Nokea
A nurse is giving post-op teaching to a person after a surgical abortion. What education should be provided?
- A. Report bleeding that is heavy, soaks more than two pads per hour for 2 hours.
- B. You can resume vaginal coitus the next day.
- C. You do not need to return to the clinic for follow-up.
- D. You should use tampons if your bleeding is heavy.
Correct Answer: A
Rationale: It is important for the nurse to educate the person who has undergone a surgical abortion about the signs of a possible complication, such as heavy bleeding. The instruction to report bleeding that is heavy, where the individual soaks more than two pads per hour for 2 hours, is crucial as it can indicate excessive bleeding that may require medical attention. Immediate reporting of such heavy bleeding can help prevent complications and ensure proper medical intervention.
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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.
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.
Which of the following best describes the mechanism of action of birth control pills?
- A. They block sperm from reaching the egg.
- B. They prevent ovulation by suppressing hormone levels.
- C. They increase cervical mucus production to block sperm entry.
- D. They reduce the size of the ovaries and fallopian tubes to prevent pregnancy.
Correct Answer: B
Rationale: Birth control pills primarily work by preventing ovulation, thereby inhibiting the release of eggs for fertilization. Choice A is incorrect because birth control pills do not directly block sperm; they prevent ovulation. Choice C is partially correct but is not the main mechanism, as the primary function is to prevent ovulation. Choice D is incorrect because birth control pills do not alter the size of reproductive organs.
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.