Nokea
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.
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A 35-year-old patient comes to the clinic 2 days after a tubal ligation. She complains of abdominal pain and swelling and redness at the surgical incision. What does the nurse know is a common complication of this procedure?
- A. Ileus
- B. Liver enlargement
- C. Constipation
- D. Infection
Correct Answer: D
Rationale: Infection is a common complication after tubal ligation, indicated by redness and swelling at the surgical site. Choice A is incorrect as ileus is a bowel obstruction, not typically a complication of tubal ligation. Choice B, liver enlargement, is unrelated to tubal ligation. Choice C, constipation, may be a side effect but is not a primary concern after this procedure.
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.
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 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.
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.