CMN 572 EVALUATION EXAMS QUESTIONS AND
ANSWERS SET A+
✔✔What do Mirena, Skyla, Liletta, and Kyleena all have in common? - ✔✔They are all
progestin-only IUD's; Highly effective with a duration of 3-5 years
✔✔Alicia is a 17 y.o sickle cell patient. She has a hx of DVT. What is your suggestion
for contraception? - ✔✔Depo Shot- b/c it decreases frequency of sickle cell crisis
✔✔How often do you administer Dep-Provera? What are its advantages? -
✔✔Administered IM q12 weeks; Advantages include: decreased risk of ectopic
pregnancy, endometrial cancer, decreased frequency of sickle cell crises, improvement
in endometriosis, and it may be used immediately post-partum by breastfeeding mom
✔✔What are the SE's/risks of Depo-Provera? - ✔✔Decreases bone density
(recommend calcium supplement), irregular/prolonged bleeding (especially during first 6
months), weight gain, mood changes/depression
✔✔Nexplanon contains what hormone(s)? - ✔✔Progestin Only
✔✔How long is Nexplanon effective for? - ✔✔3 years
✔✔Monica is interested in Nexplanon. Her BMI is 33%. What should you tell her? -
✔✔Nexplanon may be LESS EFFECTIVE in overweight women
✔✔Monica is interested in Nexplanon. She wants to know the advantages to
NExplanon? - ✔✔Reversible, convenient, long-term, highly effective, no estrogen,
improvement in dysmenorrhea and heavy menses
✔✔What are the SE's/risks to Nexplanon? - ✔✔Irregular menses, follicular cysts
(usually resolve on own), Use with caution in women w/ DM, depression, HTN. Some
women have fluid retention, increase in acne, or weight gain
,✔✔What are the contraindications to Nexplanon? - ✔✔PREGNANCY, current or hx of
thrombosis, liver tumors, benign/malignant or active liver disease,
undiagnosed/abnormal genital bleeding, hx or active breast cancer or progestin-
sensitive cancer, allergic to any components
✔✔What is the non-hormonal IUD? - ✔✔Paragard or Copper T IUD
✔✔What are advantages to Paragard? - ✔✔No hormones, reliable for 10 years, can be
placed immediately post-delivery (higher risk of expulsion), or at 2nd post partum
month, can be used by breastfeeding moms, rapidly reversible fertility, approved as
emergency contraceptive if inserted within 7 days of unprotected sex (not an
abortifacient)
✔✔What are the SE's/contraindicatios to Paragard? - ✔✔SE's: slightly heavier menses,
dysmenorrhea, increased risk of PID, ectopic pregnancy, expulsion, perforation of
uterus during insertion, risk to fetus if pregnancy occurs
CONTRAINDICATIONS: Pregnancy!!!, uterine abnormalities, acute PID, endometrial
infection in past 3 months, uterine/cervical cancer, undiagnosed vaginal bleeding, acute
mucupurulent cervicitis, Wilson's disease, allergy to components
✔✔What is the only contraindication known to any emergency contraception (except
copper IUD)? - ✔✔known current pregnancy
✔✔When can the Plan-B pill be used to prevent pregnancy? (what length of time) -
✔✔within 72 hours after unprotected sex
✔✔What are the side effects to Plan B? - ✔✔Nausea, abdominal pain, spotting,
menstrual changes for current cycle
✔✔What are side effects to Ella (EC)? - ✔✔Headache, nausea, abdominal pain,
menstrual changes
✔✔Renee had an IUD placed today in clinic. When should she follow up? - ✔✔4-6
weeks (re-check placement), then yearly
✔✔When is the appropriate f/u for pills, patches, rings? - ✔✔In 3 months, then yearly
✔✔What does the ACHES warning signs stand for? - ✔✔Abdominal pain, Chest pain,
Headache, Eye problems, Severe leg pain
✔✔What are the most common side effects to OCP's? - ✔✔Nausea and fatigue
, ✔✔When following the quick start method, what is needed if it's been > 5 days since
last menses and unprotected sex? - ✔✔urine pregnancy test
✔✔Educate your patient to expect _______________ for the first 3-6 months. This is
the most common reason women d/c their OCP's. - ✔✔BTB
✔✔Estrogen sensitive women may have heavy menstruation, nausea at midcycle,
large/painful breasts, and should be prescribed an OCP with? - ✔✔LOW estrogen
activity: POP's or those w/ 20 mcg EE
✔✔Mindy has edema, abdominal bloating, headaches and depression premenstrually.
You recognize that she is progesterone sensitive. She should be prescribed an OCP
with ? - ✔✔LOW progestational OC or a tri-phasic pill: (POPs, Alesses, Yaz
✔✔Lolita has scant menses, small breasts and midcycle spotting. You recognize that
she is estrogen deficient based off of her symptoms. What OCP is appropriate to
prescribe? - ✔✔COC with 20-25 mcg EE
✔✔Paula has prolonged menses, heavy menses, severe cramping, and BTB. What
OCP is appropriate for this progesterone deficient woman? - ✔✔COC w/ increased
progestational and/or androgenic activities (loEstrin, seasonale, seasonique, LoOvral)
✔✔When should a NP be concerned about migraines in a patient taking OCP's? - ✔✔If
the migraine is new onset or worsening- do not continue pills
Do not start OCP's in patients with migraine w/ aura
If patient has hx of premenstrual migraines, a continuous regimen may help (usually it's
the drop in estrogen that causes the headache)
✔✔When is it ok to institute POP's, Depo, or IUD before six weeks post-partum? - ✔✔If
the patient would be at high risk if another pregnancy occurred
✔✔What should be done for a patient with pre-existing HTN wanting BC? - ✔✔Refer to
OB/GYN- COC's increase angiotensin II and may cause fluid retention. Consider non-
hormonal forms of BC, such as Paragard
✔✔Mucopurulent endocervical discharge indicates? - ✔✔C. Trachomatis
✔✔How do we treat uncomplicated C. Trachomatis? - ✔✔Azithromycin 1 G x Single
Dose
OR
Doxycycline 100mg po BID x 7 days
✔✔How is C. Trachomatis treated in pregnant women? - ✔✔Azithromycin 1 G x
SINGLE DOSE
ANSWERS SET A+
✔✔What do Mirena, Skyla, Liletta, and Kyleena all have in common? - ✔✔They are all
progestin-only IUD's; Highly effective with a duration of 3-5 years
✔✔Alicia is a 17 y.o sickle cell patient. She has a hx of DVT. What is your suggestion
for contraception? - ✔✔Depo Shot- b/c it decreases frequency of sickle cell crisis
✔✔How often do you administer Dep-Provera? What are its advantages? -
✔✔Administered IM q12 weeks; Advantages include: decreased risk of ectopic
pregnancy, endometrial cancer, decreased frequency of sickle cell crises, improvement
in endometriosis, and it may be used immediately post-partum by breastfeeding mom
✔✔What are the SE's/risks of Depo-Provera? - ✔✔Decreases bone density
(recommend calcium supplement), irregular/prolonged bleeding (especially during first 6
months), weight gain, mood changes/depression
✔✔Nexplanon contains what hormone(s)? - ✔✔Progestin Only
✔✔How long is Nexplanon effective for? - ✔✔3 years
✔✔Monica is interested in Nexplanon. Her BMI is 33%. What should you tell her? -
✔✔Nexplanon may be LESS EFFECTIVE in overweight women
✔✔Monica is interested in Nexplanon. She wants to know the advantages to
NExplanon? - ✔✔Reversible, convenient, long-term, highly effective, no estrogen,
improvement in dysmenorrhea and heavy menses
✔✔What are the SE's/risks to Nexplanon? - ✔✔Irregular menses, follicular cysts
(usually resolve on own), Use with caution in women w/ DM, depression, HTN. Some
women have fluid retention, increase in acne, or weight gain
,✔✔What are the contraindications to Nexplanon? - ✔✔PREGNANCY, current or hx of
thrombosis, liver tumors, benign/malignant or active liver disease,
undiagnosed/abnormal genital bleeding, hx or active breast cancer or progestin-
sensitive cancer, allergic to any components
✔✔What is the non-hormonal IUD? - ✔✔Paragard or Copper T IUD
✔✔What are advantages to Paragard? - ✔✔No hormones, reliable for 10 years, can be
placed immediately post-delivery (higher risk of expulsion), or at 2nd post partum
month, can be used by breastfeeding moms, rapidly reversible fertility, approved as
emergency contraceptive if inserted within 7 days of unprotected sex (not an
abortifacient)
✔✔What are the SE's/contraindicatios to Paragard? - ✔✔SE's: slightly heavier menses,
dysmenorrhea, increased risk of PID, ectopic pregnancy, expulsion, perforation of
uterus during insertion, risk to fetus if pregnancy occurs
CONTRAINDICATIONS: Pregnancy!!!, uterine abnormalities, acute PID, endometrial
infection in past 3 months, uterine/cervical cancer, undiagnosed vaginal bleeding, acute
mucupurulent cervicitis, Wilson's disease, allergy to components
✔✔What is the only contraindication known to any emergency contraception (except
copper IUD)? - ✔✔known current pregnancy
✔✔When can the Plan-B pill be used to prevent pregnancy? (what length of time) -
✔✔within 72 hours after unprotected sex
✔✔What are the side effects to Plan B? - ✔✔Nausea, abdominal pain, spotting,
menstrual changes for current cycle
✔✔What are side effects to Ella (EC)? - ✔✔Headache, nausea, abdominal pain,
menstrual changes
✔✔Renee had an IUD placed today in clinic. When should she follow up? - ✔✔4-6
weeks (re-check placement), then yearly
✔✔When is the appropriate f/u for pills, patches, rings? - ✔✔In 3 months, then yearly
✔✔What does the ACHES warning signs stand for? - ✔✔Abdominal pain, Chest pain,
Headache, Eye problems, Severe leg pain
✔✔What are the most common side effects to OCP's? - ✔✔Nausea and fatigue
, ✔✔When following the quick start method, what is needed if it's been > 5 days since
last menses and unprotected sex? - ✔✔urine pregnancy test
✔✔Educate your patient to expect _______________ for the first 3-6 months. This is
the most common reason women d/c their OCP's. - ✔✔BTB
✔✔Estrogen sensitive women may have heavy menstruation, nausea at midcycle,
large/painful breasts, and should be prescribed an OCP with? - ✔✔LOW estrogen
activity: POP's or those w/ 20 mcg EE
✔✔Mindy has edema, abdominal bloating, headaches and depression premenstrually.
You recognize that she is progesterone sensitive. She should be prescribed an OCP
with ? - ✔✔LOW progestational OC or a tri-phasic pill: (POPs, Alesses, Yaz
✔✔Lolita has scant menses, small breasts and midcycle spotting. You recognize that
she is estrogen deficient based off of her symptoms. What OCP is appropriate to
prescribe? - ✔✔COC with 20-25 mcg EE
✔✔Paula has prolonged menses, heavy menses, severe cramping, and BTB. What
OCP is appropriate for this progesterone deficient woman? - ✔✔COC w/ increased
progestational and/or androgenic activities (loEstrin, seasonale, seasonique, LoOvral)
✔✔When should a NP be concerned about migraines in a patient taking OCP's? - ✔✔If
the migraine is new onset or worsening- do not continue pills
Do not start OCP's in patients with migraine w/ aura
If patient has hx of premenstrual migraines, a continuous regimen may help (usually it's
the drop in estrogen that causes the headache)
✔✔When is it ok to institute POP's, Depo, or IUD before six weeks post-partum? - ✔✔If
the patient would be at high risk if another pregnancy occurred
✔✔What should be done for a patient with pre-existing HTN wanting BC? - ✔✔Refer to
OB/GYN- COC's increase angiotensin II and may cause fluid retention. Consider non-
hormonal forms of BC, such as Paragard
✔✔Mucopurulent endocervical discharge indicates? - ✔✔C. Trachomatis
✔✔How do we treat uncomplicated C. Trachomatis? - ✔✔Azithromycin 1 G x Single
Dose
OR
Doxycycline 100mg po BID x 7 days
✔✔How is C. Trachomatis treated in pregnant women? - ✔✔Azithromycin 1 G x
SINGLE DOSE
