Nokea
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.
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The nurse provides education regarding female sterilization. What important information is provided?
- A. “You will need to wait 3 months before you are sterile.â€
- B. “You can have this procedure in the hospital after you give birth.â€
- C. “Fertilization will affect your milk supply for breast-feeding.â€
- D. “Tubal ligation is reversible.â€
Correct Answer: D
Rationale: The important information provided regarding female sterilization is that tubal ligation, which is a form of female sterilization, is generally considered irreversible. This means that it is a permanent method of contraception and should not be relied upon as a temporary solution. It is important for individuals considering this procedure to understand that it is meant to be permanent and should be approached as such. If there is any consideration for future fertility, alternative contraceptive options should be discussed with a healthcare provider.
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.
A 35-year-old patient comes to the clinic 2 days after a tubal ligation. She complains of abdominal pain and swelling and redness at the surgical incision. What does the nurse know is a common complication of this procedure?
- A. Ileus
- B. Liver enlargement
- C. Constipation
- D. Infection
Correct Answer: D
Rationale: Infection is a common complication after tubal ligation, indicated by redness and swelling at the surgical site. Choice A is incorrect as ileus is a bowel obstruction, not typically a complication of tubal ligation. Choice B, liver enlargement, is unrelated to tubal ligation. Choice C, constipation, may be a side effect but is not a primary concern after this procedure.
A 23-year-old female patient is considering intrauterine device (IUD) contraception. What is the most important information to assess before placement?
- A. Is there any family history of heart disease?
- B. Are you allergic to any metals?
- C. Have you had any previous IUDs inserted?
- D. Do you have a history of hypertension?
Correct Answer: B
Rationale: The IUD may contain metal components, and it's crucial to check for any metal allergies before placement. Choice A, family history of heart disease, is not directly related to IUD use. Choice C is incorrect because previous IUD insertion is not as crucial as identifying an allergy to the materials in the IUD. Choice D is incorrect because hypertension is not a contraindication for IUD use, though it should be monitored.
The nurse is discussing contraceptive options with a patient who states they want to become pregnant in 1 year. Which contraception choice would be appropriate for them? Select all that apply.
- A. progestin-only contraceptive injections like DMPA
- B. progestin-only oral contraceptive pills
- C. fertility awareness methods
- D. COCs
Correct Answer: C
Rationale: Fertility awareness methods involve tracking a woman's menstrual cycle to identify the fertile window when pregnancy is most likely to occur. This method does not interfere with future fertility and can be used by individuals who plan to become pregnant in the near future. Since the patient expressed a desire to conceive in one year, fertility awareness methods would be the most appropriate contraceptive option for them.