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1. Which is one of progestin's roles in hormonal contraceptives?

A. Thicken cervical mucus to slow tubal motility B. Thin cervical mucus to prevent sperm penetration C. Thicken cervical mucus to prevent endometrial thinning D. Thin cervical mucus to delay sperm transport

2. Which is TRUE about intrauterine devices (IUDs) for contraception?

A. American College of Obstetricians and Gynecologists recommends misoprostol for insertion B. They should not cause bleeding to stop completely; this is a sign of improper insertion C. Changes in menstrual bleeding and increased pain typically get worse over time D. They most commonly cause headaches, nausea, breast tenderness, and mood changes

3. Alexis is a 24-year-old female who is having trouble adhering to her prescribed combined oral contraceptive (COC) daily. She typically is late taking or completely misses 2 doses a week on average. She is 5 feet-2 inches tall, weighs 204 lbs, and is actively trying to lose weight. She has never had any children, but she plans to in the future. Which is the most appropriate birth control option to recommend she speak with her prescriber about?

A. Progestin-only pills B. Intrauterine device C. Etonogestrel implant D. Transdermal patch

4. A female patient visits your pharmacy to buy male latex condoms, but she notices that female condoms are on sale for cheaper. She decides to buy both. Which of these is an appropriate response?

A. Always use them together to prevent pregnancy and sexually transmitted infections B. Use only water-based lubricants, as oil-based ones break down condoms' barrier strength C. Female condoms are made of lamb intestine, which is not permeable to viruses D. Use Ovaprene instead; then you'll only need to insert the female condom once a month

5. How does hormone-free vaginal gel work to prevent pregnancy?

A. Increases the vaginal pH B. Decreases the vaginal pH C. Maintains normal vaginal pH D. Increases sperm motility

6. Which is TRUE about the Natural Cycles App?

A. It has a mode to plan a pregnancy and a mode to track an existing pregnancy B. It is free for patients to download and use, they just need to buy a thermometer C. Patients using the app for contraception should only have intercourse on “red days” D. It is 98% effective as contraception with typical use (2 pregnancies per year of use)

7. Which of these, if approved, would be the first new barrier contraceptive in nearly 15 years?

A. Ovaprene B. Contraceptive jewelry C. Hormone-free vaginal gel D. Zona pellucida

8. Your patient is switching from a combined oral contraceptive to the segesterone acetate/ethinyl estradiol (SAEE) vaginal ring. Which of these is an appropriate counseling point?

A. You will likely experience more estrogen-related side effects with the ring B. Do not insert the ring too far, as it will travel into the genital tract C. When you remove the SAEE ring for a hormone-free week, flush it down the toilet D. Do not use the same SAEE ring for more than 13 menstrual cycles

9. You are making phone calls about late refills to improve patient adherence. You call a patient to remind them that their combined oral contraceptive is due to refill, and she says she is going to discontinue it due to spotting around days 6 to 8 of her cycle and hot flashes. This is refill number 6 of this prescription. Which of these is the most appropriate thing to tell her?

A. These are signs of toxic shock syndrome, seek medical attention immediately B. You should call your prescriber, as your progestin dose is likely too low C. You should call your prescriber, as your estrogen dose is likely too low D. You should keep taking your COC, as these symptoms will likely resolve

10. Your patient has been using the transdermal contraceptive patch for 2 months. She calls your pharmacy to refill this prescription and mentions that she needs a new box because the third and final patch in the box fell off 4 hours ago and it won't stick back onto her leg. Which of the following is an appropriate thing to say?

A. The patch has been off too long, you are not protected from pregnancy; call your prescriber B. You should not wear the patch on your leg, you may not be protected from pregnancy C. Your insurance won't cover a refill yet; use medical tape to hold on the current patch until they will D. You're having an application-site reaction; call your prescriber to switch to another contraceptive