Family planning NCLEX-RN Practice Questions

Family Planning NCLEX-RN Practice Questions

Preparing for the NCLEX-RN requires strong command of evidence-based family planning counseling and safe contraceptive use. This topic-wise set of practice questions targets Health Promotion & Maintenance with a focus on real-world decision-making: selecting appropriate methods, recognizing contraindications, timing postpartum options, counseling on emergency contraception, and addressing safety signals like ACHES with combined hormonal contraceptives. You’ll also navigate drug–method interactions, STI prevention, consent and confidentiality with adolescents, return-to-fertility expectations, and special considerations for breastfeeding, migraines with aura, and chronic conditions. Each question is crafted at an NCLEX-RN level for advanced learners, including M. Pharma students, to solidify clinical reasoning and patient-centered teaching points essential to safer reproductive health care.

Q1. Which client report requires urgent evaluation in a woman taking a combined oral contraceptive?

• Severe unilateral leg pain with swelling
• Mild nausea after taking the pill
• Occasional breakthrough spotting
• Gradual weight gain over three months

Correct Answer: Severe unilateral leg pain with swelling

Q2. A 16-year-old requests contraception and asks that her parents not be informed. What is the nurse’s best action?

• Provide confidential counseling and contraception consistent with state laws and clinic policy
• Require parental consent before providing any contraceptive services
• Delay care until the client is 18 years old
• Schedule a joint session with both parents present

Correct Answer: Provide confidential counseling and contraception consistent with state laws and clinic policy

Q3. A client is 2 weeks postpartum and exclusively breastfeeding. She desires contraception now. Which method is most appropriate?

• Progestin-only pill
• Combined oral contraceptive
• Transdermal combined hormonal patch
• Combined vaginal ring

Correct Answer: Progestin-only pill

Q4. Which statement about the copper intrauterine device (IUD) is accurate?

• It may increase menstrual bleeding and cramping
• It releases a progestin to thin the endometrium
• It must be replaced every 12 months
• It is contraindicated in nulliparous clients

Correct Answer: It may increase menstrual bleeding and cramping

Q5. A client with BMI 34 presents 4 days after unprotected intercourse seeking the most effective emergency contraception. Which is best?

• Copper IUD placed within 5 days
• Ulipristal acetate 30 mg
• Levonorgestrel 1.5 mg
• High-dose combined oral contraceptive (Yuzpe method)

Correct Answer: Copper IUD placed within 5 days

Q6. After taking ulipristal acetate for emergency contraception, how should a client restart routine hormonal contraception?

• Start immediately; no backup is needed
• Start the next day with backup for 2 days
• Delay starting for 5 days, then use backup for 7 more days
• Avoid all hormones for one month

Correct Answer: Delay starting for 5 days, then use backup for 7 more days

Q7. Which contraceptive is most appropriate for a client with migraine with aura?

• Copper IUD
• Low-dose combined oral contraceptive
• Transdermal combined hormonal patch
• Combined vaginal ring

Correct Answer: Copper IUD

Q8. Which counseling point about depot medroxyprogesterone acetate (DMPA) injections is correct?

• It may cause reversible bone mineral density loss and delay in return to fertility
• It must be injected weekly to remain effective
• It causes heavy, predictable monthly bleeding
• It is unsafe for breastfeeding clients

Correct Answer: It may cause reversible bone mineral density loss and delay in return to fertility

Q9. Which client meets all criteria for effective use of the Lactational Amenorrhea Method (LAM)?

• Exclusively breastfeeding, amenorrheic, infant is 3 months old
• Partial breastfeeding, amenorrheic, infant is 7 months old
• Exclusively breastfeeding with occasional pumping, menses returned at 8 weeks postpartum
• Exclusively breastfeeding, amenorrheic, infant is 9 months old

Correct Answer: Exclusively breastfeeding, amenorrheic, infant is 3 months old

Q10. A client taking carbamazepine for seizures requests birth control pills. What is the best recommendation?

• Offer a method not affected by enzyme inducers, such as a copper IUD or DMPA
• Standard combined oral contraceptives are fully reliable with carbamazepine
• Use an extended-cycle transdermal patch to overcome the interaction
• Take antibiotics with oral contraceptives to enhance efficacy

Correct Answer: Offer a method not affected by enzyme inducers, such as a copper IUD or DMPA

Q11. Which instruction supports correct use of male latex condoms?

• Leave a half-inch space at the tip to collect semen
• Use oil-based lubricants to reduce friction
• Wash and reuse condoms to reduce waste
• Store condoms in a wallet for convenience

Correct Answer: Leave a half-inch space at the tip to collect semen

Q12. A client with an IUD has a positive pregnancy test and reports unilateral pelvic pain and spotting. What is the priority action?

• Urgently evaluate for ectopic pregnancy
• Remove the IUD and discharge with routine prenatal follow-up
• Reassure that pain and spotting are normal in early pregnancy
• Start combined oral contraceptives to stabilize the endometrium

Correct Answer: Urgently evaluate for ectopic pregnancy

Q13. Which statement indicates correct use of a diaphragm?

• Apply spermicide each time and leave in place at least 6 hours after intercourse
• Remove immediately after intercourse to reduce infection risk
• Use petroleum jelly to improve the seal
• Fitting never needs to be repeated after weight changes

Correct Answer: Apply spermicide each time and leave in place at least 6 hours after intercourse

Q14. A client on combined oral contraceptives reports a sudden severe headache with vision changes. This most likely indicates which risk?

• Ischemic stroke or thrombotic event
• Expected hormonal fluctuation
• Electrolyte imbalance
• Sinus congestion

Correct Answer: Ischemic stroke or thrombotic event

Q15. Which contraceptive method provides the best protection against sexually transmitted infections (STIs)?

• Male latex condoms
• Combined oral contraceptives
• Levonorgestrel IUD
• Withdrawal (coitus interruptus)

Correct Answer: Male latex condoms

Q16. A client taking a traditional progestin-only pill (norethindrone) is over 3 hours late for today’s pill. What should she do?

• Take the missed pill now and use backup contraception for 48 hours
• Discard the pack and restart with the next menses
• Take two pills tomorrow; backup is not required
• Emergency contraception is mandatory for any late pill

Correct Answer: Take the missed pill now and use backup contraception for 48 hours

Q17. A client with heavy menses and suspected copper sensitivity desires long-acting reversible contraception with lighter periods. Best option?

• Copper IUD
• Levonorgestrel-releasing IUD
• Diaphragm with spermicide
• Fertility awareness methods

Correct Answer: Levonorgestrel-releasing IUD

Q18. Which statement about the combined hormonal transdermal patch is correct?

• It is applied weekly for 3 weeks followed by 1 patch-free week
• It delivers lower estrogen exposure than most pills
• It is more effective in clients with BMI ≥30 kg/m²
• It provides reliable protection against STIs

Correct Answer: It is applied weekly for 3 weeks followed by 1 patch-free week

Q19. Which counseling point about spermicides containing nonoxynol-9 is accurate?

• Frequent use may increase genital irritation and HIV acquisition risk
• They provide reliable STI protection
• They are preferred in clients with recurrent UTIs
• They are recommended for anal intercourse

Correct Answer: Frequent use may increase genital irritation and HIV acquisition risk

Q20. A client requests an IUD immediately after a vaginal delivery. What should the nurse explain?

• Immediate postpartum IUD insertion is acceptable but has a higher expulsion risk
• IUD placement must be delayed for at least 6 months postpartum
• IUDs are contraindicated during breastfeeding
• General anesthesia is required for postpartum IUD placement

Correct Answer: Immediate postpartum IUD insertion is acceptable but has a higher expulsion risk

Q21. A 38-year-old client smokes one pack per day. Which contraceptive is safest and highly effective?

• Etonogestrel implant
• Combined oral contraceptive
• Transdermal combined patch
• Combined vaginal ring

Correct Answer: Etonogestrel implant

Q22. A client taking rifampin for tuberculosis uses combined oral contraceptives. Which teaching is best?

• Use a backup method during rifampin therapy and for 28 days after completion
• Rifampin does not affect pill efficacy
• Skip the hormone-free week to maintain hormone levels
• Double the daily pill dose while on rifampin

Correct Answer: Use a backup method during rifampin therapy and for 28 days after completion

Q23. Which statement about vasectomy is correct?

• Backup contraception is needed until semen analysis confirms azoospermia
• It is immediately effective after the procedure
• Reversal is guaranteed if desired later
• It increases the risk of prostate cancer

Correct Answer: Backup contraception is needed until semen analysis confirms azoospermia

Q24. A client has a history of hormone-sensitive breast cancer and desires effective contraception. Which is best?

• Copper IUD
• Combined oral contraceptive
• Etonogestrel implant
• DMPA injection

Correct Answer: Copper IUD

Q25. Which client is least suitable for fertility awareness-based methods?

• A client with markedly irregular menstrual cycles
• A motivated client willing to abstain during fertile days
• A client able to track daily basal body temperature and cervical mucus
• A client with predictable 28–30 day cycles

Correct Answer: A client with markedly irregular menstrual cycles

Q26. Which is a common side effect of the etonogestrel implant?

• Unpredictable or irregular bleeding patterns
• Significant weight loss
• Increased bone mineral density
• Permanent infertility

Correct Answer: Unpredictable or irregular bleeding patterns

Q27. A condom broke during intercourse less than 24 hours ago. The client is not on routine contraception. Best immediate advice?

• Take levonorgestrel emergency contraception now and use backup for 7 days
• Wait to see if the next period is late
• Start a combined oral contraceptive pack next month
• Emergency contraception is not effective after 12 hours

Correct Answer: Take levonorgestrel emergency contraception now and use backup for 7 days

Q28. Which statement about the cervical cap is true?

• It has a higher failure rate in parous women
• It does not require spermicide
• It can be left in place indefinitely
• It must be removed immediately after intercourse

Correct Answer: It has a higher failure rate in parous women

Q29. A client taking isotretinoin seeks contraceptive advice. What should the nurse emphasize?

• Use two reliable contraceptive methods and avoid pregnancy for at least 1 month after stopping
• Switch to warfarin for safer acne management in pregnancy
• Folic acid supplementation is unnecessary with isotretinoin
• Copper IUD is contraindicated with isotretinoin

Correct Answer: Use two reliable contraceptive methods and avoid pregnancy for at least 1 month after stopping

Q30. Which method is associated with a delayed return to fertility after discontinuation?

• DMPA injection
• Levonorgestrel IUD
• Etonogestrel implant
• Combined oral contraceptives

Correct Answer: DMPA injection

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