Question 1

A patient calls the nurse to report that she forgot to take a combination OC pill during the third week of her cycle. She tells the nurse that she missed another pill earlier that week. The nurse will tell her to:

Accepted Answer

A)   continue the pack, skip the inert pills, and use an additional form of contraception for 7 days.
B)   not to worry, because up to 7 days can be missed without an increased risk of pregnancy.
C)   take a pill immediately, continue the pack, and use an additional form of contraception for 1 month.
D)   take a pill now, continue the pack, skip the placebo pills, and start a new pack on week 4. D

Question 2

A patient asks about the effectiveness of various birth control methods. The nurse should inform her that the most effective methods are what?

Accepted Answer

A)   Intrauterine devices (IUDs) 
B)   Spermicides
C)   Intramuscular medroxyprogesterone acetate
D)   Etonogestrel subdermal implants
E)   Male or female sterilization A, C, D, E

Question 3

A nurse is teaching an adolescent female patient about 28-day monophasic combination oral contraceptives. The provider has instructed the patient to begin taking the pills on the first Sunday after the onset of her next period. What will the nurse tell the patient?

Accepted Answer

A)   "If breakthrough spotting occurs, you should begin taking a new pack of pills."
B)   "Protection from pregnancy will begin immediately."
C)   "Use another form of contraception for the next month."
D)   "You may take the pills at different times of day." C

Question 4

A nurse is teaching a community education class on contraceptives. The nurse tells the class that if spermicides containing nonoxynol-9 are used, the patient should take special precautions, because these spermicides have been linked to:

Accepted Answer

A)   human papillomavirus (HPV)  infections.
B)   spontaneous abortions.
C)   endometrial cancer.
D)   increased transmission of the human immunodeficiency virus (HIV) .

Question 5

An adolescent female patient with multiple sexual partners asks a nurse about birth control methods. The patient tells the nurse she tried oral contraceptives once but often forgot to take her pills. The nurse will recommend discussing which contraception with the provider?

Accepted Answer

A)   An intrauterine device with a spermicide
B)   DMPA (Depo-Provera)  and condoms
C)   Tubal ligation and condoms
D)   Progestin-only oral contraceptives

Question 6

A nurse working in a family planning clinic is teaching a class on intrauterine devices (IUDs). Which patient should be advised against using an IUD for contraception?

Accepted Answer

A)   A 45-year-old married woman with four children
B)   A 30-year-old monogamous married woman
C)   An 18-year-old woman with multiple sexual partners
D)   A 35-year-old woman with a history of rosacea

Question 7

A patient calls a family planning clinic and tells the nurse that her vaginal ring, which has been in place for 2 weeks, came out sometime during the night while she was sleeping. The nurse will instruct her to:

Accepted Answer

A)   clean the ring with warm water, reinsert it, and use condoms for 7 days.
B)   discard the ring and insert a new ring after 1 week has passed.
C)   discard the ring and insert a new one to begin a new cycle.
D)   wash the ring in hot, soapy water and reinsert it.

Question 8

A woman has been taking a progestin-only oral contraceptive and will begin using a vaginal ring. The nurse will teach the patient to insert the ring:

Accepted Answer

A)   the day the last pill is taken and use backup contraception for 7 days.
B)   1 week before taking the last pill.
C)   1 to 5 days after taking the last pill and use backup contraception for 2 days.
D)   within 7 days after taking the last pill.

Question 9

A patient has been taking a progestin-only, or "minipill," OC for 3 months and reports spotting and irregular menstrual cycles. The nurse will:

Accepted Answer

A)   question the patient about any possible missed doses of the pill.
B)   reassure the patient that this is normal with this form of contraception.
C)   recommend that she take a pregnancy test to rule out pregnancy.
D)   suggest that she use a backup form of contraception until these symptoms resolve.

Question 10

A patient has been experiencing side effects with a combination oral contraceptive, and her provider has ordered a different combination product. The nurse will instruct the patient to do what?

Accepted Answer

A)   Begin taking the new product immediately.
B)   Change products at the beginning of her next cycle.
C)   Stop taking the old OC 1 week before starting the new OC.
D)   Use an alternate method of contraception for 1 month before starting the new OC.

Question 11

A nurse is discussing various ways to obtain a medical abortion with a patient. Which statement by the patient best demonstrates understanding of mifepristone (RU 486) [Mifeprex]? "This drug is most effective if I use it:

Accepted Answer

A)   before the first missed menstrual period."
B)   the day after unprotected intercourse."
C)   within 7 weeks of conception."
D)   immediately after ovulation."

Question 12

A nurse working in a family planning clinic is preparing to administer a first dose of intramuscular DMPA [Depo-Provera] to a young adult patient. The woman tells the nurse she has just finished her period. What will the nurse do?

Accepted Answer

A)   Administer the injection today and counsel backup contraception for 7 days.
B)   Administer the injection today and tell her that protection is immediate.
C)   Obtain a pregnancy test to rule out pregnancy before administering the drug.
D)   Schedule an appointment for her to receive the injection in 3 weeks.

Question 13

A patient at increased risk for thromboembolic disorders will begin taking a progestin-only oral contraceptive. Which statement by the patient indicates understanding of how this oral contraceptive works?

Accepted Answer

A)   "I will need to use backup contraception if I miss a pill."
B)   "Irregular bleeding is an indication that I should stop using this drug."
C)   "The mini-pill is safer than combination OCs and is just as effective."
D)   "The progestin-only mini-pill will prevent me from ovulating."

Question 14

A patient who is taking a combination oral contraceptive begins taking carbamazepine. After several weeks, the patient tells the nurse she has begun experiencing spotting during her cycle. What will the nurse tell her to do?

Accepted Answer

A)   Change to condoms instead of oral contraceptives.
B)   Discuss an oral contraceptive with increased estrogen.
C)   Request a decreased dose of carbamazepine.
D)   Stop taking the oral contraceptive immediately.

Question 15

A patient is taking a combination oral contraceptive (OC) and reports breast tenderness, edema, and occasional nausea. What will the nurse recommend?

Accepted Answer

A)   The patient should ask her provider about an OC with less progestin.
B)   The patient should discuss an alternate method of birth control.
C)   The patient should request an OC containing less estrogen.
D)   The patient should take the OC at bedtime to reduce side effects.

Question 16

A patient is taking a combination oral contraceptive (OC) and tells the nurse that she is planning to undergo knee replacement surgery in 2 months. What will the nurse recommend for this patient?

Accepted Answer

A)   The patient should ask her provider about an OC with less progestin.
B)   The patient should discuss an alternate method of birth control prior to surgery.
C)   The patient should request an OC containing less estrogen after surgery.
D)   The patient should take the OC at bedtime after her surgery to reduce side effects.

Question 17

A patient has just purchased a 1-year supply of 28-day-cycle oral contraceptives. She tells the nurse she wishes she had planned things better, because she has calculated that her period will begin during her upcoming honeymoon. What will the nurse suggest?

Accepted Answer

A)   She should discard the inert pills and start a new pack during the honeymoon.
B)   She should discontinue the oral contraceptives and use an alternative form of birth control.
C)   She should discuss a prescription for an extended-cycle product with her provider.
D)   She should discuss DMPA (Depo-Provera)  injections in addition to the OC with her provider.

Exam 62: Birth Control