Questions for FITZGERALD CONTRACEPTIVES Flashcards

1
Q

Which of the following is a contraindication to estrogen/progestin-containing methods (combined oral contraception [COC], patch [Ortho Evra®], or ring [NuvaRing®])?

A. mother with a history of breast cancer

B. personal history of hepatitis A at age 10 years

C. presence of factor V Leiden mutation

D. cigarette smoking one pack per day in a 22-year-old

A

C

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2
Q
  1. A 22-year-old woman taking a 35-mcg ethinyl estradiol COC calls after forgetting to take her pills for 2 consecutive days. She is 2 weeks into the pack. You advise her to:

A. take the last pill missed immediately, even if this means taking two pills today.

B. discard two pills and take two pills today.

C. discard the rest of the pack and start a new pack with the first day of her next menses.

D. continue taking one pill daily for the rest of the cycle.

A

A

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3
Q
  1. When counseling a woman about COC use, you advise that:

A. long-term use of COC is discouraged because the body needs a “rest” from birth control pills from time to time.

B. fertility is often delayed for many months after discontinuation of COC.

C. there is an increase in the rate of breast cancer after protracted use of COC.

D. premenstrual syndrome symptoms are often improved with use of COC.

A

D

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4
Q
  1. Noncontraceptive benefits of COC use include a decrease in all of the following except:

A. iron-deficiency anemia

. B. pelvic inflammatory disease (PID).

C. cervicitis.

D. ovarian cancer.

A

C

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5
Q
  1. Which of the following women is the best candidate for progestin-only pill (POP) use?

A. an 18-year-old woman who frequently forgets to take prescribed medications

B. a 28-year-old woman with multiple sexual partners

C. a 32-year-old woman with adequately controlled hypertension

D. a 26-year-old woman who wants to use the pill to help “regulate” her menstrual cycle

A

D

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6
Q
  1. The most common reasons for discontinuing combined oral contraception use is breakthrough bleeding and:

A. nausea/vomiting.

B. inconvenience of use.

C. cost

. D. high failure rate.

A

B

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7
Q
  1. A 38-year-old nulliparous woman who smokes two and a half packs a day is in an “on-and-off” relationship. The woman presents seeking contraception. Which of the following represents the most appropriate method?

A. contraceptive ring (NuvaRing®)

B. COC

C. contraceptive patch (Ortho Evra®)

D. vaginal diaphragm

A

D

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8
Q
  1. Due to an increased risk of blood clots, an alternative to the contraceptive ring (NuvaRing®) or patch (Ortho Evra®) is preferred in all of the following women except:

A. a 42-year-old nulliparous woman with type 2 diabetes mellitus and high LDL.

B. a 31-year-old woman with a history of naturally occurring multiple gestation pregnancy.

C. a 28-year-old who smokes >15 cigarettes per day.

D. a 33-year-old with a family history of venous thrombosis.

A

B

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9
Q
  1. Which of the following statements is true concerning vaginal diaphragm use?

A. When the device is in place, the woman is aware that the diaphragm fits snugly against the vaginal walls.

B. This is a suitable form of contraception for women with recurrent urinary tract infection.

C. After the device is inserted, the cervix should be smoothly covered.

D. The device should be removed within 2 hours of coitus to minimize the risk of infection.

A

C

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10
Q
  1. According to the United States Medical Eligibility Criteria (US MEC) for Contraception Use, which of the following is a clinical condition in which the use of a copper-containing intrauterine device (Cu-IUD) or levonorgestrel-releasing IUD (LNG-IUD) should be approached with caution?

A. uncomplicated valvular heart disease

B. current pelvic inflammatory disease

C. hypertension

D. dysmenorrhea

A

B

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11
Q

11.Which of the following is the most appropriate response to a 27-year-old woman who is taking phenytoin (Dilantin®) for the treatment of a seizure disorder and is requesting hormonal contraception?

A. “A barrier method would be the preferable choice.”

B. “COC is the best option.”

C. “Depo-Provera® (medroxyprogesterone acetate in a depot injection [DMPA]) use will likely not interact with your seizure medication.”

D. “Cu-IUD or LNG-IUD use is contraindicated.”

A

C

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12
Q
  1. Which of the following is commonly found after 1 year of using DMPA (Depo-Provera®)?

A. weight gain

B. hypermenorrhea

C. acne

D. rapid return of fertility when discontinued

A

A

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13
Q

13 to 17. According to the United States Medical Eligibility Criteria (US MEC) for Contraception Use, indicate the appropriate US MEC category (1, 2, 3, or 4) for each candidate for combined hormonal contraceptives (i.e., combined oral contraceptive, patch, or vaginal ring). .

  1. a 37-year-old woman who smokes 10 cigarettes per day
  2. a 29-year-old woman with PID
  3. a 45-year-old woman with history of migraine
  4. a 32-year-old woman breastfeeding a 6-month-old infant
  5. a 28-year-old woman with type 1 diabetes mellitus without vascular disease

\

A

13: Category 3
14: Category 1
15: Category: 4
16: category 2
17: category 2

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14
Q

According to the United States Medical Eligibility Criteria for Contraception Use, indicate the appropriate US MEC category (1, 2, 3, or 4) for each candidate for a Cu-IUD or LNG-IUD.

  1. a 45-year-old woman with fibroids with uterine cavity distortion
  2. a 33-year-old woman who smokes two packs per day
  3. a 25-year-old woman with adequately controlled hypertension
  4. a 33-year-old woman with family history of breast cancer in a second-degree relative
A

18: Category 4
19. category 1

20, Category 1

  1. category 1
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15
Q

As you prescribe COC containing the progestin drospirenone (Loryna™, Ocella®, Vestura®, Yasmin®, Yaz®), you offer the following advice: A. “Always take this pill on a full stomach.” B. “You should not take acetaminophen when using this birth control pill.” C. “Avoid using potassium-containing salt substitutes.” D. “You will likely notice that premenstrual syndrome symptoms might become worse.”

A

C

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16
Q
  1. A 26-year-old mother who breastfeeds her 4-month-old child queries about hormonal contraceptives. In counseling her on the use of the progestin-only pill (POP), you mention all of the following except:

A. the pill is taken every day.

B. POP is a more effective contraceptive than COC.

C. POP does not alter the quality or quantity of breast milk.

D. POP is associated with bleeding irregularity, ranging from prolonged flow to amenorrhea.

A

B

17
Q
  1. By using a diaphragm with spermicide nonoxynol-9 during sexual intercourse, a woman is likely at increased risk for:

A. cervical stenosis.

B. urinary tract infection.

C. increased perivaginal lactobacilli colonization.

D. ovarian malignancy.

A

B

18
Q
  1. With the use of a LNG-IUD (Mirena®, Skyla®), a form of long-acting reversible contraceptive (LARC), which one of the following is normally noted?

A. endometrial hyperplasia

B. hypermenorrhea

C. increase in PID rates

D. reduction in menstrual flow

A

D

19
Q
  1. With DMPA in depot injection (Depo-Provera®), the recommended length of use is usually:

A. less than 1 year.

B. no more than 2 years.

C. as long as the woman desires this form of contraception

. D. as determined by her lipid response to the medication.

A

b

20
Q

28.Irregular bleeding associated with DMPA (DepoProvera®) can be minimized with the use of all of the following except:

A. acetaminophen.

B. ibuprofen.

C. naproxen sodium.

D. estrogen supplements.

A

A

21
Q
  1. When can a woman safely conceive after discontinuing COC or LARC use?

A. immediately

B. after 1 to 2 months

C. after 3 to 4 months

D. after 5 to 6 months

A

A

22
Q
  1. When prescribing the contraceptive patch (Ortho Evra®) or vaginal ring (NuvaRing®), the nurse practitioner (NP) considers that:

A. these are progestin-only products.

B. candidates include women who have difficulty remembering to take a daily pill

. C. there are significant drug interactions with both products.

D. contraceptive efficacy is less than with COC.

A

B

23
Q
  1. When considering the use of etonogestrel subdermal implant (Nexplanon®) for contraception, the NP realizes that:

A. three rods are placed under the skin.

B. this method provides effective contraception for up to 2 years.

C. this method can lose effectiveness over time in overweight or obese women.

D. this method is considered acceptable for select women with a history of thrombophilia forms.

A

C

24
Q
  1. When comparing the etonogestrels, it is important to note that Nexplanon®:

A. has a higher concentration of progestin.

B. is effective for a longer period of time compared with Implanon®.

C. can be self-administered.

D. is visible on x-ray. .

A

D

25
Q
  1. Answer the following questions true or false.
  2. The use of combined oral contraception (COC) reduces menstrual volume by approximately 60%, thereby reducing the risk of iron deficiency anemia.
  3. Nausea with COC use can be minimized by taking the pill on an empty stomach.
  4. Calcium and vitamin D supplementation is recommended for those taking DMPA (DepoProvera®) injections to minimize the risk of a losing bone density
A
  1. True
  2. False
  3. True