Final Chapter 4: Contraception & Safety Flashcards
A nurse is teaching a client about the use of oral contraceptives (OCs). Which of the following statements by the client indicates an understanding of the nurse’s teaching?
- a) “I can stop taking the pills at any time without backup contraception.”
- b) “I should take the pill at the same time every day to ensure its effectiveness.”
- c) “I can skip one dose and take two pills the next day.”
- d) “If I miss a pill, I don’t need to worry about pregnancy risk.”
b) “I should take the pill at the same time every day to ensure its effectiveness.”
Rationale: Consistent daily dosing at the same time is important to maintain adequate hormone levels for contraception.
A client with a history of smoking is prescribed combination oral contraceptives. The nurse should assess for which of the following?
- a) Risk for uterine fibroids
- b) Risk for endometrial cancer
- c) Increased risk of blood clots
- d) Risk for fibrocystic breast disease
c) Increased risk of blood clots
Rationale: Smoking increases the risk of thromboembolic events when using combined oral contraceptives.
Which of the following is a potential benefit of oral contraceptive use in women with endometriosis?
- a) Prevention of ovarian cancer
- b) Decreased risk of uterine fibroids
- c) Alleviation of menstrual cramps
- d) Increase in pregnancy rate
- c) Alleviation of menstrual cramps
Rationale: Oral contraceptives can help manage the symptoms of endometriosis, such as dysmenorrhea.
A client is prescribed a progestin-only pill (POP). Which statement by the client indicates a need for further teaching?
- a) “I need to take this pill at the same time every day.”
- b) “I won’t experience any menstrual bleeding with this pill.”
- c) “This pill works by thickening cervical mucus.”
- d) “I should take a backup method if I miss a pill.”
- b) “I won’t experience any menstrual bleeding with this pill.”
Rationale: Progestin-only pills can cause irregular bleeding, and the statement is incorrect.
Which of the following is an advantage of using extended-cycle oral contraceptives?
a) Increased incidence of menstrual cramps
b) Increased risk of breakthrough bleeding
c) A reduction in the number of menstrual periods per year
d) Decreased bone mineral density
d) A reduction in the number of menstrual periods per year
Rationale: Extended-cycle pills reduce the frequency of menstrual periods, offering benefits in managing menstrual disorders.
Which of the following medications can decrease the effectiveness of oral contraceptives?
a) Antibiotics
b) Antidepressants
c) Nonsteroidal anti-inflammatory drugs (NSAIDs)
d) Antihistamines
a) Antibiotics
Rationale: Certain antibiotics can reduce the effectiveness of oral contraceptives, increasing the risk of pregnancy.
The nurse is educating a client about the side effects of oral contraceptives. Which of the following should the nurse include as a common side effect?
- a) Increased libido
- b) Irregular menstrual cycles
- c) Decreased risk of blood clots
- d) Increased hair growth
- b) Irregular menstrual cycles
Rationale: Breakthrough bleeding and irregular cycles are common side effects of oral contraceptives.
Which of the following is a contraindication for oral contraceptive use?
a) History of migraines without aura
b) Age over 40 years
c) History of thromboembolic disorders
d) Non-smoker
c) History of thromboembolic disorders
Rationale: Women with a history of thromboembolic disorders should not use oral contraceptives due to the increased risk of blood clots.
Which of the following oral contraceptive formulations is most likely to be prescribed for a client who cannot tolerate estrogen?
a) Monophasic combined oral contraceptive
b) Progestin-only pill (POP)
c) Multiphasic oral contraceptive
d) Extended-cycle combination pill
b) Progestin-only pill (POP)
Rationale: Progestin-only pills do not contain estrogen and are appropriate for women who cannot tolerate estrogen.
A nurse is educating a client about taking oral contraceptives. Which of the following should the nurse instruct the client to do if they miss one dose?
a) Take two pills at the next scheduled dose
b) Skip the missed dose and continue with the next dose
c) Take a backup method for the next month
d) Stop taking the pills and contact a healthcare provider
a) Take two pills at the next scheduled dose
Rationale: If one dose is missed, the client should take two pills the next day and continue as usual.
Which of the following describes the mechanism by which combination oral contraceptives prevent pregnancy?
a) Suppression of estrogen production
b) Inhibition of cervical mucus production
c) Suppression of ovulation and alteration of cervical mucus
d) Thickening of the uterine lining
c) Suppression of ovulation and alteration of cervical mucus
Rationale: Combination oral contraceptives prevent pregnancy by inhibiting ovulation and thickening cervical mucus.
A client taking oral contraceptives reports experiencing breakthrough bleeding. Which of the following is the nurse’s best action?
- a) Reassure the client, as this is a common side effect
- b) Recommend discontinuing the oral contraceptives
- c) Suggest an increase in the dosage of oral contraceptives
- d) Instruct the client to stop using contraceptives for 7 days
a) Reassure the client, as this is a common side effect
Rationale: Breakthrough bleeding is a common side effect of oral contraceptives, particularly early in use.
A nurse is educating a client about the use of extended-cycle oral contraceptives. Which of the following should the nurse include in the teaching?
a) The client will have no menstrual bleeding
b) Extended-cycle pills are less effective than conventional pills
c) The client must take a break from the pill every 3 months
d) The client will have four withdrawal-bleeding episodes a year
d) The client will have four withdrawal-bleeding episodes a year
Rationale: Extended-cycle oral contraceptives reduce the number of periods to four per year.
A nurse is discussing oral contraceptive use with a client who has a history of asthma. Which of the following is a potential benefit of oral contraceptives in this client?
- a) Improvement in asthma symptoms
- b) Increased risk of asthma attacks
- c) No impact on asthma
- d) Decreased effectiveness in managing asthma
a) Improvement in asthma symptoms
Rationale: Some studies suggest that oral contraceptives may improve asthma symptoms in women.
Which of the following is a potential risk of long-term oral contraceptive use?
- a) Increased risk of endometrial cancer
- b) Decreased risk of colorectal cancer
- c) Increased risk of uterine fibroids
- d) Increased risk of blood clots
d) Increased risk of blood clots
Rationale: Long-term use of combination oral contraceptives increases the risk of thromboembolic events.
A client taking oral contraceptives is prescribed antibiotics. The nurse should provide which of the following instructions?
- a) “No additional contraception is necessary.”
- b) “You may need to use an alternative form of contraception while on antibiotics.”
- c) “You can continue using your oral contraceptive without any changes.”
- d) “Antibiotics will enhance the effectiveness of your oral contraceptive.”
b) “You may need to use an alternative form of contraception while on antibiotics.”
Rationale: Antibiotics can decrease the effectiveness of oral contraceptives, requiring the use of a backup method.
A nurse is preparing to educate a client on the use of Lybrel, a continuous oral contraceptive regimen. Which of the following is an important teaching point?
a) The client will have one menstrual period per year
b) The client will experience regular withdrawal bleeds every month
c) The client will take the pills every day without a break
d) The client must take a week-long break every 3 months
c) The client will take the pills every day without a break
Rationale: Lybrel is a continuous oral contraceptive that requires daily pill-taking without breaks.
Which of the following clients is MOST likely to be prescribed progestin-only contraceptives?
A. A 28-year-old smoker who is otherwise healthy
B. A 45-year-old woman with a history of blood clots
C. A 32-year-old woman with a family history of breast cancer
D. A 22-year-old woman with controlled hypertension
B. A 45-year-old woman with a history of blood clots
Rationale: Progestin-only contraceptives (POP) are recommended for women who cannot use estrogen, such as those with a history of blood clots.
Which of the following contraceptive methods is MOST appropriate for a woman who desires a long-acting, reversible contraception option without hormones?
A. Intrauterine device (IUD) with copper
B. Birth control pill
C. Diaphragm
D. Contraceptive implant
A. Intrauterine device (IUD) with copper
Rationale: The copper IUD is a non-hormonal, long-acting reversible contraception (LARC) method.
A nurse is counseling a patient about the risks associated with combined oral contraceptives (COCs). Which of the following conditions would be an absolute contraindication for the use of COCs?
A. Type 2 diabetes mellitus
B. Smokers over the age of 35
C. History of myocardial infarction
D. History of irregular menstrual cycles
C. History of myocardial infarction
Rationale: A history of myocardial infarction is an absolute contraindication for the use of combined oral contraceptives due to the increased risk of cardiovascular events.
Which of the following contraceptive methods has the highest efficacy in preventing pregnancy?
A. Contraceptive implant
B. Male condom
C. Oral contraceptive pills
D. Diaphragm
C. Oral contraceptive pills
Rationale: The contraceptive implant has the highest efficacy in preventing pregnancy because it is a long-acting, reversible method that does not require daily adherence.
A woman using oral contraceptives (OCs) is prescribed antibiotics for a urinary tract infection. What should the nurse advise the patient?
A. Continue taking the OCs without concern
B. Stop taking OCs while on antibiotics
C. Take additional OCs to ensure effectiveness
D. Use a backup contraception method while taking the antibiotics
D. Use a backup contraception method while taking the antibiotics
Rationale: Antibiotics can reduce the effectiveness of oral contraceptives, so a backup method is recommended during antibiotic use.
A 28-year-old woman is interested in using an IUD for contraception. Which of the following conditions would contraindicate the use of an intrauterine device (IUD)?
A. A history of pelvic inflammatory disease (PID)
B. A history of hypertension
C. A current history of anemia
D. A previous cesarean delivery
A. A history of pelvic inflammatory disease (PID)
Rationale: A history of PID is a contraindication for IUD use, as it increases the risk of further infection and complications.
Which of the following is a key advantage of using contraceptive implants?
A. It can be used immediately after childbirth
B. It has a low failure rate with perfect use
C. It requires a daily administration
D. It can be reversed easily within the first year
B. It has a low failure rate with perfect use
Rationale: The contraceptive implant has a very low failure rate with perfect use, and it is highly effective in preventing pregnancy.
Which of the following methods of contraception is most appropriate for a woman who is breastfeeding?
A. Combined oral contraceptives
B. Progestin-only pills
C. Contraceptive patch
D. Copper IUD
B. Progestin-only pills
Rationale: Progestin-only pills are the most appropriate for breastfeeding women because they do not affect milk production, unlike combined oral contraceptives.
A 40-year-old woman asks about the safety of using combined oral contraceptives. Which of the following conditions would make this woman a candidate for COCs?
A. History of hypertension
B. History of breast cancer
C. History of deep vein thrombosis (DVT)
D. Smokers under the age of 35
D. Smokers under the age of 35
Rationale: Combined oral contraceptives are safe for smokers under the age of 35. However, they are contraindicated for smokers over 35 due to the increased risk of thrombosis.
A nurse is counseling a patient about the use of emergency contraception. Which of the following statements about emergency contraception is accurate?
A. It should be taken within 72 hours of unprotected intercourse
B. It is most effective if taken within 5 days of unprotected intercourse
C. It is only effective for women with regular menstrual cycles
D. It is a permanent form of contraception
B. It is most effective if taken within 5 days of unprotected intercourse
Rationale: Emergency contraception is most effective within 5 days of unprotected intercourse but is preferred within 72 hours for optimal effectiveness.
Which of the following statements about barrier methods of contraception is correct?
A. Barrier methods offer no protection against sexually transmitted infections (STIs)
B. Male condoms can be used as a sole contraceptive method
C. Female condoms are less effective than male condoms
D. Diaphragms need to be used with spermicide to be effective
D. Diaphragms need to be used with spermicide to be effective
Rationale: Diaphragms must be used with spermicide to ensure proper contraceptive effectiveness.
A woman is considering the use of a contraceptive patch. Which of the following is an important teaching point for the nurse to include?
A. The patch must be replaced every 7 days
B. The patch can be worn continuously for 6 months
C. The patch should be applied to the upper arm or abdominal area
D. The patch can be used effectively during breastfeeding
C. The patch should be applied to the upper arm or abdominal area
Rationale: The contraceptive patch should be applied to the upper arm, abdomen, or buttocks for effective use, and it must be replaced weekly.
Which of the following contraceptive methods requires a healthcare provider for placement?
A. Birth control pill
B. Contraceptive implant
C. Male condom
D. IUD
D. IUD
Rationale: An intrauterine device (IUD) requires a healthcare provider for placement, unlike methods like birth control pills or male condoms.
Which of the following statements is true about the Depo-Provera contraceptive injection?
A. It must be administered every 6 months
B. It is a short-term method of contraception
C. It is given every 3 months
D. It is ineffective in women who are breastfeeding
C. It is given every 3 months
Rationale: Depo-Provera is administered every 3 months and is a long-acting, reversible method of contraception.
