Question 1

A woman who is using a NuvaRing transvaginal contraceptive product calls to report that the ring has slipped out while sleeping.The nurse will instruct the patient to rinse the ring with lukewarm water,reinsert the ring,and

Accepted Answer

If the NuvaRing slips out,it should be rinsed off and reinserted.If it has been out longer than 3 hours,the woman should be counseled to use a backup method of contraception.

Question 2

A woman comes to the clinic for a Depo-Provera injection.The nurse reviews her medical record and notes that it has been 100 days since her last injection.What action will the nurse perform?

Accepted Answer

Women should receive Depo-Provera injections every 13 weeks.Patients who are late for injections (13 weeks plus 1 day)will need to rule out pregnancy before receiving the next injection.Patients who are eligible receive 150 mg IM.It is not correct to give a higher dose.

Question 3

The nurse is caring for a woman who will begin taking ibuprofen to treat arthritis.The woman tells the nurse that she takes Yasmin for contraception.The nurse will perform which action?

Accepted Answer

Yasmin contains drospirenone,which is derived from spironolactone.Drospirenone can alter water and electrolyte balances in women,and women taking this product should avoid NSAIDs to avoid compounding this effect.The provider may want to consider another COC product.It does not alter fertility.

Question 4

A woman is taking a combination oral contraceptive and asks the nurse why progestin is necessary.The nurse will explain that progestin helps prevent pregnancy by which method?

Accepted Answer

Progestin alters the quantity and viscosity of cervical mucus,making it thick and hostile to sperm penetration.Estrogen inhibits proliferative and secretory changes in the endometrium.Progestin decreases muscle and ciliary motility and decreases the LH surge.

Question 5

A woman who is taking a combined oral contraceptive (COC)that contains 21 days of active pills and 7 days of inert pills reports having headaches accompanying withdrawal bleeding every month.The nurse will

Accepted Answer

Mircette provides 2 inert pills and 5 pills with 10 mcg of ethinyl estradiol during the counter phase,which helps to decrease withdrawal bleeding and headaches.Loestrin counters withdrawal bleeding but does not help with headaches.

Question 6

A woman will begin taking a combination oral contraceptive (COC)that has a higher estrogenic activity than her previous COC.When teaching this woman about the new product,the nurse will explain that she may experience which effect(s)?

Accepted Answer

Increased estrogenic activity may include side effects such as cyclic breast changes and chloasma as well as increased dysmenorrhea and menorrhagia.Increased progestin causes decreased libido,weight gain,and fatigue.

Question 7

A 45-year-old woman who has not had a period for 15 months reports severe hot flashes and poor sleep.The nurse reviews information about hormone replacement therapy and tells this woman that hormone therapy

Accepted Answer

Women should use hormone therapy at the lowest dose possible for a period of less than 5 years.It carries risks for breast cancer and cardiovascular disease and cannot be used indefinitely.Hormone therapy can help slow osteoporosis,but it does not prevent osteoporosis and is not recommended for this use.

Question 8

A 35-year-old woman asks the nurse about oral contraceptives.The nurse learns that the patient smokes and has a family history of venous thromboembolism (VTE).The nurse will suggest that the patient

Accepted Answer

Patients who smoke or who have an increased risk of VTE may be candidates for progestin-only products.A 35-year-old woman may still want children in the future,so recommending a tubal ligation is not indicated.Transdermal products contain estrogen and carry the same risks as COCs.

Question 9

A 45-year-old woman reports cessation of menses for the past 6 months and asks the nurse if she needs to continue using contraception.The nurse will tell her

Accepted Answer

Women should use contraception until menstruation has ceased for 1 year if they do not wish to become pregnant.Premature ovarian failure occurs when menstruation stops before age 40 years.It is not necessary to treat menopausal symptoms until they occur.

Question 10

A young woman who is taking Ortho-Tri-Cyclen for contraception tells the nurse that her provider has told her it will help to treat her acne.The nurse explains that this is because this product is

Accepted Answer

Products with low androgenic activity help to reduce acne.

Question 11

A woman who has recently begun taking a combination oral contraceptive calls the clinic to report breakthrough bleeding.The nurse will

Accepted Answer

Breakthrough bleeding is more common at the start of COC use,and there is no evidence that an episode of bleeding is associated with a decrease in the COC's effectiveness as long as the patient continues to take the pill as prescribed.She does not need to use backup contraception.Unless the bleeding continues and is problematic,there is no need to change products.A pregnancy test is not indicated.

Quiz 56: Drugs for Women’s Reproductive Health and Menopause