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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The nurse is providing education on a medical abortion. How would she describe the action of the medications?
- A. Medications thicken the lining of the uterus and decrease uterine contractions.
- B. Medications stop the fetal heart and induce contractions.
- C. Medications soften the cervix, cause uterine lining necrosis, and induce contractions.
- D. Medications thicken the cervix and the uterine lining.
Correct Answer: C
Rationale: Medications used in a medical abortion typically consist of a combination of Mifepristone and Misoprostol. The action of these medications involves three main effects: softening the cervix to facilitate the expulsion of the pregnancy tissue, causing necrosis of the uterine lining to disrupt the pregnancy, and inducing contractions to expel the contents of the uterus. This process is different from a surgical abortion, which involves a procedure to remove the pregnancy tissue from the uterus.
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 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.
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 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.