Nokea
A 30-year-old woman is considering the use of emergency contraception. Which of the following is true about its use?
- A. It is most effective when used within 72 hours after unprotected sex.
- B. It should be used at least 5 days after unprotected sex to be effective.
- C. It prevents implantation of a fertilized egg into the uterine wall.
- D. It requires a prescription from a healthcare provider.
Correct Answer: A
Rationale: Emergency contraception is most effective when taken within 72 hours of unprotected sex. Choice B is incorrect as it is not as effective after 5 days. Choice C is incorrect because emergency contraception works primarily by preventing ovulation, not by preventing implantation. Choice D is incorrect because most emergency contraception methods are available over the counter.
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A patient who has an LNG-IUC in place calls the office and states she just took a pregnancy test, and it is positive. She comes in for a visit, and the nurse does another pregnancy test, which is positive. What does the nurse know that the clinician will inform the patient regarding the IUC?
- A. Removing the IUC may increase the chance of infertility.
- B. The fetus is at risk for congenital defects.
- C. The IUC needs to be removed regardless of the plans for this pregnancy.
- D. There is no risk to the fetus if the IUC is left in place.
Correct Answer: D
Rationale: The correct statement the nurse knows that the clinician will inform the patient regarding the LNG-IUC is that there is no risk to the fetus if the IUC is left in place. The LNG-IUC (levonorgestrel-releasing intrauterine system) is a highly effective form of contraception that works by releasing progesterone locally in the uterus. The hormonal effect of the LNG-IUC is mostly limited to the uterus and very little of it circulates systemically. Therefore, there is no known increased risk of congenital defects or harm to the fetus if the IUC is left in place during pregnancy. The IUC can be left in place if the patient chooses to continue the pregnancy, provided there are no signs of infection or other complications that would necessitate its removal.
The nurse is discussing contraceptive options with a patient who states they want to become pregnant in 1 year. Which contraception choice would be appropriate for them? Select all that apply.
- A. progestin-only contraceptive injections like DMPA
- B. progestin-only oral contraceptive pills
- C. fertility awareness methods
- D. COCs
Correct Answer: C
Rationale: Fertility awareness methods involve tracking a woman's menstrual cycle to identify the fertile window when pregnancy is most likely to occur. This method does not interfere with future fertility and can be used by individuals who plan to become pregnant in the near future. Since the patient expressed a desire to conceive in one year, fertility awareness methods would be the most appropriate contraceptive option for them.
What is one difference between the copper IUC and the LNG-IUC?
- A. efficacy
- B. placement in the uterus
- C. presence of a normal period
- D. shape
Correct Answer: B
Rationale: One difference between the copper IUC and the LNG-IUC is their placement in the uterus. The copper IUC, also known as the copper intrauterine device (IUD), is a small, T-shaped device that is inserted into the uterus by a healthcare provider. On the other hand, the LNG-IUC, or levonorgestrel-releasing intrauterine system, is also a T-shaped device but it releases a hormone called levonorgestrel into the uterus. Both devices are placed within the uterus, but the LNG-IUC releases hormones while the copper IUC relies on the copper to provide contraception.
Which is a disadvantage of the progesterone-only contraception pill?
- A. Side effects could be increased for persons who are underweight.
- B. There could be a decrease in bone mineral density over time.
- C. They may cause irregular bleeding and spotting.
- D. Return to fertility after discontinuing the pill may take several months.
Correct Answer: B
Rationale: One of the main disadvantages of progesterone-only contraception pills is the potential decrease in bone mineral density over time with long-term use. Progesterone has been linked to a decrease in bone density, which can increase the risk of osteoporosis and fractures, particularly in women. It is important for individuals, especially those at higher risk for osteoporosis, to discuss this potential side effect with their healthcare provider before initiating progesterone-only contraception. Monitoring bone health and considering supplementation may be necessary for those using this type of contraception long-term.
A patient calls the clinic Monday morning. She had condomless sex Friday night and is interested in emergency contraception. What should the nurse tell this patient?
- A. Emergency contraception pills are very effective for medically induced abortions early in pregnancy.
- B. If she is not midcycle when she had sex, she does not need emergency contraception.
- C. It is too late for her to use emergency contraceptive pills, but she can come in for placement of a copper IUD.
- D. She can use emergency contraceptive pills, even if she has had other condomless sex since the Friday night event.
Correct Answer: D
Rationale: The correct advice for the patient in this scenario is to inform her that she can still use emergency contraceptive pills, even if she has had other condomless sex since the Friday night event. Emergency contraceptive pills are most effective when taken as soon as possible after unprotected sex, but they can still be used within a certain window of time depending on the type of pill used. It is important to inform the patient that she can take emergency contraception in this situation to reduce the risk of an unintended pregnancy.