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Intrauterine Devices (IUDs)
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Self-Study Post-Test for
Intrauterine Devices (IUDs)

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Section 1: Intrauterine Devices (IUDs)

1. The following are general statements regarding IUD use. Please indicate whether each
    statement is True (T) or False (F).

 T  /  F

 

a. IUD use is very common worldwide, and is most prevalent in China.

b. Early shapes for IUDs included rings, loops, shields, and other configurations.

c. IUDs have always been made of a copper covering on a plastic frame.

d. Most IUDs being inserted today are shaped like a T with copper on the stem and
    arms.

 

 

 

 

2. Which of the following are important elements for providing high-quality care for IUD use?
    Check all that apply.
   a. Proper follow-up care.
   b. Counseling on the immorality of sex before marriage.
   c. Proper infection prevention procedures.
   d. Appropriate screening.

3. Researchers believe that the main mechanism of action of copper-bearing IUDs is (check all that apply):
   a. Prevention of fertilization.
   b. Changes in the woman's uterus that prevent a fertilized egg from implanting.
   c. Changes in the woman's uterus that destroy a fertilized egg.
   d. None of the above.

4. Which of the following contraceptive methods have negligible differences (less than one
    percent) in failure rates for "typical" versus "correct and consistent" use? Check all that apply.
   a. Diaphragm.
   b. IUD.
   c. Spermicides.
   d. Female sterilization.
   e. Condoms.

5. The widely used copper TCu 380A IUD is effective for:
   a. Two years.
   b. Three to five years.
   c. Seven years.
   d. Twelve years.

6. If the cost of IUDs is spread over five years, the device is:
   a. Equivalent in cost to oral contraceptives and condoms.
   b. Less than half the cost of a year's supply of oral contraceptives or condoms.
   c. More expensive than all other contraceptive methods.
   d. None of the above.

7. The following statements pertain to characteristics of copper IUDs. Please indicate whether each
    statement is True (T) or False (F).

 T  /  F

 

a. The IUD has no systemic effects.

b. Return to fertility takes at least six months after IUD removal.

c. IUDs are easy to use, long-lasting and easily reversible.

d. IUDs should not be used by breastfeeding women.

 

 

 

 

8. Although current IUDs are safe and effective, possible side effects or complications for some
    women include which of the following? Check all that apply.
   a. Nausea and headaches.
   b. Perforation.
   c. Pain and cramping.
   d. Heavier menstrual bleeding and menstrual irregularities.
   e. Weight gain.
   f. Somewhat increased risk of pelvic inflammatory disease (PID).

9. Ways to reduce the risk of PID for IUD users include which two of the following?
   a. Screen clients for risk of sexually transmitted diseases (STIs).
   b. Schedule a follow-up visit for two years after insertion.
   c. Follow infection prevention procedures.
   d. Counsel in correct daily method use.

10. IUD expulsion rates are:
   a. Unacceptably high for late postpartum insertions.
   b. High for interval insertions.
   c. The same for both interval and early postpartum insertions.

11. IUDs can be inserted at which of the following times? Check all that apply.
   a. At any time during the menstrual cycle, if a woman is not pregnant or has no signs of
             infection.
   b. Within 48 hours postpartum, if there is no infection or hemorrhage.
   c. Within seven days postpartum.
   d. Four weeks after delivery.

Section 2: Client Screening and Counseling

12. Which of the following women could be suitable candidates for IUD use? Check all that apply.
   a. Woman at low risk for STIs.
   b. Woman who is breastfeeding.
   c. Woman who is HIV positive.
   d. Woman with ovarian cancer.
   e. Young woman who has never been pregnant.

13. Which of the following conditions should automatically rule out IUD use? Check all that apply.
   a. Unexplained vaginal bleeding (before evaluation).
   b. High blood pressure.
   c. Irregular menstrual cycles.
   d. Current STIs, PID or AIDS (without ARV treatment).
   e. Pregnancy.

14. Important issues to cover when counseling a woman who chooses the IUD include all of the
      following except which one?
   a. Possible side effects and complications.
   b. Instructions for use and follow-up visits.
   c. Assessment of current and future risk for STIs.
   d. Proximity to clinic for resupply.
   e. Effectiveness and how the IUD works.
   f. Characteristics of IUDs.

15. Dispelling myths is an important part of education to improve IUD use. Please indicate whether
      each statement is True (T) or False (F).

 T  /  F

 

a. Occasionally, men may feel the IUD string but this should not cause pain or
    discomfort; therefore, counseling the male partner may be appropriate.

b. IUDs cause infertility.

c. The IUD works by aborting a fertilized egg.

d. IUDs cannot travel to distant parts of the body.

e. Copper IUDs are often too large for small women.

 

 

 

 

 

16. The following are statements regarding IUD use, follow-up and complications. Please indicate
      whether each statement is True (T) or False (F).

 T  /  F

 

a. Clients should be counseled to use a backup method of contraception if they notice
    the strings are missing.

b. Providers should listen to a woman and honor the request that an IUD be removed
    for any reason.

c. Signs of possible complications include: severe bleeding or abdominal cramping in
    the first few days after insertion, fever or chills, pain during intercourse, unusual
    vaginal discharge or irregular bleeding.

d. A change in the length of IUD strings is cause for concern.

Section 3: Insertion Guidelines and Management Issues

17. Ways to reduce risks during IUD insertion include which of the following? Check all that apply.
   a. Use only IUDs contained in sterile unopened packages.
   b. Use only untarnished IUDs.
   c. Provide high-quality training for providers, including supervised clinical practice with
             interval and postpartum insertions.
   d. Allow only physicians to perform insertions.
   e. Wash hands, wear sterile gloves and disinfect the vagina and cervix before insertion.

18. Which of the following outlines the proper order for the actual steps in IUD insertion?
   a. Inspect, disinfect, insert IUD, perform bimanual exam, sound uterus.
   b. Inspect, perform bimanual exam, disinfect, sound uterus, insert IUD.
   c. Perform bimanual exam, insert IUD, disinfect.

19. The following are statements regarding management of IUD complications. Please indicate
      whether each statement is True (T) or False (F).

 T  /  F

 

a. A sharp pain during IUD insertion usually indicates perforation of the uterus
    and the provider should remove the IUD and begin the re-insertion process
    immediately.

b. Heavy bleeding for more than three months should cause the provider to check for
    infection, tumors or signs of anemia.

c. If pregnancy is discovered in an IUD user within the first 13 weeks, a trained health
    care provider should remove the IUD.

d. If a client says her IUD strings are missing, a provider should perform a pelvic exam
    to determine if the strings are high in the cervix or hidden by a fold in the vagina.

e. Studies show that IUD users continue to use their IUD much longer than users of
    other reversible contraceptive methods.

20. Important steps in IUD removal include which of the following?
   a. Follow infection prevention guidelines.
   b. Counsel client about possible cramping or bleeding.
   c. Apply slow gentle traction to avoid breaking strings.
   d. Refer difficult removals to a specially trained provider.
   e. All of the above.


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