Nokea
A patient has had four vaginal deliveries. What barrier contraceptive method’s efficacy is affected by this history?
- A. internal condom
- B. external condom
- C. cervical cap
- D. contraceptive gel
Correct Answer: C
Rationale: A cervical cap is a type of barrier contraceptive method that is inserted into the vagina and covers the cervix to prevent sperm from entering the uterus. The efficacy of a cervical cap can be affected by a patient's history of vaginal deliveries because multiple vaginal deliveries can cause changes in the cervix's shape and size. These changes may make it difficult for the cervical cap to fit properly and stay in place, thereby reducing its effectiveness in preventing pregnancy. This is why a cervical cap may be less reliable for women who have had multiple vaginal deliveries compared to those who have not.
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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.
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.
A 28-year-old patient has decided to use the patch contraception. The nurse is educating her on the best site to use. Where is the best place to put the patch? Select one that does not that apply.
- A. Buttocks
- B. Leg
- C. Breast
- D. Arm
Correct Answer: C
Rationale: The best sites for applying the contraceptive patch are the buttocks, arm, and leg. These areas have sufficient fat and are away from areas that might rub off the patch. Choice B (Neck) is incorrect as the neck is not recommended for patch application due to the potential for irritation and the high blood flow area. Choice C (Breast) is not recommended because the breast tissue may affect the adhesion of the patch.
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.
One goal of Healthy People 2030 is to improve pregnancy planning and prevent unintended pregnancy. What is a negative outcome related to unintended pregnancy that is related to this HP goal?
- A. lost jobs related to inabilities to continue to work
- B. depression and anxiety
- C. increased BMI and unintentional weight gain
- D. increased health-care costs in the United States
Correct Answer: B
Rationale: Depression and anxiety are negative outcomes related to unintended pregnancy that align with the goal of improving pregnancy planning and preventing unintended pregnancies in Healthy People 2030. Unintended pregnancies can lead to increased stress and mental health issues for individuals who may not have been prepared or ready for a pregnancy. This can result in higher levels of depression and anxiety, impacting both the individual's well-being and potentially their relationships and overall quality of life. By focusing on improving pregnancy planning and preventing unintended pregnancy, Healthy People 2030 aims to reduce these negative outcomes and promote better mental health outcomes for individuals and families.