What emergency contraception has the best efficacy for prevention of pregnancy?
- A. Plan B
- B. Yuzpe
- C. copper IUC
- D. progesterone-only EC
Correct Answer: C
Rationale: Copper intrauterine devices (IUDs) have the best efficacy for prevention of pregnancy among emergency contraception options. Copper IUDs are over 99% effective when used as emergency contraception, making them more reliable than other methods like Plan B, Yuzpe, or progesterone-only EC. This high efficacy is due to the mechanism of action of copper IUDs, which prevent fertilization and implantation of the fertilized egg. Additionally, once inserted, a copper IUD can continue to provide ongoing contraception for up to 10 years, making it a long-term contraceptive option as well.
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A couple who has stated that they are LGBTQIA+ during prior visits arrives at the clinic for prenatal care. What can the nurse say in the waiting area to help them feel welcome and safe?
- A. You can take this tablet to an area in the waiting room and check in. Then bring the tablet back to me when you are done.
- B. Are you pregnant? Your paperwork says your name is Tom.
- C. You can have a seat, and a person from the LGBTQIA+ office will come to assist you.
- D. Here is our paperwork. It doesn't have a box for your sex, but you can write it next to the gender box.
Correct Answer: A
Rationale: Providing a neutral and respectful approach helps create a welcoming environment for LGBTQIA+ patients.
The nurse is educating a male patient on how a vasectomy works. What is the best explanation for this procedure?
- A. The procedure blocks the sperm from entering into the semen and being ejaculated.
- B. The procedure removes the testicle so that sperm are not made.
- C. The tube that carries seminal fluid is blocked, causing no semen to be ejaculated.
- D. The procedure kills all sperm so they are unable to make it to the ovulated egg.
Correct Answer: A
Rationale: A vasectomy involves blocking or cutting the vas deferens to prevent sperm from being ejaculated with semen, making it an effective method of contraception. Choice B is incorrect because the testicles are not removed during a vasectomy, only the vas deferens is altered. Choice C is incorrect because seminal fluid is still produced, but sperm are prevented from entering it. Choice D is incorrect because sperm are not killed, but rather prevented from mixing with semen.
A pregnant client reports frequent urination and lower abdominal pressure at 36 weeks. What should the nurse explain?
- A. This is a sign of preterm labor.
- B. This indicates urinary tract infection.
- C. This is common due to fetal descent.
- D. This is caused by Braxton Hicks contractions.
Correct Answer: C
Rationale: As the fetus descends into the pelvis (lightening), increased pressure on the bladder causes frequent urination.
During which stage of the menstrual cycle does the endometrium layer thicken?
- A. Proliferative phase
- B. Ovulation phase
- C. Luteal phase
- D. Secretory phase
Correct Answer: D
Rationale: The endometrium layer thickens during the secretory phase of the menstrual cycle. This phase occurs after ovulation and is characterized by the endometrium preparing for possible implantation of a fertilized egg by further thickening and becoming more vascularized. If pregnancy does not occur, the thickened endometrial lining will be shed during menstruation. The secretory phase is under the control of the hormone progesterone, which is produced by the corpus luteum formed in the ovary after ovulation.
What history would lead you to suspect an ectopic pregnancy in a client at 8 weeks' gestation presenting with abdominal pain and bleeding?
- A. Treated one year ago for PID
- B. Irregular cycle for 1 year
- C. Oral contraception for 3 years
- D. Urinary frequency for 1 week
Correct Answer: A
Rationale: A history of previous pelvic inflammatory disease (PID) treatment would lead to suspicion of an ectopic pregnancy in a client presenting with abdominal pain and bleeding at 8 weeks' gestation. PID can cause scarring and damage to the fallopian tubes, increasing the risk of an ectopic pregnancy where the fertilized egg implants outside of the uterus, usually in the fallopian tubes. Symptoms of an ectopic pregnancy can include abdominal pain, vaginal bleeding, and signs of shock, making it important to consider this possibility in a client with a history of PID.