NURS 5362 WOMEN'S HEALTH EXAM ACTUAL QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
Why is Contraception Important?
annual pregnancies unintended (unwanted &/or mistimed) • highest risk: <20 yrs and >
40 yrs
NP Must Know these Things about the Patient • Medical h
Patient • Medical hx • Hx contraceptive use • did she stop a method and why? • Attitude
toward contraception • Sexual behavior • Understanding of own sexuality and feelings
about her body • Ability to make choices • Beliefs about contraception • Partner's
attitude & Cost and accessibility
Reasons for OC Discontinuation All Ages
Side effects 37%, Method difficulty 14%, Clinician recommended 9%
Who Uses What in the USA?
OCPs 26% • Sterilization 24% • Condom 19% • Withdrawal 6%
Contraceptive Methods • Method Failure Rate (typical use)
Pregnancy % • None 85%, • Spermicide 26 • withdrawal 28 • FAM 19 • diaphragm 40 •
condom 19 • OCPs 9 • IUD 5 • Progestins LT 1 • Sterilization 1
Oral Contraceptives
Review the menstrual cycle or OCPs won't make sense to you, • MAJOR Action:
suppression of ovulation • Estrogen effects • ovulation inhibited by inhibition
FSH/LH • uterine secretions altered • acceleration ovum transport • Progestin
, effects • suppression LH inhibits ovulation • cervical mucus thickens • ovum transport
slowed • alteration endometrium
• Systemic Hormonal Contraception (SHC)
COC combined oral contraceptives (E + P) • Pills • Patch • Vaginal ring
• POC progestin only contraceptives (P only)
• Pills • DMPA (Depo-Provera) • Implants
• Non-systemic
IUD (copper and progestin options) • Barrier methods (diaphragm, condom,
Foam/spermicide, sponge, cervical cap)
Teens & OCPs
Texas now denies minors access to contraceptive care w/o parental consent,
Adolescent Counseling • Counsel re right to say "no" to sex • Caution that OCs do not
prevent STDs • Discuss condom use: "How are you protecting yourself from HIV?" • Ask
how she plans to discuss condom use with her partner • Discuss emergency
contraception, Currently, all unmarried minors in Texas under age 17 who have sexual
contact must be reported as abused, unless there is documentation of "affirmative
defense"
Patient Question
• "What have you heard about using OCPs?" (or any method of contraception) • "What
experiences has a family member had with OCPs • "What concerns do you have or
would you have about using OCPs?
PREGNANCY STILL HAS A HIGHER ASSOCIATION MORBIDITY & MORTALITY
THAN ANY FORM OF CONTRACEPTION
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
Why is Contraception Important?
annual pregnancies unintended (unwanted &/or mistimed) • highest risk: <20 yrs and >
40 yrs
NP Must Know these Things about the Patient • Medical h
Patient • Medical hx • Hx contraceptive use • did she stop a method and why? • Attitude
toward contraception • Sexual behavior • Understanding of own sexuality and feelings
about her body • Ability to make choices • Beliefs about contraception • Partner's
attitude & Cost and accessibility
Reasons for OC Discontinuation All Ages
Side effects 37%, Method difficulty 14%, Clinician recommended 9%
Who Uses What in the USA?
OCPs 26% • Sterilization 24% • Condom 19% • Withdrawal 6%
Contraceptive Methods • Method Failure Rate (typical use)
Pregnancy % • None 85%, • Spermicide 26 • withdrawal 28 • FAM 19 • diaphragm 40 •
condom 19 • OCPs 9 • IUD 5 • Progestins LT 1 • Sterilization 1
Oral Contraceptives
Review the menstrual cycle or OCPs won't make sense to you, • MAJOR Action:
suppression of ovulation • Estrogen effects • ovulation inhibited by inhibition
FSH/LH • uterine secretions altered • acceleration ovum transport • Progestin
, effects • suppression LH inhibits ovulation • cervical mucus thickens • ovum transport
slowed • alteration endometrium
• Systemic Hormonal Contraception (SHC)
COC combined oral contraceptives (E + P) • Pills • Patch • Vaginal ring
• POC progestin only contraceptives (P only)
• Pills • DMPA (Depo-Provera) • Implants
• Non-systemic
IUD (copper and progestin options) • Barrier methods (diaphragm, condom,
Foam/spermicide, sponge, cervical cap)
Teens & OCPs
Texas now denies minors access to contraceptive care w/o parental consent,
Adolescent Counseling • Counsel re right to say "no" to sex • Caution that OCs do not
prevent STDs • Discuss condom use: "How are you protecting yourself from HIV?" • Ask
how she plans to discuss condom use with her partner • Discuss emergency
contraception, Currently, all unmarried minors in Texas under age 17 who have sexual
contact must be reported as abused, unless there is documentation of "affirmative
defense"
Patient Question
• "What have you heard about using OCPs?" (or any method of contraception) • "What
experiences has a family member had with OCPs • "What concerns do you have or
would you have about using OCPs?
PREGNANCY STILL HAS A HIGHER ASSOCIATION MORBIDITY & MORTALITY
THAN ANY FORM OF CONTRACEPTION
