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.The procedure involves inserting flexible agents into your fallopian tubes.These agents cause tissue to grow around them and block the tubes, preventing pregnancy.
Choice B is wrong because the procedure does not require general anesthesia or an operating room.It can be done in an outpatient facility with local anesthesia.
Choice C is wrong because the procedure does not make you sterile immediately after it is done.
It takes about 3 months for the tissue to grow and occlude the tubes.You need to use another form of contraception during this time and have a test to confirm the tubal blockage.
Choice D is wrong because the procedure does not affect your hormone levels or menstrual cycle.It only blocks the fallopian tubes, not the ovaries or uterus.
Correct Answer is B
Explanation
The correct answer is choice B. The nurse should advise the client to take the pill at bedtime or with food.This can help reduce nausea, which is a common side effect of COCs.Nausea usually diminishes with continued use of the same method.
Choice A is wrong because taking the pill with a glass of water on an empty stomach may increase nausea.
Choice C is wrong because switching to a different brand of COCs is not effective in treating nausea.There are no significant differences among various COCs in terms of nausea.
Choice D is wrong because stopping the pill and using another method of contraception is not necessary unless the client prefers it.Nausea is not harmful and can be managed with simple measures.
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