Chapter 54: Contraceptives

Chapter 54: Contraceptives

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A 40-year-old woman tells the primary care nurse practitioner (NP) that she does not want more children and would like a contraceptive. She does not smoke and has no personal or family history of cardiovascular disease. She has frequent tension headaches. For this patient, the NP should prescribe:

ANS:  D

Low-estrogen COCPs are recommended for women older than 40 with or without cardiovascular risk. Monophasic COCPs are recommended for women with migraine headaches. Condoms are more useful for preventing sexually transmitted diseases and not as reliable as contraception. Tubal ligation has surgical risks.

DIF:    Cognitive Level: Applying (Application)                           REF:   619

2. A primary care NP prescribes a COCP for a woman who has never taken oral contraceptives before. The woman is in a monogamous relationship, and she and her partner have been using condoms and wish to stop using them. Her last period was 1 week ago. The NP should:

ANS:  B

To start COCPs using the quick start method, the woman takes the first pill on the day of her office visit and uses a barrier method such as condoms for the first 7 days. The patient should be reasonably sure she is not pregnant; she can take a pregnancy test in 2 to 3 weeks if pregnancy is suspected later. If she is pregnant, taking the COCPs would not negatively affect early pregnancy.

DIF:    Cognitive Level: Applying (Application)                           REF:   617

3. A woman who began taking a COCP 2 months ago calls the primary care NP to report having nausea every day. She takes a pill at the same time each morning. The NP should tell her to:

ANS:  A

If nausea occurs when taking the pill, patients should be instructed to switch to the opposite time of day or to take with food. A urine pregnancy test is not indicated. If nausea occurs, patients should take the pill with food. Patients stop taking pills for 7 days at the end of each 21-day pack.

DIF:    Cognitive Level: Applying (Application)                           REF:   617

4. The primary care NP prescribes an extended-cycle monophasic pill regimen for a young woman who reports having multiple partners. Which statement by the patient indicates she understands the regimen?

ANS:  B

The extended-cycle pills have fewer pill-free intervals, so women have only four periods a year. Patients take pills every day. Because this patient has multiple partners, she should continue to use condoms. This type of pill has the same side effects as other types.

DIF:    Cognitive Level: Applying (Application)                           REF:   622