STUVIA 2024/2025
Ch 52: Women's Reproductive Health
A woman is taking a combination oral contraceptive and asks the nurse why progestin is necessary.
The nurse will explain that progestin helps prevent pregnancy by which method?
a. Altering the quantity and viscosity of cervical mucus
b. Inhibiting proliferative and secretory changes in the endometrium
c. Increasing motility of muscles and cilia in the fallopian tubes
d. Stimulating a surge in luteinizing hormone (LH) - ✔✔ANS: A
Progestin alters the quantity and viscosity of cervical mucus, making it thick and hostile to sperm
penetration. Estrogen inhibits proliferative and secretory changes in the endometrium. Progestin
decreases muscle and ciliary motility and decreases the LH surge
A woman will begin taking a combination oral contraceptive (COC) that has a higher estrogenic
activity than her previous COC. When teaching this woman about the new product, the nurse will
explain that she may experience which effect(s)?
a. Cyclic breast changes and chloasma
b. Decreased dysmenorrhea and menorrhagia
c. Decreased libido
d. Weight gain and fatigue - ✔✔ANS: A
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Increased estrogenic activity may include side effects such as cyclic breast changes and chloasma as
well as increased dysmenorrhea and menorrhagia. Increased progestin causes decreased libido,
weight gain, and fatigue.
A woman who has recently begun taking a combination oral contraceptive calls the clinic to report
breakthrough bleeding. The nurse will:
a. advise her to use a back-up method of contraception.
b. counsel her to continue taking the contraceptive as prescribed.
c. recommend discussing an alternative contraceptive with her provider.
d. suggest that she perform a home pregnancy test to rule out pregnancy. - ✔✔ANS: B
Breakthrough bleeding is more common at the start of COC use, and there is no evidence that an
episode of bleeding is associated with a decrease in the COC's effectiveness as long as the patient
continues to take the pill as prescribed. She does not need to use back-up contraception. Unless the
bleeding continues and is problematic, there is no need to change products. A pregnancy test is not
indicated.
A young woman who is taking Ortho-Tri-Cyclen for contraception tells the nurse that her provider has
told her it will help to treat her acne. The nurse explains that this is because this product is:
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, STUVIA 2024/2025
a. high in progestin.
b. low in androgenic activity.
c. low in estrogen.
d. triphasic. - ✔✔ANS: B
Products with low androgenic activity help to reduce acne.
A woman who is taking a combined oral contraceptive (COC) that contains 21 days of active pills and
7 days of inert pills reports having headaches accompanying withdrawal bleeding every month. The
nurse will:
a. counsel her to take ibuprofen to counter these side effects.
b. tell her to stop her oral contraceptive immediately.
c. recommend she use an alternative form of contraception.
d. suggest she ask her provider about changing to a product that allows for continuous oral
administration of active contraceptive pills. - ✔✔ANS: D
Withdrawal bleeding can be eliminated altogether by continuous oral administration of active pills.
The patient may discuss this approach with her provider to see if this will help with her headaches.
A woman who is using a NuvaRing transvaginal contraceptive product calls to report that the ring has
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slipped out while sleeping. The patient is not sure how long the product was dislodged. The nurse will
instruct the patient to rinse the ring with lukewarm water, reinsert the ring, and:
a. abstain from sexual intercourse for 24 h.
b. replace it with a new ring as soon as possible.
c. take an oral contraceptive product for 2 weeks.
d. use a back-up method of contraception for 7 days. - ✔✔ANS: D
If the NuvaRing slips out, it should be rinsed off and reinserted. If it has been out longer than 3 h, the
woman should be counseled to use a back-up method of contraception.
A 35-year-old woman asks the nurse about oral contraceptives. The nurse learns that the patient
smokes and has a family history of venous thromboembolism (VTE). The nurse will suggest that the
patient:
a. discuss a progestin-only oral contraceptive with her provider.
b. may want to consider having a tubal ligation.
c. use a transdermal contraceptive product.
d. will not be a candidate for oral contraceptive products. - ✔✔ANS: A
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