NURSING 6005 CHAPTER 62: BIRTH CONTROL Test Bank

NURSING 6005 CHAPTER 62: BIRTH CONTROL Test Bank MULTIPLE CHOICE 1. 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? 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 ANS: C Women at risk for sexually transmitted diseases (STDs) should not use an IUD, because the risk of infection is higher. Women who have multiple sexual partners are especially at risk for STDs. Monogamous married women are less apt to contract STDs. Women with rosacea can use an IUD. DIF: Cognitive Level: Application REF: Selecting a Birth Control Method TOP: Nursing Process: Planning MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 2. 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? a. An intrauterine device with a spermicide b. DMPA (Depo-Provera) and condoms c. Tubal ligation and condoms d. Progestin-only oral contraceptives ANS: B This patient has demonstrated a previous history of nonadherence, so a long-acting contraceptive would be more effective for her. Because she has multiple sexual partners, she should use a condom for protection against STDs. An IUD is not indicated for her; patients with multiple sexual partners who use IUDs are at greater risk for STDs. Tubal ligation carries surgical risks and should not be used by young women, because it is irreversible. Progestin-only oral contraceptives must be taken every day. DIF: Cognitive Level: Application REF: Selecting a Birth Control Method TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 3. A patient is taking a combination oral contraceptive (OC) and reports breast tenderness, edema, and occasional nausea. What will the nurse recommend? 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. ANS: C Breast tenderness, edema, and nausea are associated with estrogen; women experiencing these side effects may benefit from an OC with a lower estrogen dose. Lowering the progestin will not decrease these symptoms. It is not necessary to change birth control methods if side effects can be managed by altering the estrogen dose. Taking the OC at bedtime will not affect the symptoms. DIF: Cognitive Level: Application REF: Oral Contraceptives | Combination Oral Contraceptives | Adverse Effects | Effects Related to Estrogen or Progestin Imbalance TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 4. 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? 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. ANS: B When changing one combination OC for another, the change is best made at the beginning of a new cycle. It is not correct to begin taking the new product immediately; to stop the old product 1 week before starting the new product; or to use an alternate method of birth control between regimens. DIF: Cognitive Level: Application REF: Oral Contraceptives | Combination Oral Contraceptives | Adverse Effects | Effects Related to Estrogen or Progestin Imbalance TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 5. 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? 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. ANS: B Carbamazepine induces hepatic cytochrome P450 and thus accelerates the metabolism of oral contraceptives. Spotting is a sign of reduced OC blood levels; patients experiencing this symptom may need an increased estrogen dose. If the dose of OC is not changed, the woman may use condoms along with the OC. Reducing the dose of carbamazepine is not correct. Discontinuing the OC immediately is not correct. DIF: Cognitive Level: Application REF: Oral Contraceptives | Combination Oral Contraceptives | Drug Interactions | Drugs and Herbs That Reduce the Effects of OCs TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies