Contraception and Family Planning Nursing Exam
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Free Contraception and Family Planning Nursing Exam Questions
Which procedure of clinical interruption of a pregnancy is most likely to be performed for a woman in the first 7 to 9 weeks of a pregnancy
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Medical abortion by administration of mifepristone and misoprostol
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Surgical abortion by dilation and extraction (D&E) and hypertonic saline
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Surgical abortion by dilation and curettage (D&C) and minisuction
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Medical abortion by dilation and curettage (D&C) and minisuction
Explanation
Correct Answer A: Medical abortion by administration of mifepristone and misoprostol
Explanation:
Medical abortion using mifepristone and misoprostol is the most common and recommended method for pregnancy termination in the first 7 to 9 weeks of gestation. This method is non-surgical and involves:
Mifepristone: A progesterone receptor blocker that halts the progression of pregnancy by detaching the embryo from the uterine wall.
Misoprostol: A prostaglandin that causes uterine contractions to expel the pregnancy.
This approach is effective, safe, and does not require anesthesia or surgery in early pregnancy stages.
Why the other options are incorrect:
B) Surgical abortion by dilation and extraction (D&E) and hypertonic saline:
Incorrect. D&E is typically used in second-trimester abortions, and hypertonic saline is an outdated method rarely used today due to complications. This procedure is not appropriate or commonly used at 7–9 weeks.
C) Surgical abortion by dilation and curettage (D&C) and minisuction:
Partially correct but not the most common choice for this early gestational age. D&C with suction (manual vacuum aspiration or electric vacuum aspiration) is typically used in slightly later first-trimester pregnancies (after 9 weeks) or when medication is not an option.
D) Medical abortion by dilation and curettage (D&C) and minisuction:
Incorrect. D&C with minisuction is a surgical, not medical, procedure. Describing it as a "medical abortion" is inaccurate. Medical abortion refers specifically to pharmaceutical methods (e.g., mifepristone and misoprostol).
Complication of using IUD can be:
Abnormal bleeding
Ectopic pregnancy
PID (pelvic inflammation)
Varicose veins on the upper limbs
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1st, 2nd and 3rd answers are correct
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1st and 3rd answers are correct
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2nd and 4th answers are correct
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Only 4th answer is correct
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All of the answers are correct
Explanation
Correct Answer A: 1st, 2nd and 3rd answers are correct
Explanation:
Intrauterine devices (IUDs) are highly effective contraceptives, but like any medical device, they carry potential risks and complications:
1) Abnormal bleeding:
Correct. Particularly with copper IUDs, users may experience heavier or irregular bleeding, especially in the first few months after insertion.
2) Ectopic pregnancy:
Correct. Although IUDs reduce the overall risk of pregnancy, if pregnancy does occur, there is a higher relative risk that it may be ectopic, due to altered tubal motility or fertilization occurring outside the uterus.
3) PID (pelvic inflammatory disease):
Correct. The risk of PID is increased shortly after insertion (especially in women with preexisting STIs), but it becomes low afterward. Screening before insertion reduces this risk.
4) Varicose veins on the upper limbs:
Incorrect. There is no connection between IUD use and varicose veins in the upper limbs. This is unrelated to the mechanism or side effects of IUDs.
Absolute contraindications to the use of estrogen-containing contraceptives, except
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Endometrial cancer
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Lupus erythematosus
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Ulcerative colitis
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Fibroid
Explanation
Correct Answer D: Fibroid
Explanation:
Uterine fibroids (leiomyomas) are not an absolute contraindication to estrogen-containing contraceptives. In fact, combined oral contraceptives may help manage symptoms such as heavy menstrual bleeding often associated with fibroids.
Why the other options are incorrect:
A) Endometrial cancer:
Estrogen-containing contraceptives are contraindicated in patients with a history of endometrial cancer due to the hormone's potential to stimulate tumor growth.
B) Lupus erythematosus:
Systemic lupus erythematosus (SLE), especially with antiphospholipid antibodies, is an absolute contraindication because of the increased risk of thrombosis.
C) Ulcerative colitis:
While not always an absolute contraindication, some patients with active or severe inflammatory bowel disease may have increased risk of thromboembolic events, making estrogen use potentially unsafe depending on the case.
A 32-year-old woman is admitted to the unit with a history of fibroids and menorrhagia. Which findings does the nurse expect to encounter during assessment of the client?
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Fluid overload
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Intermittent diarrhea
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Pale mucous membranes
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Difficulty emptying the bladder
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High hemoglobin and hematocrit
Explanation
Correct Answers:
C: Pale mucous membranes
D: Difficulty emptying the bladder
Explanation:
Women with fibroids and menorrhagia (heavy menstrual bleeding) are at risk of anemia, which often presents with pale mucous membranes due to decreased hemoglobin. Additionally, large uterine fibroids may press on the bladder, causing difficulty emptying the bladder or urinary frequency.
Why the other options are incorrect:
A. Fluid overload
Not typically associated with fibroids or menorrhagia.
B. Intermittent diarrhea
Gastrointestinal symptoms like diarrhea are not common findings related to fibroids or menorrhagia.
E. High hemoglobin and hematocrit
Menorrhagia usually leads to low hemoglobin and hematocrit levels due to blood loss, not high levels.
The nurse is caring for a couple who has been undergoing infertility treatments without success.
Which statement should the nurse make to promote healthy sexual function
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Tell me about your usual sexual habits, outside of trying to conceive.
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What sexual dysfunctions are occurring
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Can you explain back to me the cause of the infertility
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What efforts have you put into improving sexual function
Explanation
Correct Answer A: Tell me about your usual sexual habits, outside of trying to conceive.
Explanation:
Infertility treatments can place significant emotional and physical stress on a couple’s sexual relationship. By asking open-ended, nonjudgmental questions like, “Tell me about your usual sexual habits, outside of trying to conceive,” the nurse:
Normalizes the conversation about sexuality
Encourages trust and openness
Helps the couple reflect on how intimacy may have shifted from emotional connection to goal-oriented behavior
This approach is supportive and holistic, recognizing that sexual health is more than reproductive function.
Why the other options are less appropriate:
B) What sexual dysfunctions are occurring?
This is too direct and clinical, and may make the patient feel defensive or embarrassed. It labels the issue as a dysfunction without first exploring their experience.
C) Can you explain back to me the cause of the infertility?
This tests knowledge rather than promotes sexual or emotional support. It may make the couple feel blamed or inadequate and does not address their sexual well-being.
D) What efforts have you put into improving sexual function?
This may come across as accusatory or critical, implying the couple hasn’t done enough. It also puts responsibility on the patient without first understanding their experience.
A 20-year-old sexually active woman presents to the clinic seeking contraception. She reports difficulty remembering to take a daily pill and desires a low-maintenance method. What contraception method might be suitable for her
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Condoms
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Depo-Provera injection
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Combined oral contraceptives
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Diaphragm
Explanation
Correct Answer B: Depo-Provera injection
Explanation:
Depo-Provera (medroxyprogesterone acetate) is a progestin-only injectable contraceptive administered once every 3 months, making it a suitable low-maintenance option for women who struggle with daily pill adherence. It is highly effective and reversible.
Why the other options are incorrect:
A) Condoms:
While effective for STI prevention, condoms require use with each sexual act and are not considered a low-maintenance method.
C) Combined oral contraceptives:
These require daily administration, which the patient has already indicated is difficult for her.
D) Diaphragm:
This method must be inserted before each act of intercourse, which also does not meet the patient's request for a low-maintenance method.
Side effect of chemical and barrier contraception methods, except:
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toxic shock syndrome
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urogenital infection
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pregnancy rate between 5-15%
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fetal congenital malformations
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salpingitis
Explanation
Correct Answer E: Menstruation
Explanation:
Menstruation is the shedding of the uterine lining that occurs when fertilization does not happen, and it does not prove ovulation by itself. While menstruation usually follows ovulation, its occurrence alone does not confirm that ovulation took place, as some menstrual cycles can be anovulatory.
Why the other options indicate ovulation:
A) BBT (Basal Body Temperature)
A sustained rise in BBT after ovulation indicates the progesterone effect and is a sign that ovulation likely occurred.
B) Pregnancy
Pregnancy confirms ovulation because fertilization requires that an ovum be released.
C) Progesterone level above 3 ng/mL
An elevated progesterone level in the luteal phase confirms ovulation as progesterone is produced by the corpus luteum after ovulation.
D) Secretory transformation of the endometrium
This histological change occurs under progesterone influence after ovulation, indicating the uterus is prepared for implantation.
The nurse recognizes that family planning care involves more than preventing pregnancy. Which goal should the nurse consider to be a part of family planning care
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Promoting healthy sexual function
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Encouraging acceptance of all available forms of contraception methods
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Encouraging the use of preferred contraceptive methods
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Promoting a healthy body image
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Providing knowledge about sexual and reproductive health
Explanation
Correct Answers:
A) Promoting healthy sexual function,
C) Encouraging the use of preferred contraceptive methods,
D) Promoting a healthy body image,
E) Providing knowledge about sexual and reproductive health
Explanation:
Family planning care is a comprehensive approach to supporting individuals and couples in making informed, autonomous decisions about their reproductive lives. It includes not just preventing pregnancy, but also empowering clients to have safe, satisfying sexual and reproductive health experiences.
A) Promoting healthy sexual function:
Correct. Sexual health is a key component of overall well-being. Family planning care includes helping clients understand and address sexual concerns, enhancing comfort, satisfaction, and function.
C) Encouraging the use of preferred contraceptive methods:
Correct. Respecting individual choice is fundamental. The nurse should support the client’s selection of contraception based on their preferences, lifestyle, health status, and values—rather than pushing uniform acceptance of all methods.
D) Promoting a healthy body image:
Correct. Body image affects self-esteem and sexual health. Family planning conversations may include discussions around body perception, especially in relation to reproductive health, contraception, and sexuality.
E) Providing knowledge about sexual and reproductive health:
Correct. Education is a cornerstone of family planning care. Clients need accurate, evidence-based information to make informed decisions about contraception, fertility, sexually transmitted infections, and pregnancy planning.
Why the other option is incorrect:
B) Encouraging acceptance of all available forms of contraception methods:
Incorrect. The goal is not to encourage acceptance of all methods, but to support informed choice. Clients have the right to decline methods that do not align with their preferences, values, or health needs.
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.
Efficacy of contraception methods from high to low effectiveness
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Oral contraceptives, IUD, condom
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Condom, IUD, oral contraceptives
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IUD, oral contraceptives, condom
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All of them represent the same efficacy
Explanation
Correct Answer C: IUD, oral contraceptives, condom
Explanation:
The IUD (intrauterine device) is one of the most effective contraceptive methods, with a failure rate of less than 1% due to its long-acting nature and minimal user error. Oral contraceptives have a typical use failure rate of around 7–9%, primarily due to missed doses. Condoms, while widely available and useful for STI prevention, have a higher typical use failure rate of 13–20% due to breakage or incorrect use.
Why the other options are incorrect:
A) Oral contraceptives, IUD, condom:
Incorrect. This order places oral contraceptives before IUDs, but IUDs are significantly more effective in practice due to lower user dependency.
B) Condom, IUD, oral contraceptives:
Incorrect. This option ranks condoms highest, which is inaccurate. Condoms have the highest failure rate among the three methods listed.
D) All of them represent the same efficacy:
Incorrect. These methods differ widely in effectiveness. IUDs are the most reliable, followed by pills, and then condoms.
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