Contraception is a cornerstone of women’s health and preventative care, offering individuals control over their reproductive lives. The pharmacist’s role in this area is expanding, from counseling on the vast array of available methods to, in some jurisdictions, prescribing them. A deep understanding of the pharmacology, risks, and benefits of each contraceptive option is a key competency taught in the “Women’s Health” module of the Patient Care 5 curriculum. This quiz will test your knowledge on the evidence-based management of contraceptive therapies.
1. What is the primary mechanism of action for combined hormonal contraceptives (CHCs)?
- a. They act as a physical barrier to sperm.
- b. They primarily work by thickening cervical mucus.
- c. They suppress ovulation by inhibiting the release of FSH and LH.
- d. They act as a spermicide.
Answer: c. They suppress ovulation by inhibiting the release of FSH and LH.
2. A patient with a history of a deep vein thrombosis (DVT) has an absolute contraindication to which of the following?
- a. A copper IUD
- b. A progestin-only pill
- c. A combined hormonal contraceptive containing estrogen
- d. Male condoms
Answer: c. A combined hormonal contraceptive containing estrogen
3. Progestin-only pills (POPs or “mini-pills”) primarily work by:
- a. Consistently inhibiting ovulation.
- b. Thickening the cervical mucus, making it difficult for sperm to penetrate.
- c. Destroying the endometrial lining.
- d. Increasing the release of FSH.
Answer: b. Thickening the cervical mucus, making it difficult for sperm to penetrate.
4. A critical counseling point for a patient taking a progestin-only pill is that it must be:
- a. Taken with a high-fat meal.
- b. Taken at the exact same time every day within a strict 3-hour window.
- c. Taken only during the first two weeks of the menstrual cycle.
- d. Stored in the refrigerator.
Answer: b. Taken at the same time every day within a strict 3-hour window.
5. The “ACHES” acronym warns patients using CHCs about the signs of serious adverse effects. The “S” stands for:
- a. Skin rash
- b. Stomach upset
- c. Severe leg pain
- d. Sleepiness
Answer: c. Severe leg pain
6. The “Contraception” lecture is a specific topic in which course?
- a. PHA5787C Patient Care 5
- b. PHA5104 Sterile Compounding
- c. PHA5703 Pharmacy Law and Ethics
- d. PHA5878C Patient Care 3
Answer: a. PHA5787C Patient Care 5
7. Which of the following is a Long-Acting Reversible Contraceptive (LARC)?
- a. The transdermal patch
- b. The etonogestrel subdermal implant (Nexplanon)
- c. The vaginal ring
- d. A combined oral contraceptive pill
Answer: b. The etonogestrel subdermal implant (Nexplanon)
8. Depot medroxyprogesterone acetate (DMPA) is an injectable contraceptive that carries a black box warning regarding:
- a. Increased risk of VTE.
- b. A significant, but largely reversible, loss of bone mineral density.
- c. Severe liver injury.
- d. An increased risk of ovarian cancer.
Answer: b. A significant, but largely reversible, loss of bone mineral density.
9. Which of the following contraceptive methods also provides protection against sexually transmitted infections (STIs)?
- a. Combined oral contraceptives
- b. The hormonal IUD
- c. The copper IUD
- d. Condoms
Answer: d. Condoms
10. Levonorgestrel 1.5 mg (Plan B One-Step) is a form of:
- a. Routine contraception
- b. Emergency contraception
- c. A medical abortifacient
- d. A fertility treatment
Answer: b. Emergency contraception
11. The management of women’s health is a topic within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
12. The primary mechanism of action of emergency contraceptives like levonorgestrel is:
- a. To prevent implantation of a fertilized egg.
- b. To act as a spermicide.
- c. To delay or inhibit ovulation.
- d. To cause shedding of the uterine lining.
Answer: c. To delay or inhibit ovulation.
13. A patient who is breastfeeding and desires hormonal contraception would be a good candidate for:
- a. A combined oral contraceptive.
- b. The contraceptive patch.
- c. A progestin-only method.
- d. The vaginal ring.
Answer: c. A progestin-only method.
14. A patient misses one active-hormone pill from their combined oral contraceptive pack. What should they do?
- a. Stop the pack and start a new one next month.
- b. Take the missed pill as soon as they remember, even if it means taking two pills in one day. No backup contraception is needed.
- c. Skip the missed pill and use backup contraception for the rest of the cycle.
- d. Go to the emergency room.
Answer: b. Take the missed pill as soon as they remember, even if it means taking two pills in one day. No backup contraception is needed.
15. Counseling patients on the appropriate use of medications and devices is a key objective for student pharmacists.
- a. True
- b. False
Answer: a. True
16. The copper IUD is a non-hormonal contraceptive that works by:
- a. Inhibiting ovulation.
- b. Thickening cervical mucus.
- c. Creating an inflammatory reaction in the uterus that is spermicidal.
- d. Releasing progestin.
Answer: c. Creating an inflammatory reaction in the uterus that is spermicidal.
17. The “Reproductive Self-Care” module is part of the Patient Care I course.
- a. True
- b. False
Answer: a. True
18. Which emergency contraceptive is available by prescription only and may be more effective than levonorgestrel, especially between 72 and 120 hours after unprotected intercourse?
- a. Copper IUD
- b. High-dose estrogen pills
- c. Ulipristal acetate (Ella)
- d. A double dose of levonorgestrel.
Answer: c. Ulipristal acetate (Ella)
19. A patient with a history of migraine with aura should avoid:
- a. Progestin-only contraceptives
- b. Estrogen-containing contraceptives
- c. The copper IUD
- d. Barrier methods
Answer: b. Estrogen-containing contraceptives
20. An active learning session on women’s health is part of the Patient Care 5 course.
- a. True
- b. False
Answer: a. True
21. A woman using the transdermal contraceptive patch should be counseled to apply a new patch:
- a. Every day
- b. Once a week for 3 weeks, followed by a patch-free week.
- c. Once a month
- d. Every 3 months
Answer: b. Once a week for 3 weeks, followed by a patch-free week.
22. Which of the following is NOT a contraindication to combined hormonal contraceptives?
- a. Age > 35 years and a smoker
- b. A history of breast cancer
- c. Uncontrolled hypertension
- d. A history of acne
Answer: d. A history of acne
23. The “Emergency Contraception” lecture is a topic within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
24. An active learning session on women’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
25. A patient taking an enzyme-inducing medication like carbamazepine or rifampin may experience what with their hormonal contraceptive?
- a. Increased efficacy
- b. Decreased efficacy and potential for contraceptive failure
- c. More side effects
- d. No interaction
Answer: b. Decreased efficacy and potential for contraceptive failure
26. The most effective form of emergency contraception is:
- a. Levonorgestrel
- b. Ulipristal acetate
- c. The copper IUD
- d. Yuzpe method (combined estrogen/progestin pills)
Answer: c. The copper IUD
27. A common side effect during the first few months of starting a new hormonal contraceptive is:
- a. Breakthrough bleeding or spotting
- b. Weight loss
- c. Improved vision
- d. Increased energy
Answer: a. Breakthrough bleeding or spotting
28. An active learning session on women’s health is part of which course module?
- a. Module 3: Women’s Health
- b. Module 1: Diabetes Mellitus
- c. Module 4: Medication Safety
- d. Module 8: Men’s Health
Answer: a. Module 3: Women’s Health
29. The term “monophasic” in the context of oral contraceptives means:
- a. The pill contains only one hormone.
- b. The pill is taken only once a month.
- c. Each active pill in the pack contains the same dose of estrogen and progestin.
- d. The pill has only one side effect.
Answer: c. Each active pill in the pack contains the same dose of estrogen and progestin.
30. The “Introduction to Women’s Health” is a lecture within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
31. A patient misses two active pills during the third week of their 28-day CHC pack. What is the correct advice?
- a. Stop taking all pills and start a new pack on Sunday.
- b. Take the most recent missed pill, continue taking the rest of the active pills, skip the placebo week, and start a new pack immediately. Use backup contraception for 7 days.
- c. Do nothing and continue the pack as normal.
- d. Just take the placebo pills early.
Answer: b. Take the most recent missed pill, continue taking the rest of the active pills, skip the placebo week, and start a new pack immediately. Use backup contraception for 7 days.
32. The primary role of the pharmacist in contraception management is:
- a. To perform a physical exam.
- b. To insert IUDs and implants.
- c. To provide patient education, screen for contraindications, and ensure appropriate use.
- d. To only recommend barrier methods.
Answer: c. To provide patient education, screen for contraindications, and ensure appropriate use.
33. The contraceptive vaginal ring (NuvaRing) is kept in place for ____, followed by a ____ ring-free interval.
- a. 1 week, 3 weeks
- b. 3 weeks, 1 week
- c. 1 month, 1 week
- d. 12 weeks, 1 week
Answer: b. 3 weeks, 1 week
34. A patient taking ulipristal acetate (Ella) for emergency contraception should be advised that:
- a. It is 100% effective.
- b. It may make their regular hormonal contraceptive less effective, so a barrier method should be used.
- c. It can be taken at any time after unprotected sex.
- d. It has no side effects.
Answer: b. It may make their regular hormonal contraceptive less effective, so a barrier method should be used.
35. Which of the following is a non-contraceptive benefit of combined hormonal contraceptives?
- a. Protection against STIs.
- b. Weight loss.
- c. Improved regulation of menstrual cycles and reduced dysmenorrhea.
- d. Increased bone mineral density.
Answer: c. Improved regulation of menstrual cycles and reduced dysmenorrhea.
36. A “quick start” method for initiating oral contraceptives means:
- a. The patient starts the pack on the first Sunday after their period begins.
- b. The patient starts the pack on the first day of their period.
- c. The patient starts the pack on the day of their office visit, regardless of their cycle, and uses backup contraception for 7 days.
- d. The patient takes two pills on the first day.
Answer: c. The patient starts the pack on the day of their office visit, regardless of their cycle, and uses backup contraception for 7 days.
37. Which of the following contraceptive methods has the highest typical-use failure rate?
- a. The subdermal implant
- b. The hormonal IUD
- c. Spermicide alone
- d. The DMPA injection
Answer: c. Spermicide alone
38. The lecture “Contraception” is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
39. A patient-centered approach to contraception counseling involves:
- a. The pharmacist deciding which method is best for the patient.
- b. Discussing options that align with the patient’s lifestyle, preferences, and medical history.
- c. Only discussing oral contraceptives.
- d. Only discussing non-hormonal methods.
Answer: b. Discussing options that align with the patient’s lifestyle, preferences, and medical history.
40. An active learning session covering women’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
41. The effectiveness of the transdermal contraceptive patch may be decreased in women:
- a. Who are underweight.
- b. Weighing more than 90 kg (198 lbs).
- c. With a history of asthma.
- d. Who are over age 30.
Answer: b. Weighing more than 90 kg (198 lbs).
42. LARCs are highly recommended because:
- a. They are the cheapest methods.
- b. They are easy to start and stop by the patient.
- c. Their effectiveness does not depend on user adherence, leading to very low real-world failure rates.
- d. They have no side effects.
Answer: c. Their effectiveness does not depend on user adherence, leading to very low real-world failure rates.
43. Which of the following is a potential side effect of the copper IUD?
- a. Amenorrhea
- b. Heavier menstrual bleeding and cramping
- c. Weight gain
- d. Hot flashes
Answer: b. Heavier menstrual bleeding and cramping
44. A patient using the vaginal ring reports that it accidentally fell out and was out for 4 hours before she reinserted it. What should she do?
- a. Leave it out and start a new ring next month.
- b. Reinsert the ring; no backup contraception is needed.
- c. Reinsert the ring and use backup contraception for 7 days.
- d. Go to the emergency room.
Answer: b. Reinsert the ring; no backup contraception is needed.
45. The primary reason a progestin is included in a combined hormonal contraceptive is for:
- a. Cycle control
- b. Contraceptive efficacy
- c. Reducing side effects
- d. Both a and b
Answer: b. Contraceptive efficacy
46. A “biphasic” oral contraceptive pill means:
- a. There are two different strengths of estrogen and/or progestin in the active pills of the pack.
- b. The pill contains two different progestins.
- c. The pill is taken twice a day.
- d. The pack contains two placebo weeks.
Answer: a. There are two different strengths of estrogen and/or progestin in the active pills of the pack.
47. Counseling on the use of contraceptive devices is a key objective for student pharmacists.
- a. True
- b. False
Answer: a. True
48. An active learning session on women’s health is part of which course module?
- a. Module 3: Women’s Health
- b. Module 1: Diabetes Mellitus
- c. Module 4: Medication Safety
- d. Module 8: Men’s Health
Answer: a. Module 3: Women’s Health
49. The overall management of contraception requires:
- a. A shared decision-making process between the patient and provider.
- b. A “one-size-fits-all” approach.
- c. A focus only on the most effective methods, regardless of patient preference.
- d. A trial of every available method.
Answer: a. A shared decision-making process between the patient and provider.
50. The ultimate goal of a pharmacist’s involvement in contraception care is to:
- a. Help patients choose and use a method safely and effectively to meet their reproductive goals.
- b. Sell the most oral contraceptives.
- c. Pass the final exam.
- d. Convince all patients to use a LARC.
Answer: a. Help patients choose and use a method safely and effectively to meet their reproductive goals.