A nurse in a clinic is caring for a client who has been taking oral contraceptives for several months and reports frequent breakthrough bleeding during her cycle.
Which of the following actions should the nurse take?
Instruct the client to take two pills daily until bleeding stops
Advise the client to stop taking oral contraceptives immediately
Tell the client to avoid smoking while taking oral contraceptives
Suggest that the client switch to a higher-dose formulation
The Correct Answer is D
The correct answer is choice D. The client should switch to a higher-dose formulation of oral contraceptives. Breakthrough bleeding is a common side effect of low-dose birth control pills, especially in the first months of use. It may indicate that the estrogen dose is too low to suppress the growth of the endometrium.
A higher-dose formulation may reduce or eliminate breakthrough bleeding by providing more estrogen.
Choice A is wrong because taking two pills daily until bleeding stops is not a recommended way to manage breakthrough bleeding.
It may cause side effects such as nausea, headache, or breast tenderness. It may also increase the risk of blood clots.
Choice B is wrong because stopping oral contraceptives immediately is not advisable unless there is a medical reason to do so.
Stopping oral contraceptives may cause irregular bleeding, ovulation, and pregnancy.
The client should consult with their provider before discontinuing any medication.
Choice C is wrong because smoking does not cause breakthrough bleeding, but it does increase the risk of serious complications from oral contraceptives, such as stroke, heart attack, or blood clots. The client should avoid smoking while taking any hormonal contraceptive, regardless of whether they experience breakthrough bleeding or not.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice C. The patient needs further teaching if they think that the implant can be inserted immediately after childbirth.According to Mayo Clinic, the implant should not be inserted until at least 21 days after giving birth, or until the milk supply is well established if breastfeeding.
Inserting the implant too soon may increase the risk of blood clots or decrease milk production.
Choice A is correct because condoms are still needed to protect against STIs, even if using the implant as a birth control method.Choice B is correct because irregular and unpredictable menstruation is a common side effect of the implant.Choice D is correct because the implant can prevent pregnancy for up to three years.
Correct Answer is A
Explanation
The correct answer is choice A.COCs prevent pregnancy byinhibiting the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are responsible for ovulation.
By suppressing ovulation, COCs prevent the release of a mature egg that can be fertilized by sperm.
Choice B is wrong because COCs do not increase the production of prostaglandins that cause uterine contractions.
Prostaglandins are involved in inflammation and pain, and are not directly related to contraception.
Choice C is wrong because COCs do not decrease the permeability of the fallopian tubes to sperm and egg.
The fallopian tubes are the site of fertilization, and COCs do not affect their function.
Choice D is partially correct but not the best answer.COCs do suppress ovulation, but they also have other mechanisms of action, such asthickening cervical mucusandaltering the uterine lining.
These effects make it harder for sperm to reach the egg and for a fertilized egg to implant in the uterus.
Therefore, choice D does not capture the full mechanism of action of COCs.
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