A nurse is caring for a patient who uses a contraceptive vaginal ring.

Which of the following symptoms should the nurse instruct the patient to report immediately?

The correct answer is choice A.“You need to have a sperm count test to confirm your sterility.”

A sperm count test is a semen analysis that measures the number of sperm in the ejaculate.

It is the only way to verify that a vasectomy has been successful and that the man is sterile.A man is considered sterile when his sperm count is zero or below 100,000 non-motile sperm per sample.

Choice B is wrong because the number of ejaculations does not guarantee sterility.Some sperm may still be present in the severed vas deferens for months after a vasectomy.

Choice C is wrong because the duration of contraception use after a vasectomy depends on the sperm count test results, not on a fixed time period.It may take more or less than 3 months for a man to become sterile after a vasectomy.

Choice D is wrong because a repeat vasectomy is unnecessary and ineffective to ensure sterility.A vasectomy is a permanent birth control method that rarely fails or reverses.

The correct answer is choice D. The client should switch to a higher-dose formulation of oral contraceptives.Breakthrough bleeding is a common side effect of low-dose birth control pills, especially in the first months of use.It may indicate that the estrogen dose is too low to suppress the growth of the endometrium.

A higher-dose formulation may reduce or eliminate breakthrough bleeding by providing more estrogen.

Choice A is wrong because taking two pills daily until bleeding stops is not a recommended way to manage breakthrough bleeding.

It may cause side effects such as nausea, headache, or breast tenderness.It may also increase the risk of blood clots.

Choice B is wrong because stopping oral contraceptives immediately is not advisable unless there is a medical reason to do so.

Stopping oral contraceptives may cause irregular bleeding, ovulation, and pregnancy.

The client should consult with their provider before discontinuing any medication.

Choice C is wrong because smoking does not cause breakthrough bleeding, but it does increase the risk of serious complications from oral contraceptives, such as stroke, heart attack, or blood clots.The client should avoid smoking while taking any hormonal contraceptive, regardless of whether they experience breakthrough bleeding or not.