Question 1

A woman had unprotected intercourse 36 hours ago and is concerned that she may become pregnant because it is her "fertile" time.In response to her question about emergency contraception,what should the nurse tell her?

Accepted Answer

To minimize the adverse effect of nausea that occurs with high doses of estrogen and progestin,the woman can take an over-the-counter antiemetic 1 hour before each dose.Emergency contraception is used within 5 days of unprotected intercourse to prevent pregnancy.Postcoital contraceptive use is 75% to 89% effective at preventing pregnancy.Oral emergency contraceptive regimens may include progestin-only and estrogen-progestin pills.Women with contraindications to estrogen use should use progestin-only pills.

Question 2

Which contraceptive method is least effective?

Accepted Answer

The method involving standard days variation on the calendar is the least effective natural birth control method.Periodic abstinence is not the least effective natural birth control method.The post-ovulation method is not the least effective natural birth control method.Coitus interruptus is not the least effective natural birth control method.

Question 3

While instructing a couple regarding birth control,what should the nurse be aware of in relation to the method called natural family planning?

Accepted Answer

Natural family planning is the only contraceptive practice acceptable to Catholic-centred organizations."Pulling out" is not the same as periodic abstinence,another name for natural family planning.The phases of the moon are not part of the calendar method or any method.Natural family planning is another name for periodic abstinence,which is the accepted way to pass safely through the fertility phases without relying on chemical or physical barriers.

Question 4

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

Accepted Answer

Barrier methods such as condoms best protect against STIs and HIV.Periodic abstinence and hormonal methods ("the pill")offer no protection against STIs or HIV.

Question 5

With regard to the noncontraceptive medical effects of combined oral contraceptive pills (COCs),what should the nurse be aware of?

Accepted Answer

The effectiveness of COCs can be altered by some over-the-counter medications and herbal supplements as well as by prescription drugs.Toxic shock syndrome can occur in some diaphragm users,but it is not a consequence of taking oral contraceptive pills.Hormonal withdrawal bleeding usually is lighter than in normal menstruation and lasts a couple of days.Oral contraceptive pills offer protection against the risk of endometrial and ovarian cancers.

Question 6

Which fact would the nurse expect in an educational packet provided to a patient about tubal ligation?

Accepted Answer

A woman is unlikely to become pregnant after tubal ligation,although it is not 100% effective.Sterilization offers no protection against STIs.Typically,the menstrual cycle remains the same after a tubal ligation.

Question 7

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

Accepted Answer

Abortions can be either medically or surgically induced.They are mostly done in the first trimester.They can be induced for reasons of maternal or fetal health.

Question 8

Which statement is true about the term contraceptive failure rate?

Accepted Answer

Contraceptive effectiveness varies from couple to couple,depending on how well a contraceptive method is used and how well it suits the couple.The contraceptive failure rate measures the likelihood of accidental pregnancy in the first year only.Failure rates decline over time because users gain experience.

Question 9

What should nurses be aware of with regard to the use of intrauterine devices (IUDs)?

Accepted Answer

The woman has up to 120 hours to insert the IUD after unprotected sex.Return to fertility is immediate after removal of the IUD.IUDs offer no protection against sexually transmitted infections.A consent form is required for insertion,as is a negative pregnancy test.

Question 10

When completing discharge teaching for the patient after an induced abortion,the nurse should inform the patient to report which symptom to her health care provider?

Accepted Answer

Part of discharge teaching includes informing the woman that if she has no return of menstrual period within 6 weeks she should contact her health care provider.A temperature greater than 38° C should be reported,not one below that value.Abdominal tenderness is expected unless it is felt when pressure is applied.Spotting or flow on day 4 is normal;teaching includes having the patient report bleeding greater than two saturated pads in 2 hours or heavy bleeding that lasts a few days.

Question 11

A woman will be taking oral contraceptives using a 28-day pack.What should the nurse advise this woman for protection against pregnancy?

Accepted Answer

To maintain adequate hormone levels for contraception and to enhance compliance,patients should take oral contraceptives at the same time each day.If contraceptives are to be started at any time other than during normal menses or within 3 weeks after birth or abortion,another method of contraception should be used through the first week to prevent the risk of pregnancy.Taken exactly as directed,oral contraceptives prevent ovulation,and pregnancy cannot occur.No strong pharmacokinetic evidence indicates a link between the use of broad-spectrum antibiotics and altered hormone levels in oral contraceptive users.If the patient misses two pills during week 1,she should continue to take one pill a day,finish the package,and use a backup method the next 7 consecutive days.

Question 12

Which action should the nurse take first when meeting with a new patient to discuss contraception?

Accepted Answer

Determining the woman's level of contraceptive knowledge is the primary step of this nursing assessment and is necessary before completing the process and moving on to a nursing diagnosis.Once the patient's level of knowledge is determined,the nurse can interact with the woman to compare options,reliability,cost,comfort level,protection from sexually transmitted infections,and a partner's willingness to participate.Although important,obtaining data about the frequency of coitus is not the first action that the nurse should take when completing an assessment.Data should include not only the frequency of coitus but also the number of sexual partners,level of contraceptive involvement,and partner's objections (if any).Assessing the woman's willingness to touch herself is a key factor for the nurse to discuss should the patient express interest in using one of the fertility awareness methods of contraception.The nurse must be aware of the patient's plan regarding whether she is attempting to prevent conception,delay conception,or conceive;however,but this evaluation is not the nurse's initial step.

Quiz 8: Infertility, Contraception, and Abortion