A 22-year-old woman visits the clinic requesting birth control. Her medical history includes dysmenorrhea, irregular menstrual cycles, and menorrhagia. She smokes half a pack of cigarettes daily and reports being sexually active with multiple partners. Which birth control method is most appropriate for this client?

Depo-Provera

Contraceptive implant

Combination oral contraceptives

Barrier methods such as female condoms

Answer and Explanation

The Correct Answer is D

A. "Depo-Provera."
Depo-Provera (medroxyprogesterone injection) is effective for contraception, but it may worsen menstrual irregularities and cause bone density loss with long-term use, making it less ideal.

B. "Contraceptive implant."
While progestin-only implants (e.g., Nexplanon) are effective, they do not protect against STIs. Additionally, irregular bleeding is a common side effect, which may not be ideal for someone with menorrhagia and irregular cycles.

C. "Combination oral contraceptives."
Estrogen-containing contraceptives (e.g., combined oral contraceptive pills) are contraindicated in women who smoke and are ≥35 years old due to the increased risk of venous thromboembolism (VTE). While this client is 22 years old, smoking still makes this option less preferable.

D. "Barrier methods such as female condoms."
Barrier methods reduce the risk of sexually transmitted infections (STIs), which is crucial for this client with multiple sexual partners. Additionally, they do not contain hormones, making them safer for smokers.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. "We will monitor your blood pressure to see if it decreases."
While magnesium sulfate may have a mild antihypertensive effect, it is not primarily given to lower blood pressure; antihypertensives are used for that purpose.

B. "We will check for a reduction in swelling and fluid retention."
Edema in preeclampsia is due to capillary leakage and kidney dysfunction, not directly affected by magnesium sulfate.

C. "We will assess for a decrease in seizure activity and improved reflexes."
Magnesium sulfate is used primarily as a seizure prophylaxis in preeclampsia by stabilizing the central nervous system and reducing hyperreflexia and clonus, which are signs of worsening preeclampsia.

D. "You should feel less pain and have fewer headaches."
While magnesium sulfate can improve symptoms, it is not an analgesic and does not directly relieve pain.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B","dropdown-group-3":"C"}

Explanation

Correct answers: The nurse's greatest concern is the client's risk of developing HELLP syndrome and related to thrombocytopenia and elevated liver enzymes.

Rationale:

I. HELLP syndrome (Hemolysis, Elevated Liver Enzymes, and Low Platelets) is a severe form of preeclampsia that can lead to life-threatening complications.

Ii. Thrombocytopenia (low platelets) (120,000) increases the risk of bleeding.

Iii. Elevated liver enzymes (ALT 75, AST 78, Alkaline Phosphatase 184) suggest liver involvement, which is a hallmark of HELLP syndrome.

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Naxlex Comprehensive Predictor Exams

A nurse is monitoring a client who is receiving magnesium sulfate for severe preeclampsia. The client asks, "How will I know if the medication is working?" Which response by the nurse is most appropriate?

Correct Answer is C

Explanation

G1P1, 37 weeks' gestation patient with a scheduled nonstress test (NST) Complete the following sentence using the drop-down options. The nurse's greatest concern is the client's risk of developing __i_____ and related to __ii____ and ___iii____.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B","dropdown-group-3":"C"}

Explanation

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