Nokea
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.
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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.
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 woman asks about the side effects of the contraceptive implant. Which of the following should the nurse include in the discussion?
- A. The implant will cause heavy menstrual bleeding.
- B. The implant may cause irregular bleeding patterns, including light spotting.
- C. The implant can cause weight gain.
- D. The implant may cause hair loss.
Correct Answer: B
Rationale: Irregular bleeding, including spotting, is a common side effect of the contraceptive implant. Choice A is incorrect because the implant typically leads to lighter periods or no periods at all. Choice C is incorrect as weight gain is not a guaranteed side effect, though some women report it. Choice D is incorrect because hair loss is not commonly associated with the implant.
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 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.