Chapter 08: Contraception and Abortion Lowdermilk: Maternity & Women’s Health Care, 11th Edition

TEST BANK FOR MATERNITY & WOMEN’S HEALTH CARE 11TH EDITION BY LOWDERMILK Chapter 08: Contraception and Abortion Lowdermilk: Maternity & Women’s Health Care, 11th Edition MULTIPLE CHOICE 1. A woman has chosen the calendar method of conception control. Which is the most important action the nurse should perform during the assessment process? 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. CORRECT ANSWER: 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. DIF: Cognitive Level: Analyze REF: p. 174 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 2. A married couple is discussing alternatives for pregnancy prevention and has asked about fertility awareness methods (FAMs). Which response by the nurse is most appropriate? a. ―They‘re not very effective, and it is very likely that you‘ll get pregnant.‖ b. ―FAMs can be effective for many couples; however, they require motivation.‖ c. ―These methods have a few advantages and several health risks.‖ d. ―You would be much safer going on the pill and not having to worry.‖ CORRECT ANSWER: B FAMs are effective with proper vigilance about ovulatory changes in the body and with adherence to coitus intervals. FAMs are effective if correctly used by a woman with a regular menstrual cycle. The typical failure rate for all FAMs is 24% during the first year of use. FAMs have no associated health risks. The use of birth control has associated health risks. In addition, taking a pill daily requires compliance on the client‘s part. DIF: Cognitive Level: Apply REF: pp. 173-174 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 3. 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.‖ CORRECT ANSWER: 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. DIF: Cognitive Level: Apply REF: p. 184 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 4. A woman who has just undergone a first-trimester abortion will be using oral contraceptives. To protect against pregnancy, the client should be advised to do what? a. Avoid sexual contact for at least 10 days after starting the pill. b. Use condoms and foam for the first few weeks as a backup. c. Use another method of contraception for 1 week after starting the pill. d. Begin sexual relations once vaginal bleeding has ended. CORRECT ANSWER: C If oral contraceptives are to be started within 3 weeks after an abortion, additional forms of contraception should be used throughout the first week to avoid the risk of pregnancy. DIF: Cognitive Level: Apply REF: p. 193 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 5. Which client would be an ideal candidate for injectable progestins such as Depo-Provera (DMPA) as a contraceptive choice? a. The ideal candidate for DMPA 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. CORRECT ANSWER: C Advantages of DMPA include 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, DMPA injections must be administered every 11 to 13 weeks. Access to health care is necessary to prevent pregnancy or potential complications. DIF: Cognitive Level: Understand REF: p. 186 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance