Fitz test 3 With 75 Test Questions
A patient is currently taking combined oral contraception and now
wants a progestin IUD. The first day of her last period was 10 days ago
and she denies having heterosexual intercourse since then. What is the
best course of action?
A. Insert the progestin IUD within 5 days of the next menstrual period
B. Insert the progestin IUD now but advise a barrier method of
contraception for two weeks
C. Insert the progestin IUD now but continue COC for one week
D. Insert the progestin IUD today and advise that no additional
contraceptive method is needed - Correct Answer ✔️✔️D. Insert
the progestin IUD today and advise that no additional contraceptive
method is needed
,The progestin IUD can be inserted and presumed to confer protection
immediately. There is no requirement to wait until the next period and
no reason to advise a back-up contraceptive method. A pregnancy test
is not needed given her recent sexual history.
Ana is a 30-year-old woman who had her third child 3 months ago. She
has not had what she would call "a normal period" since giving birth.
Ana discontinued breastfeeding approximately 8 weeks ago, and she
has not had any vaginal bleeding for almost two weeks. She wants to
have a progestin implant (Nexplanon) inserted. A urine pregnancy test
is negative, but she does report having had unprotected sex
approximately two weeks ago. The best action would be to:
A. Insert the implant today but advise Ana to use a backup method for
one week.
,B. Tell Ana that she is not a candidate for the implant until she has had
a normal menstrual cycle.
C. Offer Ana another method of contraception and insert the implant
within 5 days of the start of her next menstrual period.
D. Suggest to Ana that a progestin IUD would be more appropriate if
she wants insertion today. - Correct Answer ✔️✔️C. Offer Ana
another method of contraception and insert the implant within 5 days
of the start of her next menstrual period.
Because Ana's last episode of vaginal bleeding was more than two
weeks ago and she has had unprotected sex, she is not a candidate for
implant insertion today. While she does not need to go through an
entire "normal" cycle, the implant should not be inserted until she
begins her next period. Therefore, the best advice is to suggest another
method of contraception, such as the pill/patch/ring or barrier, and
then schedule her for insertion of the implant within 5 days of the start
, of her next period. The guidelines for a progestin IUD are the same as
those for progestin implants, therefore a progestin IUD is not an
appropriate alternative.
A 26-year-old well woman wants to begin injection contraception
(medroxyprogesterone depot {Depo-Provera}) today. Her last
menstrual period began 4 days ago. The nurse practitioner informs the
patient that:
A. She will have her first injection today and should return in 3 months
for the next one.
B. A urine pregnancy test is required and if the result is negative, she is
able to have her first injection today.
C. The first injection must be given on the first day of the menstrual
period; she will need to use another method this month and return
next month.
A patient is currently taking combined oral contraception and now
wants a progestin IUD. The first day of her last period was 10 days ago
and she denies having heterosexual intercourse since then. What is the
best course of action?
A. Insert the progestin IUD within 5 days of the next menstrual period
B. Insert the progestin IUD now but advise a barrier method of
contraception for two weeks
C. Insert the progestin IUD now but continue COC for one week
D. Insert the progestin IUD today and advise that no additional
contraceptive method is needed - Correct Answer ✔️✔️D. Insert
the progestin IUD today and advise that no additional contraceptive
method is needed
,The progestin IUD can be inserted and presumed to confer protection
immediately. There is no requirement to wait until the next period and
no reason to advise a back-up contraceptive method. A pregnancy test
is not needed given her recent sexual history.
Ana is a 30-year-old woman who had her third child 3 months ago. She
has not had what she would call "a normal period" since giving birth.
Ana discontinued breastfeeding approximately 8 weeks ago, and she
has not had any vaginal bleeding for almost two weeks. She wants to
have a progestin implant (Nexplanon) inserted. A urine pregnancy test
is negative, but she does report having had unprotected sex
approximately two weeks ago. The best action would be to:
A. Insert the implant today but advise Ana to use a backup method for
one week.
,B. Tell Ana that she is not a candidate for the implant until she has had
a normal menstrual cycle.
C. Offer Ana another method of contraception and insert the implant
within 5 days of the start of her next menstrual period.
D. Suggest to Ana that a progestin IUD would be more appropriate if
she wants insertion today. - Correct Answer ✔️✔️C. Offer Ana
another method of contraception and insert the implant within 5 days
of the start of her next menstrual period.
Because Ana's last episode of vaginal bleeding was more than two
weeks ago and she has had unprotected sex, she is not a candidate for
implant insertion today. While she does not need to go through an
entire "normal" cycle, the implant should not be inserted until she
begins her next period. Therefore, the best advice is to suggest another
method of contraception, such as the pill/patch/ring or barrier, and
then schedule her for insertion of the implant within 5 days of the start
, of her next period. The guidelines for a progestin IUD are the same as
those for progestin implants, therefore a progestin IUD is not an
appropriate alternative.
A 26-year-old well woman wants to begin injection contraception
(medroxyprogesterone depot {Depo-Provera}) today. Her last
menstrual period began 4 days ago. The nurse practitioner informs the
patient that:
A. She will have her first injection today and should return in 3 months
for the next one.
B. A urine pregnancy test is required and if the result is negative, she is
able to have her first injection today.
C. The first injection must be given on the first day of the menstrual
period; she will need to use another method this month and return
next month.
