Nokea
The nurse is educating an adolescent patient about Depo-Provera. Which statement should be included in this teaching session?
- A. You only need to come in every 5 months to get each injection.
- B. You may lose weight on this medication, so make sure to maintain a well-balanced diet.
- C. You may experience heavy bleeding or spotting monthly or none at all.
- D. You will not be able to start this medication until you have been pregnant at least once.
Correct Answer: C
Rationale: Depo-Provera can cause irregular bleeding patterns, including spotting or no bleeding at all. Choice A is incorrect because Depo-Provera needs to be administered every 3 months, not every 5 months. Choice B is incorrect as weight gain is more commonly associated with Depo-Provera, not weight loss. Choice D is incorrect as Depo-Provera can be used regardless of whether the woman has been pregnant before.
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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.
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.
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.
The nurse assesses a patient for medical eligibility for contraceptive use. What is the meaning of an MEC score of 1?
- A. There is no restriction for the use of the contraceptive method.
- B. There is an unacceptable health risk if the contraceptive method is used.
- C. There is a risk that outweighs the advantages of the contraceptive method.
- D. There is an advantage of using a contraceptive method that outweighs any risk.
Correct Answer: A
Rationale: In the context of medical eligibility for contraceptive use, an MEC (Medical Eligibility Criteria) score of 1 indicates that there are no restrictions for using the particular contraceptive method. A score of 1 suggests that the advantages of using the contraceptive method outweigh any potential risks, making it a safe and recommended choice for the patient. Therefore, a patient with an MEC score of 1 can use the contraceptive method without any concerns regarding health risks or restrictions.
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.