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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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.
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.
A patient is taking oral contraceptives and asks whether they will still be effective if she has diarrhea. What should the nurse respond?
- A. Oral contraceptives will still work if taken with food.
- B. Oral contraceptives may be less effective during diarrhea due to absorption issues.
- C. Oral contraceptives need to be stopped for 7 days when experiencing diarrhea.
- D. Oral contraceptives will be more effective during diarrhea due to faster metabolism.
Correct Answer: B
Rationale: Diarrhea can reduce the absorption of oral contraceptives, potentially making them less effective. Choice A is incorrect because food does not always affect oral contraceptive absorption. Choice C is incorrect because there is no need to stop the contraceptives, but additional methods may be recommended during diarrhea. Choice D is incorrect because diarrhea does not increase the effectiveness of oral contraceptives.
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.
Why would FAM not be appropriate for the nurse to recommend to a perimenopausal person?
- A. At that age, people do not have intercourse on a regular basis.
- B. They are married and do not need contraception.
- C. They have irregular menstrual periods.
- D. Pregnancy is not a concern when a person is perimenopausal.
Correct Answer: C
Rationale: Fertility Awareness Methods (FAM) rely on tracking menstrual cycles and using that information to predict fertile and infertile days. In perimenopausal individuals, menstrual periods can become irregular due to hormonal fluctuations associated with menopause. As a result, it can be challenging to accurately determine fertile and infertile days, making FAM less effective for contraception in this population. Therefore, recommending FAM to a perimenopausal person with irregular menstrual periods would not be appropriate.