Chapter 08- Contraception and Abortion LowdermilkMaternity & Women's Health Care, 12th Edition
(Questions And Answers 2022-2023 A+)
1. A woman has
... [Show More] chosen the calendar method of conception control. Which is the most
important action the nurse should perform during the assessment process in
preparation to discuss the implementation of this method?
a. Obtain a history of the woman's menstrual cycle lengths for the past 6 to 12 months.
b. Determine the client's weight gain and loss pattern for the previous year.
c. Examine skin pigmentation and hair texture for hormonal changes.
d. Explore the client's previous experiences with conception control. - ANS: A
The calendar method of conception control is based on the number of days in each
cycle, counting from the first day of menses. The fertile period is determined after the
lengths of menstrual cycles have been accurately recorded for 6 months. Weight gain or
loss may be partly related to hormonal fluctuations, but it has no bearing on the use of
the calendar method. Integumentary changes may be related to hormonal changes, but
they are not indicators for use of the calendar method. Exploring previous experiences
with conception control may demonstrate client understanding and compliancy, but
these experiences are not the most important aspect to assess for the discussion of the
calendar method.
2. A woman who has a seizure disorder and takes barbiturates and phenytoin sodium
daily asks the nurse about the pill as a contraceptive choice. What is the nurse's best
response?
a. "Oral contraceptives are a highly effective method, but they have some side effects."
b. "Your current medications will reduce the effectiveness of the pill."
c. "Oral contraceptives will reduce the effectiveness of your seizure medication."
d. "The pill is a good choice for a woman of your age and with your personal history." -
ANS: B
Because the liver metabolizes oral contraceptives, their effectiveness is reduced when
they are simultaneously taken with anticonvulsants. Stating that the pill is an effective
birth control method with side effects is a true statement, but this response is not the
most appropriate. The anticonvulsant reduces the effectiveness of the pill, not the other
way around. Stating that the pill is a good choice for a woman of her age and personal
history does not teach the client that the effectiveness of the pill may be reduced
because of her anticonvulsant therapy.
3. Which client would be an ideal candidate for injectable progestins such as
medroxyprogesterone acetate as a contraceptive choice?
a. The ideal candidate wants menstrual regularity and predictability.
b. The client has a history of thrombotic problems or breast cancer.
c. The ideal candidate has difficulty remembering to take oral contraceptives daily.
d. The client is homeless or mobile and rarely receives health care. - ANS: C
Advantages of medroxyprogesterone acetate includes its contraceptive effectiveness,
compared with the effectiveness of combined oral contraceptives, and the requirement
of only four injections a year. The disadvantages of injectable progestins are prolonged
amenorrhea and uterine bleeding. The use of injectable progestin carries an increased
risk of venous thrombosis and thromboembolism. To be effective, injections must be
administered every 11 to 13 weeks. Access to health care is necessary to prevent
pregnancy or potential complications.
4. A client currently uses a diaphragm and spermicide for contraception. She asks the
nurse to explain the major differences between the cervical cap and the diaphragm.
What is the most appropriate response by the nurse?
a. "No spermicide is used with the cervical cap, so it's less messy."
b. "The diaphragm can be left in place longer after intercourse."
c. "Repeated intercourse with the diaphragm is more convenient."
d. "The cervical cap can be safely used for repeated acts of intercourse without adding
more spermicide later." - ANS: D
The cervical cap can be inserted hours before sexual intercourse without the need for
additional spermicide later. Spermicide should be used inside the cap as an additional
chemical barrier. The cervical cap should remain in place for 6 hours after the last act of
intercourse. Repeated intercourse with the cervical cap is more convenient because no
additional spermicide is needed
5. Which statement regarding emergency contraception is correct?
a. Emergency contraception requires that the first dose be taken within 120 hours of
unprotected intercourse.
b. Emergency contraception may be taken right after ovulation.
c. Emergency contraception has an effectiveness rate in preventing pregnancy of
approximately 50%.
d. Emergency contraception is commonly associated with the side effect of menorrhagia
- ANS: A
Emergency contraception should be taken as soon as possible or within 72 hours of
unprotected intercourse to prevent pregnancy. If taken before ovulation, follicular
development is inhibited, which prevents ovulation. The risk of pregnancy is reduced by
as much as 75%. The most common side effect of postcoital contraception is nausea.
6. Which is the most common technique used for the termination of a pregnancy in the
second trimester?
a. Dilation and evacuation (D&E)
b. Methotrexate administration
c. Prostaglandin administration
d. Vacuum aspiration - ANS: A
D&E can be performed at any point up to 20 weeks of gestation. It is more commonly
performed between 13 and 16 weeks of gestation. Methotrexate is a cytotoxic drug that
causes early abortion by preventing fetal cell division. Prostaglandins are also used for
early abortion and work by dilating the cervix and initiating uterine wall contractions.
Vacuum aspiration is used for abortions in the first trimester.
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