Which of the following information should the nurse include when teaching a group of students about effective use of the vaginal contraceptive ring?
Contact your provider for a new ring if you gain or lose more than 4.5 kg (10 lb).
Leave the ring inserted for 3 weeks followed by a week without the ring.
Wash the ring with warm soap and water after each use.
Insert the ring up to 6 hr before sexual intercourse.
The Correct Answer is B
Choice A reason: Weight changes of 4.5 kg do not necessitate a new vaginal contraceptive ring, as its efficacy relies on local hormone release, not body weight. The ring delivers consistent estrogen and progestin doses, preventing ovulation and altering cervical mucus, unaffected by minor weight fluctuations, per contraceptive pharmacology.
Choice B reason: Leaving the ring inserted for 3 weeks followed by a 1-week removal is the correct regimen, allowing hormonal contraception to prevent ovulation and maintain endometrial stability. This cycle mimics the menstrual cycle, ensuring continuous protection while permitting withdrawal bleeding, aligning with the ring’s pharmacokinetic design for effective contraception.
Choice C reason: Washing the ring with soap and water after use is incorrect, as it may degrade the device or reduce efficacy. The ring is disposable or reusable per cycle, and cleaning disrupts its hormonal matrix. Proper hygiene involves handwashing before insertion, not cleaning the ring itself, per manufacturer guidelines.
Choice D reason: Inserting the ring 6 hours before intercourse is incorrect, as the vaginal ring provides continuous contraception, not on-demand use. It requires insertion for 3 weeks to deliver steady hormones, preventing ovulation and altering cervical mucus, unlike barrier methods, making this timing irrelevant to its contraceptive mechanism.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Obtaining the client’s temperature, heart rate, and blood pressure assesses maternal status but is not the highest priority. Nausea and an urgent need for a bowel movement suggest advanced labor or fetal head compression. Fetal heart rate (FHR) monitoring is critical, as strong contractions may reduce placental perfusion, risking fetal hypoxia, which takes precedence over maternal vital signs to ensure immediate fetal safety.
Choice B reason: Examining vaginal discharge for meconium indicates potential fetal stress but is not the highest priority. Nausea and bowel urgency suggest rapid labor progression or fetal head compression, impacting FHR. Assessing FHR first ensures fetal oxygenation status, as meconium is a secondary finding that does not immediately guide interventions for acute distress during strong contractions.
Choice C reason: Determining the fetal heart rate in relationship to contractions is the highest priority, as nausea and bowel urgency indicate possible second-stage labor or fetal head compression, causing FHR decelerations. Strong contractions may reduce placental blood flow, risking hypoxia. Continuous monitoring via scalp electrode detects late or variable decelerations, guiding urgent interventions to ensure fetal safety.
Choice D reason: Performing a sterile vaginal examination assesses labor progress but is not the highest priority. Nausea and bowel urgency suggest advanced labor, but FHR assessment takes precedence to rule out fetal distress. Vaginal exams risk infection or membrane rupture and do not directly address fetal oxygenation, critical during strong contractions that may compromise placental perfusion.
Correct Answer is A
Explanation
Choice A reason: Rho(D) immune globulin is administered after a miscarriage in Rh-negative women to prevent isoimmunization, as fetal blood mixing can occur. This immunoglobulin neutralizes Rh-positive fetal antigens, preventing maternal antibody formation that could affect future pregnancies. The immune response could otherwise lead to hemolytic disease in subsequent Rh-positive fetuses.
Choice B reason: Administering Rho(D) immune globulin at 12 weeks is not standard practice. It is typically given at 28 weeks and post-delivery or after events like miscarriage. Early administration is unnecessary unless a sensitizing event occurs, as maternal-fetal blood mixing is rare before the third trimester, per immunological principles.
Choice C reason: Rho(D) immune globulin does not prevent preterm labor, which is driven by uterine or hormonal factors. The injection targets Rh isoimmunization by neutralizing Rh-positive fetal antigens. Preterm labor involves prostaglandin and oxytocin pathways, unrelated to Rh sensitization, making this statement irrelevant to the immunoglobulin’s immunological mechanism.
Choice D reason: Rho(D) immune globulin is unnecessary post-delivery if the baby is Rh-negative, as no sensitization occurs without Rh-positive fetal blood. The injection is given only if the baby is Rh-positive to prevent maternal antibody formation. This statement reflects a misunderstanding of Rh immunology and isoimmunization risk in pregnancy.
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