A nurse is teaching a group of students about effective use of the vaginal contraceptive ring.
Which of the following information should the nurse include?
Leave the ring inserted for 3 weeks followed by a week without the ring.
Contact your provider for a new ring if you gain or lose more than 4.5 kg (10 lb).
Wash the ring with warm soap and water after each use.
Insert the ring up to 6 hours before sexual intercourse.
The Correct Answer is A
Choice A rationale
The vaginal contraceptive ring is designed for cyclic use, specifically to be left inserted for 3 consecutive weeks, followed by a 1-week ring-free interval. This regimen allows for a withdrawal bleed during the ring-free week, mimicking a natural menstrual cycle while maintaining contraceptive efficacy by providing continuous hormone release for 21 days.
Choice B rationale
Body weight fluctuations of 4.5 kg (10 lb) do not significantly impact the effectiveness of the vaginal contraceptive ring. The ring delivers a localized and consistent dose of hormones that is not dependent on systemic absorption influenced by minor weight changes. Therefore, contacting a provider for a new ring due to this weight change is unnecessary.
Choice C rationale
The vaginal contraceptive ring should not be washed with soap and water after each use. The ring is a single-use, disposable device designed to be inserted and remain in place for the full 3-week duration. Washing it could potentially degrade the material or interfere with the controlled release of hormones, compromising its efficacy.
Choice D rationale
The vaginal contraceptive ring does not need to be inserted immediately before sexual intercourse. It provides continuous contraceptive protection as long as it is inserted and used correctly according to the 3-week in, 1-week out schedule. Its efficacy is not tied to the timing of individual sexual acts.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Step 1 is to determine the number of days from April 1 to December 26. Days in April = 30 - 1 + 1 = 30 days. Days in May = 31 days. Days in June = 30 days. Days in July = 31 days. Days in August = 31 days. Days in September = 30 days. Days in October = 31 days. Days in November = 30 days. Days in December = 26 days. Total number of days = 30 + 31 + 30 + 31 + 31 + 30 + 31 + 30 + 26 = 270 days.
Step 2 is to convert the total number of days into weeks. 270 days ÷ 7 days/week = 38.57 weeks.
Step 3 is to round to the nearest whole week. The anticipated gestational age is 39 weeks.
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
Vacuum-assisted delivery increases the risk of postpartum hemorrhage due to potential trauma to the birth canal and uterine atony caused by prolonged pressure or rapid extraction. The vacuum device can bruise the cervix, vagina, or perineum, leading to lacerations that bleed excessively. It can also overstretch uterine muscles, impairing their ability to contract effectively after birth.
Choice B rationale
A newborn weight of 2.948 kg (6 lb 8 oz) is within the normal weight range for a full-term infant. This weight does not typically pose an increased risk for postpartum hemorrhage. Larger infants (macrosomia, generally > 4 kg) are associated with higher risks due to increased uterine stretching and potential for prolonged labor or birth trauma.
Choice C rationale
Labor induction with oxytocin significantly increases the risk for postpartum hemorrhage, particularly due to uterine atony. Prolonged oxytocin administration can lead to desensitization of myometrial receptors, reducing the uterus's ability to contract effectively postpartum. This impaired contractility prevents compression of uterine blood vessels, resulting in excessive bleeding.
Choice D rationale
A history of uterine atony is a substantial risk factor for recurrent postpartum hemorrhage. Uterine atony is the most common cause of postpartum hemorrhage, accounting for a majority of cases. A prior history indicates a predisposition for the uterine musculature to fail in contracting adequately after birth, leading to uncontrolled blood loss.
Choice E rationale
A history of human papillomavirus (HPV) infection does not directly increase the risk of postpartum hemorrhage. HPV is a viral infection that primarily affects epithelial cells, often leading to genital warts or cervical dysplasia. It does not inherently alter uterine contractility, coagulation factors, or predispose to abnormal placental implantation, which are direct causes of hemorrhage.
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