A client asks for a contraceptive method that does not require daily administration. The nurse describes a medication that is taken once a week on the same day. Which medication fits this description?

Appeared in: NORCET 9 Prelims-2025

Explanation

Saheli (Ormeloxifene), also known as Centchroman, is a non-steroidal oral contraceptive specifically designed for a weekly dosage schedule.
The standard regimen for Saheli is twice a week for the first three months, followed by a maintenance dose of once a week, which matches the description in the question.
Unlike hormonal pills, its primary mechanism of action is to prevent the implantation of a fertilized ovum in the uterus rather than inhibiting ovulation.
This method is a suitable alternative for women who want to avoid daily pill intake or the hormonal side effects of conventional contraceptives.

Option A: Combined oral contraceptive pills must be taken daily for 21 consecutive days, followed by a 7-day break. This does not match the 'once a week' requirement.
Option B: The progestin-only pill, or 'minipill', requires even stricter adherence than combined pills, needing to be taken at the exact same time every day without any break.
Option D: The emergency contraceptive pill is intended for 'morning after' use following unprotected intercourse or contraceptive failure. It is not a regular, scheduled method of contraception.

Visual 1: Comparison Table - A table comparing different oral contraceptives (Saheli, Combined Pill, Minipill, Emergency Pill) based on their type, administration frequency, and mechanism of action.
Visual 2: Flowchart - A visual guide illustrating the dosage schedule for Saheli, clearly showing the initial twice-weekly phase for three months and the subsequent once-weekly maintenance phase.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacology of Oral Contraceptives to guide bedside assessment, documentation, and the next nursing action.
A key nursing role in family planning is to provide comprehensive counseling on all available contraceptive methods, including their specific administration schedules, benefits, and side effects, to help the client make an informed choice.
For Saheli, it is critical to educate the client about the initial twice-weekly schedule for the first three months to ensure maximum efficacy before switching to the weekly maintenance dose.
Patient adherence is a major factor in contraceptive effectiveness. Offering options with different schedules, like the weekly Saheli pill, can improve compliance for clients who find daily routines difficult.

How to Approach the Question

First, identify the key requirement from the question stem: the client is looking for a contraceptive that is taken 'once a week'.
Next, evaluate each option based on its standard administration frequency.
Recall that combined oral contraceptives and progestin-only pills are both daily medications. This allows you to eliminate these two options.
Recognize that the emergency contraceptive pill is for post-coital use only and not a regular, scheduled contraceptive. This eliminates this option.
By elimination, Saheli (Ormeloxifene) remains. Recall or deduce that it is known for its unique weekly dosage schedule, making it the correct answer.

Concept Tested & Keywords

Concept Tested: Pharmacology of Oral Contraceptives
Stem keywords: contraceptive method, not daily administration, once a week
Lead-in keywords: Which medication
Clinical cues: client asks for a contraceptive method that does not require daily administration

QxgkB_2OOckIk7nja31P86

Practise the full NORCET 9 Prelims-2025

Attempt every question from this paper in a timed mock, then review the full solution for each one.