unit 2 OB

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A client with genital herpes simplex infection asks the nurse, “Will I ever be cured of this infection?” Which response by the nurse would be most appropriate?

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Nursing

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1

A client with genital herpes simplex infection asks the nurse, “Will I ever be cured of this infection?” Which response by the nurse would be most appropriate?

“There is no cure, but drug therapy helps to reduce symptoms and recurrences.”

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2

______ is a lifelong viral infection. No cure exists, but antiviral drug therapy helps to reduce or suppress symptoms, shedding, and recurrent episodes.

Genital herpes

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3

______ is used to treat syphilis.

Penicillin

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4

When obtaining the health history from an adolescent client, which factor would lead the nurse to suspect that the client has an increased risk for sexually transmitted infections (STIs)?

five different sexual partners

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5

A client with trichomoniasis is to receive metronidazole. What should the nurse instruct the client to avoid while taking this drug?

alcohol

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6

The client should be instructed to avoid consuming alcohol when taking metronidazole because severe ___ and ____ could occur.

nausea and vomiting

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7

Working at the college health care clinic, the nurse recognizes the importance of educating students that the human papillomavirus has been confirmed to be the cause of essentially all cases of which type of cancer?

cervical

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8

The nurse is educating a client newly diagnosed with genital herpes. Which statement by the client indicates teaching has been successful?

“I can spread this infection if I have unprotected anal, vaginal, or oral sex.”

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9

A woman comes into the health clinic complaining of thick, cottage cheese–like vaginal discharge, with white patches on her labia that worsens before her menses. She complains of intense pruritus and dyspareunia. The health care provider would order which preparation for treatment?

fluconazole

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10

A pregnant woman is diagnosed with chlamydia and asks the nurse, "How will this infection affect my baby and pregnancy?" Which responses by the nurse are accurate? Select all that apply.

"Your newborn can be infected during birth."

"Your newborn may have eye infections from this infection ."

"Your membranes may rupture earlier than normal."

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11

A female sex trade worker has been diagnosed with secondary syphilis. Which findings would most likely correlate with this diagnosis?

sore throat and flu-like symptoms

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12

With a secondary infection of syphilis, there would be________. Present would be a maculopapular rash (hands and feet); a sore throat; lymphadenopathy; and flu-like symptoms.

no evidence of vaginal lesions present

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13

Which medications are appropriate to treat vaginal candidiasis? Select all that apply.

miconazole & fluconazole

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14

A______ vaginal discharge is for gonorrhea.

yellow

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15

A client with syphilis did not receive treatment and has now progressed into the tertiary stage of the disorder. Which symptoms would the nurse expect the client to exhibit?

heart disease and inflammation of the aorta, eyes, brain, central nervous system, and skin

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16

The client with______ syphilis is noninfectious because the microorganism has invaded the central nervous system (CNS) as well as other organs of the body.

late or tertiary

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17

Symptoms of ______ syphilis include fever, malaise, rash, headache, sore throat, and lymph node enlargement.

secondary

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18

An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported?

syphilis

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19

(true/false) The law mandates reporting of syphilis, chlamydia, gonorrhea, chancroid, and HIV/AIDS.

true

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20

A primary care provider tells a client to return 2 to 3 months after treatment to have a repeat culture done to verify the cure. This prescription would be appropriate for a woman with which condition?

gonorrhea

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21

A nurse is performing an assessment on a new client. The woman estimates that she is approximately 16 weeks pregnant. While assessing her, the nurse asks her about apparent scratch marks on her hands, and she tells the nurse that she has three cats at home. What screening would be prescribed for this woman?

toxoplasmosis

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22

Toxoplasmosis is a common infection in humans and usually produces no symptoms.  Transmission is via ____ and _____.

undercooked meat and through cat feces.

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23

A nurse is interviewing a pregnant woman who has come to the clinic for her first prenatal visit. During the interview, the client tells the nurse that she works in a day care center with 2- and 3-year olds. Based on the client's history, the nurse would be alert for the development of which condition?

cytomegalovirus

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24

A nurse is conducting a review class for a group of perinatal nurses working at the local clinic. The clinic sees a high population of women who are HIV positive. After discussing the recommendations for antiretroviral therapy with the group, the nurse determines that the teaching was successful when the group identifies which rationale as the underlying principle for the therapy?

reduction in viral loads in the blood

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25

A nurse is preparing a presentation for a group of young adult pregnant women about common infections and their effect on pregnancy. When describing the infections, which infection would the nurse include as the most common congenital and perinatal viral infection in the world?

cytomegalovirus is most common

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26

A nurse is providing care to several pregnant women at different weeks of gestation. The nurse would expect to screen for group B streptococcus (GBS) infection in the client who is at:

36 week’s gestation

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27

Pregnant women between 36 and 37 weeks’ gestation should be universally screened for GBS infection during a prenatal visit and, if positive, receive appropriate intrapartum______.

antibiotic prophylaxis.

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28

A nurse is conducting a presentation for a group of pregnant women about measures to prevent toxoplasmosis. The nurse determines that additional teaching is needed when the group identifies which measure as preventive?

cooking all meat to an internal temperature of 125° F (52° C) because they need to be cooked to a temperature of 160° F (71° C)

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29

A pregnant woman at 36 weeks' gestation comes to the care center for a follow-up visit. The woman is to be screened for group B streptococcus (GBS) infection. When describing this screening to the woman, the nurse would explain that a specimen will be taken from which area(s)? Select all that apply.

vagina and rectum

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30

A postpartum mother has the following lab data recorded: a negative rubella titer. What is the appropriate nursing intervention?

Administer rubella vaccine before discharge.

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31

A woman comes to the clinic for her first prenatal visit. As part of the assessment, the woman is screened for rubella antibodies. The nurse determines that a client has immunity against rubella based on which rubella titer?

1:8

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32

(true/false) Rubella is an infection, which when contracted during pregnancy has significant complications for the fetus. The illness is mild to the adult but can result in the infant being born deaf and blind

false; it is a virus with no cure

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33

(true/false) Women with titers of less than 1:8 should be immunized.

true because they do not have enough antibodies

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34

A woman is diagnosed with primary dysmenorrhea and is prescribed ibuprofen as part of her treatment plan. When teaching the woman about using this medication, which instruction would be important for the nurse to emphasize?

"Start taking the medication when you first get your period."

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35

When taking a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, for dysmenorrhea, it is important for the woman to start therapy ______ and use sufficient doses to maximally suppress prostaglandin production.

prophylactically

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36

After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing abnormal uterine bleeding. Which statement by the client would support the nurse's suspicions?

“I've been having bleeding off and on that's irregular and sometimes heavy.”

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37

A nurse is reviewing the history and physical examination of a client diagnosed with secondary dysmenorrhea for possible associated causes. Which etiology would the nurse need to keep in mind as being the most common?

endometriosis

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38

A male client asks the nurse to explain which structure is cut during a vasectomy. What response should the nurse give the client?

the vas deferens

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39

A 45-year-old client and her spouse are present in the clinic. Results of fertility testing indicate that the client has damage to her fallopian tubes. Which would be the most appropriate infertility option for this client?

In vitro fertilization

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40

In vitro fertilization fertilizes an ovum and then inserts it into a women’s uterus. This is ideal when the fallopian tubes would need to be ____.

bypassed

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41

A couple comes to the clinic and states to the nurse, "I don't think we are ever going to be able to have children. We have been trying but have had no luck." What assessments does the nurse anticipate will be performed for this couple? Select all that apply.

semen analysis

ovulation monitoring

tubal patency

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42

A nurse is required to assess a client reporting unusual vaginal discharge for bacterial vaginosis. For which classic manifestation of this condition should the nurse assess?

characteristic “stale fish” odor and thin, white homogeneous vaginal discharge

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43

The nurse is assessing a primigravida woman who reports vaginal itching, a great deal of foamy yellow-green discharge, and pain during intercourse. The nurse suspects the woman has contracted which disorder?

trichomoniasis

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44

Which finding would alert the nurse to suspect that a client has a yeast infection?

vulvar burning and itching

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45

A nurse educator is teaching a client about sexually transmitted infections. The client would learn that which medications are appropriate to treat chlamydia? Select all that apply.

doxycycline

azithromycin

ceftriaxone

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46

A nurse is teaching a group of pregnant young women about sexually transmitted infections (STIs) and the possible effects that may occur in the fetus or newborn. Which STIs would the nurse describe as being transmitted to the newborn during birth? Select all that apply.

chlamydia

gonorrhea

genital herpes

HIV

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47

(true/false) Syphilis can be transmitted to the fetus while in utero.

true; occurs while inside

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48

A couple in their mid-30s are at their primary care provider's office because they have been unable to conceive for 3 years. They already have one child who is 4 years of age. The care provider explains to them that they are dealing with what kind of infertility?

secondary infertility

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49

A pregnant woman in her second trimester comes to the prenatal clinic for a routine visit. She reports that she has a new kitten. The nurse would have the woman evaluated for which infection?

toxoplasmosis

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50

After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment?

genital herpes

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51

A clinic nurse explains to a client who is undergoing an infertility workup that the patency of her fallopian tubes will be checked. Which test is currently used to do this?

hysterosalpingography

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52

The nurse is preparing a teaching session for a client considering tubal ligation. Which factor should the nurse prioritize in this session?

This is a permanent and irreversible procedure for birth control.

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53

A client reports that she has multiple sex partners and has a lengthy history of various pelvic infections. She would like to know if there is any temporary contraceptive method that would suit her condition. Which method should the nurse suggest for this client?

condoms

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54

The client cannot use an____ as a contraceptive because of her history of various pelvic infections.

IUD

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55

A pregnant client states they are interested in having a tubal ligation following the birth of the child. Which statement by the nurse is a priority at this time?

“A tubal ligation is an effective method for permanent sterilization.”

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56

A couple who have been experiencing infertility have been prescribed clomiphene citrate. What information should be included in teaching about the medication therapy? Select all that apply.

This medication therapy will promote ovulation in the woman.

The medication is usually used for no more than 3 cycles at a time.

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57

_______ is a nonsteroidal synthetic antiestrogen used to induce ovulation.

Clomiphene citrate

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58

The nurse informs the client that a diaphragm (a circular rubber disk placed over the cervix before intercourse) is an example of which type of contraception?

mechanical barrier

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59

A woman uses a diaphragm for contraception. The nurse would instruct her to return to the clinic to have her diaphragm fit checked after which occurrence?

a weight gain of 10 lb (4.5 kg) bc it may shift the relationship of pelvic organs enough that the diaphragm no longer fits correctly

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60

A nurse should instruct a client who has premenstrual syndrome (PMS) to make which lifestyle modification?

Reduce caffeine, walk several times a week, use relaxation techniques, and maintain a regular sleep schedule.

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61

Which medication is used to suppress viral load of the HSV-2 infection?

acyclovir

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62

The _____ acyclovir, valacyclovir, and famciclovir are recommended to suppress the viral load and decrease recurrence and shedding.

antiviral agents

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63

A 24-year-old female client reports various issues. She admits to having unprotected sexual intercourse. Which findings would indicate possible pelvic inflammatory disease (PID)? Select all that apply.

lower abdominal tenderness

adnexal tenderness

cervical motion tenderness

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64

The client is interested in using an injectable contraceptive that works by suppressing pituitary secretions. The nurse provides the client with literature and discusses which contraceptive with her?

medroxyprogesterone acetate

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65

Medroxyprogesterone acetate is an ______ of a progesterone-only contraceptive that is given every 12 weeks. It works by suppressing ovulation and the production of FSH and LH by the pituitary gland

injectable form

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66

_____ is a single-rod progestin implantable form contraceptive.

Etonogestrel

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67

Norelgestromin/ethinyl estradiol is a _____ contraceptive,

patch-type

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68

Evonorgestrel/ethinyl estradiol is an ____ contraceptive that uses a 365-day combination dosing.

oral

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69

The nurse is preparing a postpartum nursing care plan for a single HIV-positive primigravida client. The nurse should prioritize in the plan how to acquire which resource?

formula

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70

It is possible to transmit ____ via breastfeeding, and formula is the only option for feeding.

HIV

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71

The nurse is providing education to a male client on vasectomy. What teaching should the nurse include? Select all that apply.

“The vas deferens is cut or cauterized to stop the passage of sperm .”

“You can resume sexual intercourse in about one week.”

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72

The ______ procedure will be done under local anesthesia in office or ambulatory setting. Sexual intercourse can resume in about one week, but the client should use additional birth control for 6 to 10 weeks.

vasectomy

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73

A nurse is instructing a client on birth control methods. The client asks about the cervical mucus method. When should the nurse tell the client she is fertile in relation to her mucus?

when it is thin, watery, and copious

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74

A client needs additional information about the cervical mucus ovulation method after having read about it in a magazine. She asks the nurse about cervical changes during ovulation. What information should the nurse give the client?

Cervix is high or deep in the vagina.

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75

The school nurse is preparing a health education session on the topic of birth control for a college group. Which method should the nurse emphasize for this group?

barrier

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76

The condom will help not only with birth control but with______, which is common in college age groups.

the spread of STIs

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77

The nurse is caring for a client at the ambulatory care clinic who questions the nurse for information about contraception. The client reports that she is not comfortable about using any barrier methods and would like the option of regaining fertility after a couple of years. Which method should the nurse suggest to this client?

CycleBeads or medroxyprogesterone injection

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78

A client with a history of herpes simplex virus type 2 (HSV-2) asks the nurse about future sexual activity. Which response by the nurse is most appropriate?

“To be responsible, you or your partner need to wear a condom during intercourse.”

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79

A nurse will be educating a client about contraceptives. Which contraceptive method(s) will the nurse include as a mechanical barrier method? Select all that apply.

condom

cervical cap

cervical sponge

diaphragm

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80

The vaginal estrogen/progestin (contraceptive) ring is considered a _____ method of contraception.

hormonal

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81

Pelvic infection is most commonly caused by:

sexual transmission.

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82

A young newly married woman comes to the clinic and asks about ways to prevent pregnancy. When the nurse begins to talk about oral contraceptives, the client says that her religion does not allow oral contraceptives. What can the nurse recommend for this client?

Rhythm method

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83

A client is seen in the clinic requesting an emergency postcoital contraception pill levonorgestrel (Plan B). The client states that she had unprotected sex 3 ½ days ago. What is the most appropriate response by the nurse?

“Unfortunately you are past the time frame to take that prescription.”

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84

A male client visits a fertility clinic after one year of attempting unsuccessfully to impregnate his wife. What is a risk factor associated with male infertility?

no or few sperm cells produced (Azoospermia or oligospermia)

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85

Which definition best explains the term “subfertility/infertility”?

failure to achieve pregnancy after 1 year of unprotected intercourse

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86

A nurse who is conducting sessions on preventing the spread of sexually transmitted infections (STIs) discovers that there is a very high incidence of hepatitis B in the community. Which measure should the nurse prioritize to help prevent further spread of the infection in the community?

Instruct people to get vaccinated.

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87

A school health nurse is presenting information on sexually transmitted infections (STIs) to a high school class. The nurse feels confident that learning has taken place when the students report:

female adolescents are more susceptible to STIs due to their anatomy.

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88

A pregnant client has tested positive for hepatitis B virus. When discussing the situation with the client, the nurse explains that her newborn will be vaccinated with an initial HBV vaccine dose at which time?

within 12 hours of birth

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89

A client with a family history of cervical cancer is to undergo a Papanicolaou test. During the client education, what group should the nurse include as at risk for cervical cancer?

clients who have genital warts

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90

The nurse is meeting with a young couple who have undergone the initial screenings for infertility. The man is questioning the possibility of using intrauterine (artificial) insemination if he is found to be infertile. Which response should the nurse prioritize?

“Intrauterine (artificial) insemination is your best option if you are found infertile.”

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91

A client is requesting information on the various available contraceptives. When explaining a vaginal spermicide, which information should the nurse prioritize?

Insert the product by applicator in the vagina prior to intercourse.

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92

______ provide a physical barrier that prevents sperm penetration and a chemical barrier that kills sperm. It is designed to be inserted vaginally immediately before or within a few hours before sexual intercourse.

Vaginal spermicides

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93

An 18-year-old female client who is sexually active asks the nurse for information on barrier contraceptives. Which statement is appropriate for the nurse to include in the response?

“Cervical caps are most effective when used along with a spermicidal agent.”

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94

(true/false) Cervical caps cannot be purchased over the counter, because the client must be properly fitted for the device to work effectively.

true; must go back tp HCP if wt. gain of 10 lbs or more

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95

Frequent _______ are a contraindication to the use of diaphragms because diaphragm use can place pressure placed on the urinary tract.

urinary tract infections

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96

A 30-year-old client tells the nurse that she would like to use a contraceptive sponge but does not know enough about its use and whether it will protect her against sexually transmitted infections (STIs). Which information should the nurse provide the client about using a contraceptive sponge? Select all that apply.

Wet the sponge with water before inserting it.

Insert the sponge 24 hours before intercourse.

Leave the sponge in place for at least 6 hours following intercourse.

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97

A nurse is providing a client with information on hormonal contraception. Which could the nurse use as an example of hormonal contraception?

medroxyprogesterone

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98

The nurse should inform the client that medroxyprogesterone is a ______.

hormonal contraceptive.

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99

A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her?

She has a family history of thromboembolism.

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100

The ______ content of birth control pills may lead to increased blood clotting, leading to an increased incidence of thromboembolism. Women who already are prone to this should not increase their risk further.

estrogen

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