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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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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.
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.
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.
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.
One goal of Healthy People 2030 is to improve pregnancy planning and prevent unintended pregnancy. What is a negative outcome related to unintended pregnancy that is related to this HP goal?
- A. lost jobs related to inabilities to continue to work
- B. depression and anxiety
- C. increased BMI and unintentional weight gain
- D. increased health-care costs in the United States
Correct Answer: B
Rationale: Depression and anxiety are negative outcomes related to unintended pregnancy that align with the goal of improving pregnancy planning and preventing unintended pregnancies in Healthy People 2030. Unintended pregnancies can lead to increased stress and mental health issues for individuals who may not have been prepared or ready for a pregnancy. This can result in higher levels of depression and anxiety, impacting both the individual's well-being and potentially their relationships and overall quality of life. By focusing on improving pregnancy planning and preventing unintended pregnancy, Healthy People 2030 aims to reduce these negative outcomes and promote better mental health outcomes for individuals and families.