Nokea
A patient calls the clinic Monday morning. She had condomless sex Friday night and is interested in emergency contraception. What should the nurse tell this patient?
- A. Emergency contraception pills are very effective for medically induced abortions early in pregnancy.
- B. If she is not midcycle when she had sex, she does not need emergency contraception.
- C. It is too late for her to use emergency contraceptive pills, but she can come in for placement of a copper IUD.
- D. She can use emergency contraceptive pills, even if she has had other condomless sex since the Friday night event.
Correct Answer: D
Rationale: The correct advice for the patient in this scenario is to inform her that she can still use emergency contraceptive pills, even if she has had other condomless sex since the Friday night event. Emergency contraceptive pills are most effective when taken as soon as possible after unprotected sex, but they can still be used within a certain window of time depending on the type of pill used. It is important to inform the patient that she can take emergency contraception in this situation to reduce the risk of an unintended pregnancy.
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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 26-year-old woman is interested in using an IUD for contraception. What is the primary advantage of using an IUD over other contraceptive methods?
- A. It requires no daily action from the patient once inserted.
- B. It provides immediate protection after insertion.
- C. It is effective immediately after the first sexual activity after insertion.
- D. It is effective only for 6 months before needing replacement.
Correct Answer: A
Rationale: One of the primary advantages of the IUD is that it requires no daily action, making it a convenient and reliable method. Choice B is incorrect because it may take a few days for some types of IUDs to provide full protection. Choice C is incorrect because immediate protection may not be ensured immediately after insertion, especially for hormonal IUDs. Choice D is incorrect because IUDs typically last for several years, not just 6 months.
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.
Before giving a client oral combination contraceptives, which side effects should the nurse tell the patient to be aware of? Select one that does not apply.
- A. Irregular bleeding
- B. Thick vaginal discharge
- C. Nausea
- D. Breast tenderness
Correct Answer: B
Rationale: The common side effects of oral combination contraceptives include irregular bleeding, nausea, and breast tenderness. Choice B is incorrect because thick vaginal discharge is not a typical side effect of oral contraceptives.
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.