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 A
Explanation
The correct answer is choice A. Elevated liver enzymes.Medroxyprogesterone injections can cause liver damage and impair its function.Elevated liver enzymes are a sign of liver injury and should be reported to the provider immediately.
Choice B is wrong because decreased hemoglobin is not a common side effect of medroxyprogesterone injections.
Decreased hemoglobin can indicate anemia, which can have many causes unrelated to medroxyprogesterone injections.
Choice C is wrong because increased platelets are not a common side effect of medroxyprogesterone injections.
Increased platelets can indicate inflammation, infection, or cancer, which can have many causes unrelated to medroxyprogesterone injections.
Choice D is wrong because decreased potassium is not a common side effect of medroxyprogesterone injections.
Decreased potassium can indicate dehydration, diarrhea, vomiting, or diuretic use, which can have many causes unrelated to medroxyprogesterone injections.
Correct Answer is D
Explanation
The nurse should include all of the following information in the teaching:
- The typical failure rate for IUDs is 1% to 3% per year.
- This means that out of 100 women who use an IUD for a year, one to three may get pregnant.
- The risk of pelvic inflammatory disease (PID) is highest in the first 6 weeks after insertion.
- PID is an infection of the reproductive organs that can cause infertility, chronic pain, or ectopic pregnancy.
- The risk of PID is higher if the woman or her partner has multiple sexual partners or a sexually transmitted infection (STI).
- The IUD can be inserted at any time during the menstrual cycle.
- However, some doctors may prefer to insert it during or right after the period, when the cervix is more open and the chance of pregnancy is lower.
Choice A is wrong because it only states one piece of information that the nurse should include in the teaching.
Choice B is wrong because it only states one piece of information that the nurse should include in the teaching.
Choice C is wrong because it only statesone piece of information that the nurse should include in the teaching
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