A woman who is 6 weeks postpartum and breast-feeding seeks contraception. She would like to have another child in 1 year. Which of the following is the preferred method of contraception?
|A)||Combined oral contraceptive|
A 32-year-old obese woman comes to the pharmacy to pick up her prescription for norgestimate-ethinyl estradiol (Ortho-Cyclen). As she pulls the prescription out of her bag, a pack of cigarettes falls on to the counter. This is of concern because:
|A)||Smoking increases the risk of venous thromboembolism|
|B)||Smoking inhibits the metabolism of oral contraceptives, increasing the risk for related side effects|
|C)||Smoking increases the risk of ovarian cancer|
|D)||Oral contraceptives increase the risk for smoking-related gastroduodenal ulcers|
A 21-year-old woman comes to the pharmacy for her second refill of norethindrone-ethinyl estradiol (Ortho-Novum 7/7/7). She is complaining of nausea and breast tenderness and wonders if you can recommend something for this problem. You recommend that she:
|A)||Call her physician to change her prescription to another oral contraceptive with less estrogenic effects|
|B)||Buy a home pregnancy test to rule out pregnancy|
|C)||Wait another 2 months to see if the symptoms improve on their own|
|D)||Take a multivitamin rich in B vitamins to treat her symptoms|
An 18-year-old woman with a seizure disorder, taking carbamazepine, seeks contraception. Which of the following contraceptive methods would be most appropriate?
|A)||Combination oral contraceptives|
|B)||Medroxyprogesterone acetate (Depo-Provera)|
A 23-year-old frantic woman comes to the pharmacy asking for help in choosing a home pregnancy test. She says that her partner’s condom broke during intercourse last night and that she’s worried that she might be pregnant. She started her last period 18 days ago. You recommend that she:
|A)||Not worry; chances are she is not pregnant|
|B)||Buy emergency contraception|
|C)||Make an appointment with her doctor to discuss an additional method of hormonal contraception|
|D)||Purchase a home pregnancy test to use if her period is late|
A 22-year-old woman has been using Depo-Provera for the past year. She comes to the office for her quarterly injection (her last injection was 13 weeks ago). The nurse asks you about the administration of medroxyprogesterone acetate (Depo-Provera), and you recommend that she:
|A)||Have the patient wait until her next period before receiving her injection|
|B)||Tell the patient to come back the next week for her injection|
|C)||Give the injection today but use a second method of contraception for the next cycle|
|D)||Do a pregnancy test in the office and give the injection if the test is negative|
In which of the following situations would it be inappropriate to recommend combined oral contraceptives?
|A)||Sickle cell disease with vasoocclusive crisis approximately every 6 to 9 months|
|B)||Hypertension treated with hydrochlorothiazide and an average blood pressure of 172/92 mm Hg|
|C)||History of simple migraine headaches (without aura)|
|D)||Dyslipidemia without coronary artery disease treated with a statin|
Oral contraceptives are associated with a known decreased risk for which of the following conditions?
|B)||Pelvic inflammatory disease|
A patient is taking the oral contraceptive, drospirenone-ethinyl estradiol (Yasmin), and calls you because she has missed her pill for 2 days. You recommend which of the following management plans:
|A)||If the missed pills were in the first week of the pill pack, take two pills as soon as possible then finish the pill pack; use a backup method for 7 days|
|B)||If the missed pills were in the first week of the pill pack, just start a new pill pack|
|C)||If the missed pills were in the second or third week of the pill pack, skip the missed doses and finish the pill pack; use a backup method for 7 days|
|D)||If the missed pills were in the last week of the pill pack, take two pills as soon as possible then finish the pill pack; use a back-up method for 7 days|
Intrauterine devices should not be used in which of the following groups of women?
|A)||Those with multiple sexual partners|
|B)||Those who desire passive, long-term contraception|
|C)||Those with contraindications to estrogen|
|D)||Those with heavy menstrual bleeding|
Which of the following mechanisms of action is unique to progesterone in preventing pregnancy?
|A)||Inhibition of implantation|
|B)||Accelerated ovum transport|
|C)||Inhibition of ovulation|
|D)||Production of thick cervical mucus|
Injectable progestins (e.g., medroxyprogesterone acetate [Depo-Provera]) are the most appropriate contraceptive choice in women who:
|A)||Have a history of antiphospholipid syndrome|
|B)||Desire contraceptive that is rapidly reversible|
|C)||Have menstrual irregularities (frequent breakthrough bleeding and spotting)|
In which of the following situations would use of combined oral contraceptives be appropriate?
|A)||A low-dose oral contraceptive (35 mcg ethinyl estradiol) in a heavy smoker (>15 cigarettes per day)|
|B)||A low-dose oral contraceptive (35 mcg ethinyl estradiol) in a light smoker (<15 cigarettes per day)|
|C)||A very-low dose oral contraceptive (20 mcg ethinyl estradiol) in a light smoker (<15 cigarettes per day)|
|D)||A very-low dose oral contraceptive (20 mcg ethinyl estradiol) in a heavy smoker (>15 cigarettes per day)|
Which of the following statements is true regarding emergency contraception:
|A)||Levonorgestrel-ethinyl estradiol (Alesse) is an oral contraceptive that can be used with a dose of three pills taken within 72 hours of unprotected intercourse and three more pills taken 12 hours later|
|B)||Progestin-only pills can be used (20 tablets per dose, separated by 12 hours) but frequently cause nausea and vomiting|
|C)||If a patient vomits within 6 hours of taking the pills, the dose should be repeated and given in conjunction with an antiemetic|
|D)||Emergency contraception is most effective when given within 72 hours of unprotected intercourse|
A 25-year-old, 103-kg woman comes for her first prescription of hormonal contraception. Which hormonal contraceptive would be inappropriate in this case?
|A)||Vaginal contraceptive ring|
|C)||Norethindrone ethinyl estradiol (Ortho 1/35)|