Contraception: missed combined pills: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Contraception: missed combined pills

Sample item

A woman on a 21-day combined pill regimen forgets two pills in the third week of a pack. What is the correct advice?

AStop and start a new pack after a 7-day gapBContinue as usual with no extra measuresCUse emergency contraception in all casesDTake the most recent pill, finish the active pills and start the next pack without the pill-free break

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Take the most recent pill, finish the active pills and start the next pack without the pill-free break

Missing two or more pills in the third week extends the hormone-free interval and risks ovulation, so the pill-free break is skipped by starting the next pack directly after the active pills, with condoms for 7 days. Emergency contraception is mainly relevant for missed pills in week 1. Missed pills in week 2 need the most recent pill taken and condoms for 7 days.

Option by option

A. Stop and start a new pack after a 7-day gap
A 7-day gap after missed pills lengthens the unprotected interval.
B. Continue as usual with no extra measures
No extra measures leaves a real risk of ovulation.
C. Use emergency contraception in all cases
Emergency contraception is not routinely needed for week 3 errors.
D. Take the most recent pill, finish the active pills and start the next pack without the pill-free break (correct)
Correct. Skipping the hormone-free interval prevents ovulation after missed week 3 pills.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Take the most recent pill, finish the active pills and start the next pack without the pill-free break. Missing two or more pills in the third week extends the hormone-free interval and risks ovulation, so the pill-free break is skipped by starting the next pack directly after the active pills, with condoms for 7 days.

Why is "Stop and start a new pack after a 7-day gap" not the answer?

A 7-day gap after missed pills lengthens the unprotected interval.

Why is "Continue as usual with no extra measures" not the answer?

No extra measures leaves a real risk of ovulation.

Why is "Use emergency contraception in all cases" not the answer?

Emergency contraception is not routinely needed for week 3 errors.

What concept does this question test?

It tests Contraception: missed combined pills in OBG. Emergency contraception is mainly relevant for missed pills in week 1. Missed pills in week 2 need the most recent pill taken and condoms for 7 days.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Contraception: missed combined pills?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.