Birth Control Methods Questions for CNM WHNP Exam
Your patient desires the use of spermicide as a method of contraception. For how many
hours after the last intercourse should they remain with the spermicide in place? -
ANSWER 6 hours
Your patient desires the use of FemCap (cervical cap). How many hours before
intercourse should they insert the cap? - ANSWER 15 mins before intercourse to form
suction.
Your patient would wish to use FemCap-cervical cap. What does this client need to use
along with the cap besides the cap? ANSWER Spermicide (nonoxynol-9).
Your patient would like to use FemCap-cervical cap. For how long can they keep the
cervical cap in place after intercourse? ANSWER Leave in place at least 6h and no
longer than 48h after sex.
Your patient would like to use the contraceptive sponge. How long after intercourse
does she need to keep the sponge in? How long can she LEAVE the sponge in after
intercourse? -ANSWER Leave in place for at least 6 hours after last intercourse. Do not
wear the sponge for more than 24-30h.
How long does a Cu IUD last? -ANSWER 10 years
How many years is the Skyla effective for? - ANSWER 3 years
How many years is the Liletta effective for? - ANSWER 5 years
How many years is the Mirena effective for? - ANSWER 5 years
,How many years is the Kyleena effective for? - ANSWER 5 years
Your patient wishes to initiate the Paragard and they are curious as to how it works.
What are the Paragards 3 MOAs? - ANSWER (1) inhibit sperm capacitation
(2) alters tubal/uterine transport of ovum
(3) enzymatic influence on endometrium
Your patients wants to start a LNG-IUD (progestin influence) and they want to know how
it works. What are the LNG-IUD 4 MOAs? - ANSWER (1) thickens cervical mucus
(2) produces atrophic endometrium
(3) slows ovum transport through tube
(4) inhibits sperm motility and fxn
Does NOT prevent ovulation.
Your patient would like to start an IUD and is worried about PID. For how many days
after the initial insertion of the IUD are you at risk for PID? -ANSWER 20 days.
Your patient wants to start an LNG-IUD but says she's been told that she must wait until
after her next period. What do you say to her? -ANSWER Not necessary to wait for
menses if can be reasonably certain that patient is not pregnant.
Your patient has just delivered. What do you know about timing of IUD placement?
-ANSWER Safe to place within 48h after delivery (vaginal or cesarean) or 4 weeks PP.
What is your risk for placing an IUD between >48h after delivery or <4 weeks PP?
-ANSWER Increased risk of uterine perforation.
Your patient has just received a Cu-IUD. What do you advise them regarding use of a
back up method? - ANSWER Back up method not necessary after placement of CuIUD.
, Your patient has just received a LNG-IUD. What do you advise them regarding use of a
back up method? - ANSWER Use a barrier method for the next 7 days.
Your patient had a Cu-IUD placed 3 months ago and presents to you complaining of
irregular bleeding. What do you counsel them regarding the bleeding and what do you
recommend for treatment? ANSWER Irregular bleeding is normal for the first 3 - 6
months of Cu-IUD. Recommend 5-7d NSAID to help decrease bleeding.
Your patient had a LNG-IUD placed 2 months ago and presents to you with complaints of
cramping, spotting, and dyspareunia. What are you concerned about for this patient? -
ANSWER Partial or complete expulsion, pregnancy
Your patient had a LNG-IUD placed 2 months ago and presents to your office with
cramping, spotting, and dyspareunia. You perform an exam and find the IUD is located
within the cervical canal. What is this presentation called and how do you manage it? -
ANSWER Partial expulsion
(1) Remove IUD
(2) R/o pregnancy + infection
(3) Replace IUD if patient desires
(4) Doxycycline for 5-7d
Your patient had a LNG-IUD placed 2 months ago and presents with cramping, spotting
and dyspareunia. Patient reports the other day she was able to feel the IUD in the vagina
and easily removed it. What is this presentation called and how do you manage it? -
ANSWER Complete expulsion
(1) Remove IUD if not already fully removed
(2) R/o pregnancy test
(3) Replace IUD if patient desires
Your patient desires the use of spermicide as a method of contraception. For how many
hours after the last intercourse should they remain with the spermicide in place? -
ANSWER 6 hours
Your patient desires the use of FemCap (cervical cap). How many hours before
intercourse should they insert the cap? - ANSWER 15 mins before intercourse to form
suction.
Your patient would wish to use FemCap-cervical cap. What does this client need to use
along with the cap besides the cap? ANSWER Spermicide (nonoxynol-9).
Your patient would like to use FemCap-cervical cap. For how long can they keep the
cervical cap in place after intercourse? ANSWER Leave in place at least 6h and no
longer than 48h after sex.
Your patient would like to use the contraceptive sponge. How long after intercourse
does she need to keep the sponge in? How long can she LEAVE the sponge in after
intercourse? -ANSWER Leave in place for at least 6 hours after last intercourse. Do not
wear the sponge for more than 24-30h.
How long does a Cu IUD last? -ANSWER 10 years
How many years is the Skyla effective for? - ANSWER 3 years
How many years is the Liletta effective for? - ANSWER 5 years
How many years is the Mirena effective for? - ANSWER 5 years
,How many years is the Kyleena effective for? - ANSWER 5 years
Your patient wishes to initiate the Paragard and they are curious as to how it works.
What are the Paragards 3 MOAs? - ANSWER (1) inhibit sperm capacitation
(2) alters tubal/uterine transport of ovum
(3) enzymatic influence on endometrium
Your patients wants to start a LNG-IUD (progestin influence) and they want to know how
it works. What are the LNG-IUD 4 MOAs? - ANSWER (1) thickens cervical mucus
(2) produces atrophic endometrium
(3) slows ovum transport through tube
(4) inhibits sperm motility and fxn
Does NOT prevent ovulation.
Your patient would like to start an IUD and is worried about PID. For how many days
after the initial insertion of the IUD are you at risk for PID? -ANSWER 20 days.
Your patient wants to start an LNG-IUD but says she's been told that she must wait until
after her next period. What do you say to her? -ANSWER Not necessary to wait for
menses if can be reasonably certain that patient is not pregnant.
Your patient has just delivered. What do you know about timing of IUD placement?
-ANSWER Safe to place within 48h after delivery (vaginal or cesarean) or 4 weeks PP.
What is your risk for placing an IUD between >48h after delivery or <4 weeks PP?
-ANSWER Increased risk of uterine perforation.
Your patient has just received a Cu-IUD. What do you advise them regarding use of a
back up method? - ANSWER Back up method not necessary after placement of CuIUD.
, Your patient has just received a LNG-IUD. What do you advise them regarding use of a
back up method? - ANSWER Use a barrier method for the next 7 days.
Your patient had a Cu-IUD placed 3 months ago and presents to you complaining of
irregular bleeding. What do you counsel them regarding the bleeding and what do you
recommend for treatment? ANSWER Irregular bleeding is normal for the first 3 - 6
months of Cu-IUD. Recommend 5-7d NSAID to help decrease bleeding.
Your patient had a LNG-IUD placed 2 months ago and presents to you with complaints of
cramping, spotting, and dyspareunia. What are you concerned about for this patient? -
ANSWER Partial or complete expulsion, pregnancy
Your patient had a LNG-IUD placed 2 months ago and presents to your office with
cramping, spotting, and dyspareunia. You perform an exam and find the IUD is located
within the cervical canal. What is this presentation called and how do you manage it? -
ANSWER Partial expulsion
(1) Remove IUD
(2) R/o pregnancy + infection
(3) Replace IUD if patient desires
(4) Doxycycline for 5-7d
Your patient had a LNG-IUD placed 2 months ago and presents with cramping, spotting
and dyspareunia. Patient reports the other day she was able to feel the IUD in the vagina
and easily removed it. What is this presentation called and how do you manage it? -
ANSWER Complete expulsion
(1) Remove IUD if not already fully removed
(2) R/o pregnancy test
(3) Replace IUD if patient desires
