You are seeing a 15-year-old female patient for a gynecological examination and to explore birth control options. The patient’s mother scheduled the  appointment after learning that her daughter has become sexually  active. The patient is current with all immunizations, including  Gardasil, and has no significant health history that would  contraindicate the use of birth control.

  1. This is the patient’s first gynecological examination, and she expresses  feeling nervous and embarrassed that her mother has shared her sexual  experience with strangers. Taking this into account, how would you begin  the patient encounter?
  2. As you begin asking questions to determine the patient’s  gynecological history, the patient appears frustrated and embarrassed  and reminds you that she has only had sex one time. What should the  patient understand about the importance of reviewing gynecological  history?
  3. What are the most popular birth control methods prescribed in the  United States? What determines the success or failure of a birth control  method?
  4. The patient expresses a desire for the most effective form of birth  control but is concerned about weight gain and other side effects. How  should you respond to her concerns?
  5. The patient seems unsure about the best option for birth control and  asks if she can take some time to think about the choices. As the use  of birth control is ultimately the patient’s choice, you offer to answer  any questions and agree to a follow-up visit or call. The patient asks  whether using a condom is okay if she decides to have sexual intercourse  before selecting a method of birth control. What should you tell her?

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