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.
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A 17-year-old patient receives emergency contraception in a clinic. What is the priority nursing education for this patient at this time?
- A. The need for further contraception because the emergency contraception is only temporary
- B. The need to protect herself from STIs
- C. The need to come back in for a pelvic examination 1 week after taking the medication
- D. The need to drink plenty of fluids while on this medication
Correct Answer: A
Rationale: The patient should be informed that emergency contraception is a temporary measure and they need a long-term contraceptive plan. Choice B, while important for overall sexual health, is not the priority immediately after administering emergency contraception. Choice C is not necessary unless there are complications or a follow-up consultation is needed. Choice D about drinking fluids is unnecessary and not specific to the effectiveness of emergency contraception.
The nurse provides counseling on coitus interruptus. What important counseling should be included?
- A. The partners must communicate well to use this method.
- B. This method is 100 percent effective because semen does not enter the vagina.
- C. BBT must be used with this method.
- D. All persons are able to control ejaculate in time to withdraw.
Correct Answer: A
Rationale: The important counseling that should be included when discussing coitus interruptus (withdrawal method) is that the partners must communicate well to use this method effectively. Coitus interruptus involves the male partner withdrawing his penis from the vagina before ejaculation to prevent sperm from entering the woman's reproductive tract. Effective communication between partners is crucial to ensure that the method is used correctly and consistently. This method does not protect against sexually transmitted infections (STIs), so it's also important to discuss alternative methods of contraception for STI prevention. The statement that this method is 100 percent effective is incorrect, as pre-ejaculate can contain sperm and there is a risk of pregnancy if withdrawal is not done correctly.
The nurse assesses a patient for medical eligibility for contraceptive use. What is the meaning of an MEC score of 1?
- A. There is no restriction for the use of the contraceptive method.
- B. There is an unacceptable health risk if the contraceptive method is used.
- C. There is a risk that outweighs the advantages of the contraceptive method.
- D. There is an advantage of using a contraceptive method that outweighs any risk.
Correct Answer: A
Rationale: In the context of medical eligibility for contraceptive use, an MEC (Medical Eligibility Criteria) score of 1 indicates that there are no restrictions for using the particular contraceptive method. A score of 1 suggests that the advantages of using the contraceptive method outweigh any potential risks, making it a safe and recommended choice for the patient. Therefore, a patient with an MEC score of 1 can use the contraceptive method without any concerns regarding health risks or restrictions.
A patient calls and says she used her diaphragm on Saturday night at 8:00 p.m., again on Sunday morning at 2:00 a.m., and again at 8:00 a.m. She is wondering when she can safely remove it while still having effective contraception. What is the nurse’s best response?
- A. 10:00 a.m. Sunday
- B. 2:00 p.m. Sunday
- C. 10:00 p.m. Sunday
- D. 8:00 a.m. Monday
Correct Answer: D
Rationale: In general, a diaphragm should be left in place for at least 6 hours after intercourse but no more than 24 hours. Based on the patient's usage times on Saturday night at 8:00 p.m., Sunday morning at 2:00 a.m., and Sunday morning at 8:00 a.m., she can safely remove the diaphragm on Monday morning at 8:00 a.m. This ensures she has used it for the necessary timeframe for effective contraception.
The nurse is educating an adolescent patient about Depo-Provera. Which statement should be included in this teaching session?
- A. You only need to come in every 5 months to get each injection.
- B. You may lose weight on this medication, so make sure to maintain a well-balanced diet.
- C. You may experience heavy bleeding or spotting monthly or none at all.
- D. You will not be able to start this medication until you have been pregnant at least once.
Correct Answer: C
Rationale: Depo-Provera can cause irregular bleeding patterns, including spotting or no bleeding at all. Choice A is incorrect because Depo-Provera needs to be administered every 3 months, not every 5 months. Choice B is incorrect as weight gain is more commonly associated with Depo-Provera, not weight loss. Choice D is incorrect as Depo-Provera can be used regardless of whether the woman has been pregnant before.