Contraception and Family Planning Nursing Exam
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Free Contraception and Family Planning Nursing Exam Questions
A 35-year-old woman with a history of migraine headaches presents to the clinic seeking contraception. She smokes and has a family history of venous thromboembolism. What contraception method should be avoided in this patient
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Intrauterine device (IUD)
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Progestin-only pill
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Combined hormonal contraceptives
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Condoms
Explanation
Correct Answer C: Combined hormonal contraceptives
Explanation:
Combined hormonal contraceptives (CHCs), which contain estrogen, are contraindicated in women over age 35 who smoke and/or have risk factors for thromboembolism (such as a personal or strong family history of VTE or migraines with aura). Estrogen increases the risk of blood clots, stroke, and cardiovascular events in such individuals.
Why the other options are incorrect:
A) Intrauterine device (IUD):
Safe and effective. Both hormonal and non-hormonal IUDs do not contain estrogen and do not increase VTE risk.
B) Progestin-only pill:
Safe. These pills do not contain estrogen, making them suitable for women with VTE risk or migraines.
D) Condoms:
Safe. Condoms are non-hormonal and carry no systemic health risks.
Which is not an indication for intrauterine insemination (IUI
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Unexplained infertility
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Cervical factor
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Ovulation dysfunction
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Mild oligozoospermy
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Tubal occlusion both sides
Explanation
Correct Answer E: Tubal occlusion both sides
Explanation:
Bilateral tubal occlusion (blockage of both fallopian tubes) is not an indication for IUI because sperm cannot reach the ovum without patent (open) fallopian tubes. In such cases, in vitro fertilization (IVF) is the recommended treatment, as fertilization must occur outside the body.
Why the other options are incorrect:
A) Unexplained infertility:
Correct indication. IUI is commonly used when no specific cause of infertility is identified.
B) Cervical factor:
Correct indication. IUI bypasses cervical mucus, which may be hostile or insufficient.
C) Ovulation dysfunction:
Correct indication, especially when combined with ovulation induction medications like clomiphene citrate or letrozole.
D) Mild oligozoospermy:
Correct indication. IUI can concentrate and introduce a prepared sample of sperm directly into the uterus, improving chances of fertilization.
Hormonal Contraception Methods, except
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Implant
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Vaginal ring
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Female condom
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Intramuscular injection
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Transdermal patch
Explanation
Correct Answer C: Female condom
Explanation:
The female condom is a barrier method, not a hormonal method of contraception. It works by physically blocking sperm from entering the uterus and contains no hormones.
Why the other options are incorrect:
A) Implant:
Correct. The contraceptive implant (e.g., Nexplanon) releases a progestin hormone and is a long-acting reversible hormonal contraceptive.
B) Vaginal ring:
Correct. The vaginal ring (e.g., NuvaRing) releases both estrogen and progestin, making it a combined hormonal method.
D) Intramuscular injection:
Correct. The injectable contraceptive (e.g., Depo-Provera) is a progestin-only hormonal method administered every 3 months.
E) Transdermal patch:
Correct. The patch (e.g., Xulane) delivers combined estrogen and progestin hormones through the skin.
The nurse is teaching a couple who are planning to become pregnant.
Which behavior can be excluded as a health risk that must be immediately covered before the pregnancy
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Getting a flu shot
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Drinking coffee
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Breathing secondhand smoke
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Taking prescription medicine
Explanation
Correct Answer A: Getting a flu shot
Explanation:
Getting a flu shot is not a health risk—in fact, it is recommended for individuals planning pregnancy. The influenza vaccine is safe before and during pregnancy and helps protect both the mother and the fetus from complications associated with the flu, including preterm birth and severe respiratory illness.
Why the other options are considered health risks and should be addressed:
B) Drinking coffee:
Excessive caffeine intake has been linked to increased risk of miscarriage and low birth weight. It is recommended to limit caffeine to 200 mg per day or less when trying to conceive and during pregnancy.
C) Breathing secondhand smoke:
Secondhand smoke exposure is associated with infertility, low birth weight, miscarriage, and birth defects. Couples planning pregnancy should eliminate exposure to tobacco smoke.
D) Taking prescription medicine:
Some prescription medications are teratogenic (harmful to the developing fetus). It’s critical to review all medications with a healthcare provider before conception to ensure they are safe during pregnancy.
The lifespan of the Copper-IUD device
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1 year
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3 years
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5 years
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20 years
Explanation
Correct Answer C: 5 years
Explanation:
Copper IUDs (such as Paragard or other regional equivalents) are more than 99% effective at preventing pregnancy and are classified as long-acting reversible contraceptives (LARCs). Depending on the specific brand and country, copper IUDs can be effective for up to 5 to 10 years. The most commonly used types are officially approved for at least 5 years, with some extended to 10 years.
Why the other options are incorrect:
A) 1 year:
Incorrect. Copper IUDs are not designed for short-term use. They are effective for several years.
B) 3 years:
Incorrect. This is more typical of certain hormonal IUDs like Kyleena, not copper-based devices.
D) 20 years:
Incorrect. While some studies suggest copper IUDs may still be effective up to 12 years or more, current clinical approval generally limits use to 5–10 years, not 20.
The nurse has been caring for a couple planning to undergo in vitro fertilization.
Which statement reflects an expected nursing outcome
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The patient will make an informed decision about the treatment
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The patient will schedule the egg-retrieval procedure
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The patient will express their desire to conceive naturally
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The patient will successfully undergo in vitro fertilization
Explanation
Correct Answer A: The patient will make an informed decision about the treatment.
Explanation:
An expected nursing outcome focuses on the patient’s knowledge, decision-making, and well-being, rather than the procedural or clinical results, which are influenced by many uncontrollable factors.
The goal of nursing care in this context is to ensure the patient is fully informed about the IVF process, risks, benefits, alternatives, and emotional implications—allowing them to make a decision that aligns with their values and circumstances.
Why the other options are incorrect:
B) The patient will schedule the egg-retrieval procedure:
This is a task or action, not a nursing outcome. It reflects planning or implementation, not the nurse's goal of supporting patient understanding or autonomy.
C) The patient will express their desire to conceive naturally:
This may be part of the discussion but does not reflect the expected outcome of IVF-focused care. If IVF is already the chosen treatment, expressing a desire for natural conception may indicate the need for further counseling, not the achievement of a goal.
D) The patient will successfully undergo in vitro fertilization:
This is an unrealistic nursing outcome because the success of IVF depends on medical, biological, and individual factors beyond the nurse’s control. Nursing outcomes should be measurable, achievable, and nursing-focused, such as education, emotional support, and informed consent.
A 25-year-old woman comes to the clinic complaining of increased vaginal discharge, milky gray in color with a "fishy" odor that both she and her husband have noticed. A wet smear is performed and the presence of "clue cells" is confirmed. Which type of infection does the nurse suspect
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Candidiasis
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Trichomoniasis
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Bacterial vaginosis
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Group B Streptococcus
Explanation
Correct Answer C: Bacterial vaginosis
Explanation:
Bacterial vaginosis (BV) is the most common cause of malodorous, milky gray vaginal discharge with a characteristic “fishy” odor, especially after intercourse. On microscopic examination, “clue cells” (vaginal epithelial cells coated with bacteria) are a hallmark finding. BV results from an imbalance in the vaginal flora, where normal lactobacilli are replaced by overgrowth of anaerobic bacteria, such as Gardnerella vaginalis.
Why the other options are incorrect:
A. Candidiasis
Incorrect. Candidiasis is characterized by thick, white, “cottage cheese-like” discharge, vulvar itching, and redness, but not a fishy odor or clue cells.
B. Trichomoniasis
Incorrect. Trichomoniasis often presents with frothy, yellow-green discharge, vaginal irritation, and a strong odor, but clue cells are not seen. Instead, motile trichomonads may be visible on wet prep.
D. Group B Streptococcus
Incorrect. Group B Strep is typically a concern in pregnancy due to its risk of neonatal infection. It does not cause a fishy odor or clue cells, and often does not present with noticeable symptoms in non-pregnant individuals.
A couple is beginning evaluation for infertility.
Which diagnostic test should the nurse expect to be done first for evaluation of the male partner
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Semen analysis
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Scrotal ultrasound
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Testicular biopsy
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Hormonal evaluation
Explanation
Correct Answer A: Semen analysis
Explanation:
Semen analysis is the first and most essential diagnostic test in the evaluation of male infertility. It assesses
Sperm count (concentration)
Sperm motility (movement)
Sperm morphology (shape and structure)
Volume and quality of seminal fluid
This test is noninvasive, cost-effective, and provides comprehensive initial information about male reproductive function. If abnormalities are found, further testing can be directed accordingly.
Why the other options are not first-line tests:
B) Scrotal ultrasound:
This may be used if physical abnormalities (e.g., varicocele, testicular mass) are suspected or if semen analysis results are abnormal, but it is not the initial diagnostic step.
C) Testicular biopsy:
This is an invasive procedure reserved for cases where sperm production is extremely low or absent, and other tests have been inconclusive. It is not a first-line investigation.
D) Hormonal evaluation:
Hormone testing (e.g., FSH, LH, testosterone) may be done if semen analysis is abnormal, particularly in cases of low sperm count or suspected endocrine causes. It is not the starting point.
A 19-year-old woman presents to the clinic seeking emergency contraception. She reports unprotected intercourse within the past 72 hours. What emergency contraception method might be appropriate for her
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Combined oral contraceptives
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Copper intrauterine device (IUD)
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Levonorgestrel (Plan B)
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Sterilization
Explanation
Correct Answer C: Levonorgestrel (Plan B)
Explanation:
Levonorgestrel (Plan B) is a widely available emergency contraceptive pill effective when taken within 72 hours after unprotected intercourse. It is easy to use, has fewer side effects than some alternatives, and does not require a clinical procedure.
Why the other options are incorrect:
A) Combined oral contraceptives:
Less commonly used for emergency contraception and generally less effective than levonorgestrel or copper IUD.
B) Copper intrauterine device (IUD):
The most effective emergency contraception and can be used up to 5 days after intercourse, but it requires clinical insertion, which may not be accessible or preferred by all patients.
D) Sterilization:
A permanent method and not suitable for emergency contraception
The nurse planning to teach a woman about perimenopause would include that lowered estrogen levels
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prevent osteoporosis
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decrease vaginal lubrication
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raise the level of low-density lipoproteins
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raise the level of high-density lipoproteins
Explanation
Correct Answer B: decrease vaginal lubrication
Explanation:
During perimenopause, estrogen levels gradually decline, leading to a variety of physical changes. One of the most common and noticeable effects is a decrease in vaginal lubrication. This can result in vaginal dryness, irritation, and discomfort during intercourse, often referred to as vaginal atrophy. This symptom is directly linked to estrogen deficiency and is a key topic in perimenopause education.
Why the other options are incorrect:
A. prevent osteoporosis
Incorrect. Estrogen helps maintain bone density, so lower estrogen levels increase the risk of osteoporosis, not prevent it.
C. raise the level of low-density lipoproteins
Incorrect. Lower estrogen levels are actually associated with an increase in LDL (bad cholesterol), which raises cardiovascular risk, making this statement factually incorrect in this context.
D. raise the level of high-density lipoproteins
Incorrect. Estrogen typically helps maintain or increase HDL (good cholesterol). As estrogen declines, HDL levels may decrease, not increase.
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