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 D
Explanation
The correct answer is choiceD.
All of the above.
Here is why:
- Choice A is correct because obtaining informed consent from the client is a necessary step before any invasive procedure, including IUD insertion.
- Choice B is correct because performing a Pap smear and cervical culture can help screen for cervical cancer and sexually transmitted infections, which are contraindications for IUD use.
- Choice C is correct because administering an analgesic medication can help reduce the pain and discomfort associated with IUD insertion, especially in nulliparous women who have a smaller cervical diameter.
- Choice D is correct because it includes all of the above actions, which are recommended by the American College of Obstetricians and Gynecologists (ACOG) for IUD insertion in nulliparous women.
- Choice A is wrong if it is the only action taken, because it does not address the other aspects of IUD insertion such as screening and pain management.
- Choice B is wrong if it is the only action taken, because it does not ensure the client’s consent and comfort during the procedure.
- Choice C is wrong if it is the only action taken, because it does not verify the client’s eligibility and suitability for IUD use.
Correct Answer is C
Explanation
The correct answer is choice C. Copper intrauterine device.This is because copper intrauterine devices do not contain hormones and are therefore safe for women with a history of breast cancer and cardiovascular disease.
Some possible explanations for the other choices are:
- Choice A. Injectable progestins.This is wrong because injectable progestins may increase the risk of breast cancer in women with the BRCA1 geneand may also worsen hypertension and dyslipidemia.
- Choice B. Contraceptive vaginal ring.This is wrong because contraceptive vaginal rings contain estrogen and progestin, which may increase the risk of thromboembolic events, stroke, and myocardial infarction in women with cardiovascular disease.
- Choice D. Combined oral contraceptives.This is wrong because combined oral contraceptives also contain estrogen and progestin, which have the same risks as contraceptive vaginal rings for women with cardiovascular disease.Additionally, combined oral contraceptives may interact with some medications used to treat chronic conditions and reduce their effectiveness.
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