NORCET 2 -2021 (Shift-2)
Obstetrics & Gynaecology
Medium
Which of the following Emergency contraceptive methods, except?
Appeared in: NORCET 2 -2021 (Shift-2)
Explanation
- DMPA (Depot Medroxyprogesterone Acetate) is a long-acting reversible contraceptive (LARC), not an emergency contraceptive.
- It is administered as an injection every 3 months to provide continuous pregnancy prevention.
- Its mechanism involves slowly releasing progestin to inhibit ovulation over a long period, which is not suitable for a single, time-sensitive emergency intervention.
- The onset of action is not immediate, making it ineffective for preventing pregnancy shortly after unprotected intercourse.
Why Other Options Were Wrong
- Option A: Levonorgestrel (LNG) is a primary component of hormonal emergency contraceptive pills, commonly known as the 'morning-after pill'.
- Option B: Mifepristone, in low doses, is an effective emergency contraceptive pill that works by delaying ovulation.
- Option D: The copper Intrauterine Device (IUD) is the most effective form of emergency contraception. It can be inserted up to 5 days after unprotected intercourse to prevent pregnancy.
Related Visual
- Visual 1: Table - A comparison table showing different emergency contraceptive methods, their effectiveness rates, window of use, and mechanism of action.
- Visual 2: Infographic - A flowchart guiding the choice of emergency contraception based on the time elapsed since unprotected intercourse and patient factors.
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Methods of Emergency Contraception as background academic context rather than a clinical decision trigger.
- Nurses play a crucial role in counseling patients on contraceptive options. It is vital to distinguish between routine, long-acting methods like DMPA and time-sensitive emergency methods.
- Patient education must include the correct timing for using emergency contraception, as its effectiveness decreases with time.
- What if? If a patient who received a DMPA injection last week presents after an episode of unprotected sex, she is already protected by the DMPA and does not require additional emergency contraception.
How to Approach the Question
- First, identify the negative keyword 'except' in the question stem. This means you are looking for the option that does not belong in the group.
- The group is 'Emergency contraceptive methods'.
- Evaluate each option to determine if it is used for emergency contraception.
- Recall or deduce the primary use of each option: LNG (pill), Mifepristone (pill), DMPA (injection), and IUD (device).
- Identify that LNG, Mifepristone, and Copper IUDs are all used post-coitally for emergency prevention.
- Recognize that DMPA is a long-term, scheduled injection for routine contraception, making it the exception in this list.
Concept Tested & Keywords
- Concept Tested: Methods of Emergency Contraception
- Stem keywords: Emergency contraceptive, methods
- Lead-in keywords: except
- Clinical cues: The care setting changes urgency, monitoring level, and the expected nursing action.
- Negative lead-in flag: The question asks to identify the option that is NOT an emergency contraceptive method.
Question ID
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Practise the full NORCET 2 -2021 (Shift-2)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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