Nokea
A woman asks about the side effects of the contraceptive implant. Which of the following should the nurse include in the discussion?
- A. The implant will cause heavy menstrual bleeding.
- B. The implant may cause irregular bleeding patterns, including light spotting.
- C. The implant can cause weight gain.
- D. The implant may cause hair loss.
Correct Answer: B
Rationale: Irregular bleeding, including spotting, is a common side effect of the contraceptive implant. Choice A is incorrect because the implant typically leads to lighter periods or no periods at all. Choice C is incorrect as weight gain is not a guaranteed side effect, though some women report it. Choice D is incorrect because hair loss is not commonly associated with the implant.
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What is an advantage of the cervical cap over the diaphragm?
- A. a lower failure rate
- B. its ease of insertion
- C. that it can remain in place for 48 hours
- D. that spermicide is not needed
Correct Answer: A
Rationale: The advantage of the cervical cap over the diaphragm is that it typically has a lower failure rate in preventing pregnancy. Failure rates for contraceptive methods refer to the percentage of women who become pregnant within the first year of typical use. The cervical cap is generally associated with a lower failure rate compared to the diaphragm due to its snugger fit and ability to cover the cervix more effectively, resulting in better protection against sperm entering the uterus. This makes the cervical cap a more reliable option for women seeking effective contraception.
A young girl comes to the OB-GYN office to begin contraception. What is the most important information the nurse should find in the history before starting a contraceptive?
- A. Do your cramps prevent you from daily activities?
- B. When was your last menstrual period?
- C. How much water do you drink?
- D. How many pads do you soak per day during your cycle?
Correct Answer: A
Rationale: Cramps that interfere with daily activities could indicate underlying issues that need to be addressed before starting contraception. This is a priority because it could suggest a need for further evaluation or treatment before prescribing a contraceptive method. Choice B is important but less critical than assessing the impact of menstrual symptoms on daily life. Choice C, while important for overall health, does not have a direct impact on contraception planning. Choice D is less useful in this context compared to understanding how menstrual symptoms affect daily functioning.
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.
Which statement by the client would alert the nurse that she should not take oral contraceptives?
- A. I drink one to two alcohol drinks a few times a week.
- B. I am slightly overweight and have a difficult time fitting exercise into my schedule.
- C. I am trying to limit cigarettes to one pack a week.
- D. I try to have my boyfriend wear a condom every time we have sex.
Correct Answer: C
Rationale: Cigarette smoking, particularly in women over the age of 35, is a significant risk factor when using oral contraceptives due to the increased risk of blood clots. Choice A is incorrect as moderate alcohol consumption does not directly contraindicate oral contraceptive use. Choice B, being overweight, may increase the risk of side effects, but it does not necessarily contraindicate oral contraceptives. Choice D is unrelated to oral contraceptive use and does not provide relevant information.
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.