the calendar method of conception control. During the assessment process, it is most important that the nurse:

A) Obtain a history of menstrual cycle lengths for the past 6 months.
B) Determine the woman's weight gain and loss pattern for the previous year.
C) Examine skin pigmentation and hair texture for hormonal changes.
D) Explore the woman's previous experiences with conception control.

Question 17

Which contraceptive method has a failure rate of less than 25%?

A) Standard days
B) Periodic abstinence
C) Ovulation method
D) Coitus interruptus

Question 18

A woman will be taking oral contraceptives using a 28-day pack. The nurse should advise this woman to protect against pregnancy by:

A) Limiting sexual contact for one cycle after starting the pill.
B) Using condoms and foam instead of the pill for as long as she takes an antibiotic.
C) Taking one pill at the same time every day.
D) Throwing away the pack and using a backup method if she misses two pills during week 1 of her cycle.

Question 19

A couple comes in for an infertility workup, having attempted to get pregnant for 2 years. The woman, 37, has always had irregular menstrual cycles but is otherwise healthy. The man has fathered two children from a previous marriage and had a vasectomy reversal 2 years ago. The man has had two normal semen analyses, but the sperm seem to be clumped together. What additional test is needed?

A) Testicular biopsy
B) Antisperm antibodies
C) Follicle-stimulating hormone (FSH) level
D) Examination for testicular infection

Question 20

A woman had unprotected intercourse 36 hours ago and is concerned that she may become pregnant because it is her "fertile" time. She asks the nurse about emergency contraception. The nurse tells her that:

A) It is too late; she needed to begin treatment within 24 hours after intercourse.
B) Preven, an emergency contraceptive method, is 98% effective at preventing pregnancy.
C) An over-the-counter antiemetic can be taken 1 hour before each contraceptive dose to prevent nausea and vomiting.
D) The most effective approach is to use a progestin-only preparation.

Question 21

You (the nurse) are reviewing the educational packet provided to a patient about tubal ligation. What is an important fact you should point out? Choose all that apply.

A) "It is highly unlikely that you will become pregnant after the procedure."
B) "This is an effective form of 100% permanent sterilization. You won't be able to get pregnant."
C) "Sterilization offers some form of protection against sexually transmitted infections (STIs)."
D) "Sterilization offers no protection against STIs."
E) "Your menstrual cycle will greatly increase after your sterilization."