TEST BANK For Maternity and Women's Health Care
A woman has 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. - ANSWER-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
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." -
ANSWER-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.
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.
- ANSWER-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
,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." - ANSWER-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.
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. - ANSWER-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.
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 - ANSWER-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.
A woman will be taking oral contraceptives using a 28-day pack. What advice should
the nurse provide to protect this client from an unintended pregnancy? a. Limit sexual
contact for one cycle after starting the pill. b. Use condoms and foam instead of the pill
for as long as the client takes an antibiotic. c. Take one pill at the same time every day.
d. Throw away the pack and use a backup method if two pills are missed during week 1
of her cycle. - ANSWER-ANS: C To maintain adequate hormone levels for
contraception and to enhance compliance, clients should take oral contraceptives at the
same time each day. If contraceptives are to be started at any time other than during
normal menses or within 3 weeks after birth or an abortion, then another method of
contraception should be used through the first week to prevent the risk of pregnancy.
Taken exactly as directed, oral contraceptives prevent ovulation, and pregnancy cannot
occur. No strong pharmacokinetic evidence indicates a link between the use of broad-
spectrum antibiotics and altered hormonal levels in oral contraceptive users. If the client
,misses two pills during week 1, then she should take two pills a day for 2 days and
finish the package and use a backup contraceptive method for the next 7 consecutive
days.
Which information is most important to provide to the client interested in using the
lactational amenorrhea method for contraception? a. LAM is effective until the infant is 9
months of age. b. This popular method of birth control works best if the mother is
exclusively breastfeeding. c. Its typical failure rate is 5%. d. Feeding intervals should be
6 hours during the day. - ANSWER-ANS: B The LAM works best if the mother is
exclusively or almost exclusively breastfeeding. Disruption of the breastfeeding pattern
increases the risk of pregnancy. After the infant is 6 months of age or menstrual flow
has resumed, effectiveness decreases. The typical failure rate is 1% to 2%. Feeding
intervals should be no greater than 4 hours during the day and 6 hours at night.
Which term best describes the conscious decision concerning deciding when to
conceive or avoid pregnancy as opposed to the intentional prevention of pregnancy
during intercourse? a. Family planning b. Birth control c. Contraception d. Assisted
reproductive therapy - ANSWER-ANS: A Family planning is the process of deciding
when and if to have children. Birth control is the device and/or practice used to reduce
the risk of conceiving or bearing children. Contraception is the intentional prevention of
pregnancy during sexual intercourse. Assisted reproductive therapy is one of several
possible treatments for infertility.
In the acronym BRAIDED, which letter is used to identify the key components of
informed consent that the nurse must document? a. B stands for birth control. b. R
stands for reproduction. c. A stands for alternatives. d. I stands for ineffective. -
ANSWER-ANS: C In the acronym BRAIDED, A stands for alternatives and information
about other viable methods. B stands for benefits and information about the advantages
of a particular birth control method and its success rates. R stands for risks and
information about the disadvantages of a particular method and its failure rates. I stands
for inquiries and the opportunity to ask questions.
The nurse is providing contraceptive instruction to a young couple who are eager to
learn. The nurse should be cognizant of which information regarding the natural family
planning method? a. The natural family planning method is the same as coitus
interruptus or "pulling out." b. This contraception method uses the calendar method to
align the woman's cycle with the natural phases of the moon. c. This practice is the only
contraceptive method acceptable to the Roman Catholic Church. d. The natural family
planning method relies on barrier methods during the fertility phases. - ANSWER-ANS:
C Natural family planning is the only contraceptive practice acceptable to the Roman
Catholic Church. "Pulling out" is not the same as periodic abstinence, another name for
natural family planning. The phases of the moon are not part of the calendar method or
any method. Natural family planning is another name for periodic abstinence, which is
the accepted way to pass safely through the fertility phases without relying on chemical
or physical barriers.
, Which contraceptive method should the nurse identify as protecting against sexually
transmitted infections (STIs) and the human immunodeficiency virus (HIV)? a. Periodic
abstinence b. Barrier methods c. Hormonal methods d. Same protection with all
methods - ANSWER-ANS: B Barrier methods, such as condoms, protect against STIs
and the HIV the best of all contraceptive methods. Periodic abstinence and hormonal
methods, such as birth control pills, offer no protection against STIs or the HIV.
Nurses should be cognizant of what information regarding the non-contraceptive
medical effects of combination oral contraceptives (COCs)? a. COCs can cause TSS if
the prescription is wrong. b. Hormonal withdrawal bleeding is usually a little more
profuse than in normal menstruation and lasts a week for those who use COCs. c.
COCs increase the risk of endometrial and ovarian cancers. d. Effectiveness of COCs
can be altered by some over-the-counter medications and herbal supplements. -
ANSWER-ANS: D The effectiveness of COCs can be altered by some over-the-counter
medications and herbal supplements. TSS can occur in some who use the diaphragm,
but it is not a consequence of taking oral contraceptive pills. Hormonal withdrawal
bleeding usually is lighter than in normal menstruation and lasts a couple of days. Oral
contraceptive pills offer protection against the risk of endometrial and ovarian cancers.
Importantly, the nurse must be aware of which information related to the use of
intrauterine devices (IUDs)? a. Return to fertility can take several weeks after the device
is removed. b. Copper IUDs can serve as an emergency contraception under certain
situations. c. IUDs offer the same protection against STIs as the diaphragm. d. Consent
forms are not needed for IUD insertion. - ANSWER-ANS: B The woman has up to 5
days to insert the IUD after unprotected sex. The return to fertility is immediate after the
removal of the IUD. IUDs offer no protection against STIs. A consent form is required for
insertion, as is a negative pregnancy test.
A woman is using the basal body temperature (BBT) method of contraception. She calls
the clinic and tells the nurse, "My period is due in a few days, and my temperature has
not gone up." What is the nurse's most appropriate response? a. "This probably means
that you're pregnant." b. "Don't worry; it's probably nothing." c. "Have you been sick this
month?" d. "You probably didn't ovulate during this cycle." - ANSWER-ANS: D The
absence of a temperature decrease most likely is the result of a lack of ovulation.
Pregnancy cannot occur without ovulation, which is being measured using the BBT
method. A comment such as, "Don't worry; it's probably nothing," discredits the client's
concerns. Illness is most likely the cause of an increase in BBT.
A male client asks the nurse why it is better to purchase condoms that are not lubricated
with nonoxynol-9 (a common spermicide). Which response by the nurse is the most
accurate? a. "The lubricant prevents vaginal irritation." b. "Nonoxynol-9 does not provide
protection against STIs as originally thought" c. "The additional lubrication improves
sex." d. "Nonoxynol-9 improves penile sensitivity." - ANSWER-ANS: B Nonoxynol-9
does not provide protection against STIs as originally thought; it has also been linked to
an increase in the transmission of the HIV and can cause genital lesions. Nonoxynol-9
A woman has 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. - ANSWER-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
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." -
ANSWER-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.
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.
- ANSWER-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
,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." - ANSWER-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.
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. - ANSWER-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.
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 - ANSWER-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.
A woman will be taking oral contraceptives using a 28-day pack. What advice should
the nurse provide to protect this client from an unintended pregnancy? a. Limit sexual
contact for one cycle after starting the pill. b. Use condoms and foam instead of the pill
for as long as the client takes an antibiotic. c. Take one pill at the same time every day.
d. Throw away the pack and use a backup method if two pills are missed during week 1
of her cycle. - ANSWER-ANS: C To maintain adequate hormone levels for
contraception and to enhance compliance, clients should take oral contraceptives at the
same time each day. If contraceptives are to be started at any time other than during
normal menses or within 3 weeks after birth or an abortion, then another method of
contraception should be used through the first week to prevent the risk of pregnancy.
Taken exactly as directed, oral contraceptives prevent ovulation, and pregnancy cannot
occur. No strong pharmacokinetic evidence indicates a link between the use of broad-
spectrum antibiotics and altered hormonal levels in oral contraceptive users. If the client
,misses two pills during week 1, then she should take two pills a day for 2 days and
finish the package and use a backup contraceptive method for the next 7 consecutive
days.
Which information is most important to provide to the client interested in using the
lactational amenorrhea method for contraception? a. LAM is effective until the infant is 9
months of age. b. This popular method of birth control works best if the mother is
exclusively breastfeeding. c. Its typical failure rate is 5%. d. Feeding intervals should be
6 hours during the day. - ANSWER-ANS: B The LAM works best if the mother is
exclusively or almost exclusively breastfeeding. Disruption of the breastfeeding pattern
increases the risk of pregnancy. After the infant is 6 months of age or menstrual flow
has resumed, effectiveness decreases. The typical failure rate is 1% to 2%. Feeding
intervals should be no greater than 4 hours during the day and 6 hours at night.
Which term best describes the conscious decision concerning deciding when to
conceive or avoid pregnancy as opposed to the intentional prevention of pregnancy
during intercourse? a. Family planning b. Birth control c. Contraception d. Assisted
reproductive therapy - ANSWER-ANS: A Family planning is the process of deciding
when and if to have children. Birth control is the device and/or practice used to reduce
the risk of conceiving or bearing children. Contraception is the intentional prevention of
pregnancy during sexual intercourse. Assisted reproductive therapy is one of several
possible treatments for infertility.
In the acronym BRAIDED, which letter is used to identify the key components of
informed consent that the nurse must document? a. B stands for birth control. b. R
stands for reproduction. c. A stands for alternatives. d. I stands for ineffective. -
ANSWER-ANS: C In the acronym BRAIDED, A stands for alternatives and information
about other viable methods. B stands for benefits and information about the advantages
of a particular birth control method and its success rates. R stands for risks and
information about the disadvantages of a particular method and its failure rates. I stands
for inquiries and the opportunity to ask questions.
The nurse is providing contraceptive instruction to a young couple who are eager to
learn. The nurse should be cognizant of which information regarding the natural family
planning method? a. The natural family planning method is the same as coitus
interruptus or "pulling out." b. This contraception method uses the calendar method to
align the woman's cycle with the natural phases of the moon. c. This practice is the only
contraceptive method acceptable to the Roman Catholic Church. d. The natural family
planning method relies on barrier methods during the fertility phases. - ANSWER-ANS:
C Natural family planning is the only contraceptive practice acceptable to the Roman
Catholic Church. "Pulling out" is not the same as periodic abstinence, another name for
natural family planning. The phases of the moon are not part of the calendar method or
any method. Natural family planning is another name for periodic abstinence, which is
the accepted way to pass safely through the fertility phases without relying on chemical
or physical barriers.
, Which contraceptive method should the nurse identify as protecting against sexually
transmitted infections (STIs) and the human immunodeficiency virus (HIV)? a. Periodic
abstinence b. Barrier methods c. Hormonal methods d. Same protection with all
methods - ANSWER-ANS: B Barrier methods, such as condoms, protect against STIs
and the HIV the best of all contraceptive methods. Periodic abstinence and hormonal
methods, such as birth control pills, offer no protection against STIs or the HIV.
Nurses should be cognizant of what information regarding the non-contraceptive
medical effects of combination oral contraceptives (COCs)? a. COCs can cause TSS if
the prescription is wrong. b. Hormonal withdrawal bleeding is usually a little more
profuse than in normal menstruation and lasts a week for those who use COCs. c.
COCs increase the risk of endometrial and ovarian cancers. d. Effectiveness of COCs
can be altered by some over-the-counter medications and herbal supplements. -
ANSWER-ANS: D The effectiveness of COCs can be altered by some over-the-counter
medications and herbal supplements. TSS can occur in some who use the diaphragm,
but it is not a consequence of taking oral contraceptive pills. Hormonal withdrawal
bleeding usually is lighter than in normal menstruation and lasts a couple of days. Oral
contraceptive pills offer protection against the risk of endometrial and ovarian cancers.
Importantly, the nurse must be aware of which information related to the use of
intrauterine devices (IUDs)? a. Return to fertility can take several weeks after the device
is removed. b. Copper IUDs can serve as an emergency contraception under certain
situations. c. IUDs offer the same protection against STIs as the diaphragm. d. Consent
forms are not needed for IUD insertion. - ANSWER-ANS: B The woman has up to 5
days to insert the IUD after unprotected sex. The return to fertility is immediate after the
removal of the IUD. IUDs offer no protection against STIs. A consent form is required for
insertion, as is a negative pregnancy test.
A woman is using the basal body temperature (BBT) method of contraception. She calls
the clinic and tells the nurse, "My period is due in a few days, and my temperature has
not gone up." What is the nurse's most appropriate response? a. "This probably means
that you're pregnant." b. "Don't worry; it's probably nothing." c. "Have you been sick this
month?" d. "You probably didn't ovulate during this cycle." - ANSWER-ANS: D The
absence of a temperature decrease most likely is the result of a lack of ovulation.
Pregnancy cannot occur without ovulation, which is being measured using the BBT
method. A comment such as, "Don't worry; it's probably nothing," discredits the client's
concerns. Illness is most likely the cause of an increase in BBT.
A male client asks the nurse why it is better to purchase condoms that are not lubricated
with nonoxynol-9 (a common spermicide). Which response by the nurse is the most
accurate? a. "The lubricant prevents vaginal irritation." b. "Nonoxynol-9 does not provide
protection against STIs as originally thought" c. "The additional lubrication improves
sex." d. "Nonoxynol-9 improves penile sensitivity." - ANSWER-ANS: B Nonoxynol-9
does not provide protection against STIs as originally thought; it has also been linked to
an increase in the transmission of the HIV and can cause genital lesions. Nonoxynol-9
