Review Practice Excercise 2

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Practice Excercise 2

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Total Questions : 5

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Question 1:

A nurse is teaching a patient about the cervical mucus method. What indicates fertile days?

A. Thick, sticky mucus B. Clear, stretchy mucus C. Dry, minimal mucus D. Cloudy, opaque mucus

Answer and Explanation

Choice A:

Thick, sticky mucus is progesterone-dominant and occurs after ovulation. It forms a barrier to sperm and indicates non-fertile days.

Choice B:

Clear, stretchy mucus indicates high estrogen levels and imminent ovulation. It resembles raw egg white and allows sperm to swim easily through the cervix, marking the fertile window.

Choice C:

Dry, minimal mucus is typical in the early follicular phase or post-ovulation. It reflects low estrogen and is not conducive to sperm survival or transport.

Choice D:

Cloudy, opaque mucus appears during transitional phases but does not indicate peak fertility. It lacks the elasticity and clarity of fertile mucus and impedes sperm motility.

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Question 2:

A client presents to the clinic requesting emergency contraception after unprotected intercourse 48 hours ago. She has no contraindications to any method. Which of the following emergency contraceptive options is generally considered the most effective?

A. Combined Estrogen-Progestin Pills (Yuzpe method) B. Levonorgestrel (LNG) pill (e.g., Plan B One-Step) C. Ulipristal Acetate (UPA) pill (e.g., EllaOne) D. Copper IUD insertion

Answer and Explanation

Choice A:

Yuzpe method has a failure rate of 2–3% and causes nausea and vomiting due to high estrogen. It is less effective than other options and not preferred when better alternatives exist.

Choice B:

Levonorgestrel is effective only if taken before LH surge. Its efficacy drops significantly after ovulation begins. It is less reliable than ulipristal or copper IUD.

Choice C:

Ulipristal acetate is more effective than levonorgestrel, especially closer to ovulation, but still less effective than copper IUD. It delays ovulation even after LH surge but does not prevent implantation.

Choice D:

Copper IUD is the most effective emergency contraceptive, with failure rates <0.1%. It prevents fertilization and implantation and is effective up to 120 hours post-intercourse regardless of cycle timing.

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Question 3:

Which of the following are advantages of barrier methods? Select all that apply.

A. Protection against STIs B. High efficacy with typical use C. Female-controlled options D. Long-term contraception E. No prescription required

Answer and Explanation

Choice A:

Barrier methods, especially latex condoms, reduce transmission of STIs including Chlamydia trachomatis, Neisseria gonorrhoeae, and HIV. They form a physical barrier preventing exchange of genital secretions.

Choice B:

High efficacy with typical use is not a feature of barrier methods. Male condoms have a typical-use failure rate of ≈13%, and diaphragms ≈17%. These rates are higher than hormonal methods or IUDs, which have failure rates <1%.

Choice C:

Female-controlled options like female condoms, diaphragms, and cervical caps allow women to initiate and manage contraception independently, enhancing autonomy and accessibility.

Choice D:

Barrier methods are not long-term contraception. They must be used with each act of intercourse and do not provide continuous protection. Long-term methods include IUDs, implants, and sterilization.

Choice E:

Most barrier methods, including male and female condoms, are available over-the-counter and do not require a prescription, making them easily accessible and usable without clinical intervention.

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Question 4:

A nurse is reinforcing education on male condom use for a sexually active adolescent. Which of the following instructions is crucial for effective condom use and STI prevention?

A. Store condoms in a wallet for easy access. B. Use oil-based lubricants to prevent tearing. C. Apply the condom before any genital contact occurs. D. Re-use condoms if they appear intact after intercourse.

Answer and Explanation

Choice A:

Storing condoms in a wallet exposes them to heat and friction, which degrade latex and increase the risk of breakage. Ideal storage is in a cool, dry place away from direct sunlight.

Choice B:

Oil-based lubricants (e.g., petroleum jelly) weaken latex and increase the risk of tearing. Only water-based or silicone-based lubricants are safe with latex condoms.

Choice C:

Applying the condom before any genital contact is essential to prevent transmission of STIs and pregnancy from pre-ejaculate fluid, which may contain sperm and pathogens like HIV or Chlamydia trachomatis.

Choice D:

Re-using condoms is unsafe and ineffective. Microscopic tears and loss of elasticity compromise barrier function, increasing risk of pregnancy and STI transmission.

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Question 5:

Which of the following are true about emergency contraception? Select all that apply.

A. Does not terminate established pregnancies B. Includes copper IUD as an option C. Requires daily administration D. Time-sensitive effectiveness E. Causes endometrial shedding

Answer and Explanation

Choice A:

Emergency contraception acts before implantation and does not terminate an established pregnancy. It is ineffective once the embryo has implanted and hCG levels begin to rise above 5 mIU/mL.

Choice B:

Copper IUD is a highly effective emergency contraceptive option. It creates a spermicidal intrauterine environment and prevents fertilization and implantation when inserted within 120 hours post-intercourse.

Choice C:

Emergency contraception does not require daily administration. Levonorgestrel and ulipristal acetate are single-dose regimens. Copper IUD is a one-time insertion. Daily dosing is not part of emergency contraceptive protocols.

Choice D:

Emergency contraception is time-sensitive. Levonorgestrel is most effective within 72 hours, ulipristal acetate within 120 hours, and copper IUD up to 120 hours. Delay reduces efficacy due to progression of ovulation and fertilization.

Choice E:

Hormonal emergency contraceptives alter the endometrial lining, making it unreceptive to implantation. This shedding effect contributes to their mechanism of action, especially if ovulation has already occurred.

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Practice Excercise 2

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