A 19-year-old client comes to the clinic seeking information about the use of the morning-after pill (levonorgestrel) for emergency contraception.
Which of the following statements made by the client indicates a need for further teaching?
"I can use the morning-after pill as a regular form of birth control.”.
"I should take the morning-after pill as soon as possible after unprotected intercourse.”.
"The morning-after pill does not protect against sexually transmitted infections.”.
"The morning-after pill can be less effective if I take it more than 72 hours after unprotected sex.”. . . .
The Correct Answer is A
Choice A rationale
The morning-after pill, containing levonorgestrel, is intended for emergency contraception and should not be used as a regular method of birth control. Frequent use can disrupt the menstrual cycle and may be less effective over time compared to consistent contraception methods like oral contraceptives, IUDs, or barrier methods. These regular methods provide continuous protection against pregnancy.
Choice B rationale
The morning-after pill is most effective when taken as soon as possible after unprotected intercourse. Its efficacy decreases with time, and it is significantly less effective after 72 hours. The medication works primarily by delaying or preventing ovulation, and its effectiveness is highest when administered before ovulation occurs.
Choice C rationale
The morning-after pill does not provide any protection against sexually transmitted infections (STIs). It only reduces the risk of pregnancy. Individuals should use barrier methods like condoms during sexual activity to protect themselves and their partners from STIs. Emergency contraception addresses pregnancy risk, not STI transmission.
Choice D rationale
The efficacy of the morning-after pill declines significantly if taken more than 72 hours after unprotected sex. While it may still offer some protection up to 120 hours, its effectiveness is considerably reduced compared to when taken within the first 72 hours. Prompt use is crucial for maximizing its contraceptive effect. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D","E"]
Explanation
Choice A rationale: Assist the patient onto her left side
Positioning the patient on her left side helps improve uteroplacental blood flow by reducing compression of the inferior vena cava. This can enhance oxygen delivery to the fetus and mitigate late decelerations.
Choice B rationale: Assist with a vaginal exam for cord prolapse
Cord prolapse occurs when the umbilical cord slips ahead of the presenting fetal part, leading to variable decelerations rather than late decelerations. Since late decelerations indicate placental insufficiency rather than cord prolapse, this intervention is not necessary.
Choice C rationale: Discontinue the oxytocin infusion
Oxytocin is used to stimulate contractions, but excessive contractions can lead to uteroplacental insufficiency, causing late decelerations. Discontinuing oxytocin reduces uterine stress and improves fetal oxygenation.
Choice D rationale: Administer oxygen at 10 L/min via nonrebreather face mask
Providing high-flow oxygen increases maternal oxygenation, which in turn enhances fetal oxygen delivery. This intervention is a standard response to late decelerations.
Choice E rationale: Notify the health care provider
Late decelerations suggest fetal distress due to uteroplacental insufficiency, requiring urgent evaluation and possible escalation of care, such as intrauterine resuscitation or expedited delivery.
Choice F rationale: Stop the magnesium sulfate
Magnesium sulfate is administered for seizure prevention in preeclampsia and does not directly contribute to late decelerations. Therefore, stopping magnesium sulfate is not necessary in this situation.
Correct Answer is D
Explanation
Choice A rationale
A fetal heart rate of 160 beats per minute is at the upper limit of the normal range (110-160 beats per minute) and could indicate fetal stress or maternal fever. While moderate variability is a positive sign of fetal well-being, the elevated heart rate warrants further investigation and does not solely indicate optimal fetal status.
Choice B rationale
A fetal heart rate consistently below 120 beats per minute indicates bradycardia, which can be a sign of fetal distress or hypoxia. The absence of accelerations, which are transient increases in FHR, further suggests a lack of fetal reserve and is not indicative of well-being.
Choice C rationale
The presence of late decelerations, which are decreases in FHR that begin after the peak of a uterine contraction and return to baseline after the contraction ends, is a pattern associated with uteroplacental insufficiency. This indicates that the fetus is not receiving adequate oxygen during contractions and is a sign of fetal distress, not well-being.
Choice D rationale
Increased fetal movement between contractions is often a reassuring sign of fetal well-being. It indicates that the fetus has adequate oxygenation and is active. While a decrease or absence of fetal movement can be concerning, increased movement suggests the fetus is healthy and responsive.
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