NSG 6330 Week 3 DQ 1: contraception for Karen's case
Using the latest evidence-based guidelines, discuss the contraceptive methods Karen would be medically eligible for, identify the one you would recommend and why, and say which methods you would not recommend and for what reason.
Editorial process
Last reviewed · August 14, 2026
Every detail in this vignette is a US MEC category
This case is written so that each clinical detail maps onto a category in the US Medical Eligibility Criteria for Contraceptive Use, and the post is graded on whether you use that document rather than general knowledge. Work through them. Migraine matters enormously, but the guideline distinguishes migraine with aura from migraine without aura, and the vignette does not say which — so state that you would ask, and give the answer both ways, because migraine with aura makes combined hormonal contraception a category 4 at any age. Smoking matters, and the threshold is age 35: at 33 Karen's smoking alone does not prohibit combined methods, but it will in two years, which is worth saying aloud. Blood pressure of 138/76 sits in a category the guideline addresses explicitly. The family history of DVT in her father is not the same as a personal history and does not by itself restrict anything, which is a distinction students routinely get wrong.
Then answer the three questions in order and commit to a recommendation. Karen's own priorities narrow it quickly: she wants something more reliable than condoms, does not want pregnancy in the near future, and has heavy, painful menses lasting seven to eight days — so a method that treats menorrhagia is doing two jobs at once. The levonorgestrel intrauterine system answers all of that, is unaffected by the migraine and smoking questions because it is progestin-only, is top-tier for effectiveness, and reduces bleeding substantially. Say why you chose it over the copper IUD, which typically increases bleeding, and over the implant and depot injection, which are also eligible. For the exclusions, name combined pills, the patch and the ring, and give the reason — aura if present, and the approaching age-35 smoking threshold regardless. Close by noting that condoms continue for infection prevention with a new partner, and that her mother's cervical cancer history is a screening conversation, not a contraceptive one.
Likely learning objectives
Inferred from the brief — check these against your own rubric.
- 01Apply the US Medical Eligibility Criteria to a specific patient's history.
- 02Distinguish migraine with aura from migraine without aura in contraceptive decisions.
- 03Weigh non-contraceptive benefits when selecting a method.
- 04Justify exclusions by category rather than by preference.
Read the full question
Review every instruction before using the planning guidance that follows.
Course-wide instructions that accompany this question
ADDITIONAL INSTRUCTIONS FOR THE CLASS Discussion Questions (DQ) Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. NSG 6330 Week 3 DQ 1 One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses. Weekly Participation Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. APA Format and Writing Quality Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition. Use of Direct Quotes I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. LopesWrite Policy For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score. Late Policy The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. Communication Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
Turn the brief into deliverables
- 01The contraceptive methods Karen is medically eligible for, per current guidelines.
- 02The guideline categories that produce those eligibility decisions.
- 03One method identified as most beneficial for Karen.
- 04The reasoning behind that selection.
- 05Methods you would not recommend, and why.
- 06APA citations and references.
Eligibility, recommendation, and the exclusions
What the vignette is testing
Show that each detail is a guideline category, not colour.
Migraine, with or without aura
State the missing information and give the decision either way.
Smoking, age and blood pressure
The age-35 threshold and where 138/76 sits.
Family versus personal history
Why a father's DVT does not restrict her options.
The recommendation
A method that answers reliability and menorrhagia together, with alternatives compared.
What you would not offer
Combined methods and the copper IUD, each with a stated reason.
The guideline that decides this case
Recommended databases
- CDC contraception guidance
- StatPearls, NCBI Bookshelf
- PubMed Central
- South University Online Library
Search sequence
- 1.Open the current US Medical Eligibility Criteria and find migraine, smoking and hypertension.
- 2.Note the category numbers rather than paraphrasing them.
- 3.Check the evidence on levonorgestrel intrauterine systems and menorrhagia.
- 4.Confirm the effectiveness tiers you intend to cite.
- 5.Decide your recommendation before writing the eligibility list.
Reference shortlist
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Nothing here is cleared for citation until you have read it.
- 01
U.S. Medical Eligibility Criteria for Contraceptive Use, 2024
Centers for Disease Control and Prevention · 2024
The category system that decides every element of this case.
- 02
Evidence reviews for management of heavy menstrual bleeding
NICE guideline NG88, via NCBI Bookshelf · 2021
The evidence for the levonorgestrel intrauterine system in heavy menstrual bleeding.
- 03
Migraine Headache
StatPearls, NCBI Bookshelf · 2023
The aura distinction and its vascular significance.
- 04
Medical eligibility criteria for contraceptive use
World Health Organization, via NCBI Bookshelf · 2015
The international categories for smoking, age and migraine, alongside the US criteria.
Review before submission
Common mistakes
- Ignoring the aura distinction, which changes the answer completely.
- Treating smoking at 33 as an absolute contraindication to combined methods.
- Reading a father's DVT as a personal thrombotic history.
- Recommending a copper IUD to a patient with heavy, painful menses.
- Listing eligible methods without choosing one, which the prompt requires.
- Forgetting that no hormonal method prevents sexually transmitted infection.
Submission checklist
- Each clinical detail is mapped to a guideline category.
- The aura question is raised and answered both ways.
- The age-35 smoking threshold is stated correctly.
- One method is recommended, with reasons that include the menorrhagia.
- Excluded methods are named with their category.
- Current guidelines are cited in APA format.
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Aaron Bishop
MA, Education
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Aaron leads the EssayCrackers editorial desk. He works on how assignment briefs are read — what a rubric is actually asking for, and where students most often answer a different question than the one set.

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