A nurse in a family planning clinic is caring for a client who requests an oral contraceptive. Which of the following findings in the client's history should the nurse recognize as a contraindication to oral contraceptives? (Select all that apply)
Cholecystitis
Hypertension
Human papillomavirus
Migraine headaches
Anxiety disorder
Correct Answer : A,B,D
Choice A Reason:
Cholecystitis is correct. Both estrogen and progesterone have been shown to increase the risk of gallstones.Estrogen has been shown to increase cholesterol production in the liver, with excess amounts precipitating in bile and leading to the formation of gallstones.Progesterone has been shown to decrease gall-bladder motility, which impedes bile flow and leads to gallstone formation.
Choice B Reason:
Hypertension is correct. Women with uncontrolled hypertension or severe hypertension are generally advised against using oral contraceptives due to the increased risk of cardiovascular events.
Choice C Reason:
Human papillomavirus (HPV) is incorrect. HPV is not a contraindication to oral contraceptives.Overall, while there may be some association between oral contraceptive use and HPV infection or its progression, the absolute increase in risk is generally considered small, and the benefits of oral contraceptives in preventing unintended pregnancies and managing menstrual issues often outweigh the potential risks.
Choice D Reason:
Migraine headaches is correct. Women with migraines with aura, especially those over 35 years old, are often advised against using estrogen-containing contraceptives due to an increased risk of stroke.
Choice E Reason:
Anxiety disorder is incorrect. Anxiety disorder alone is not a contraindication to oral contraceptives. However, individual health considerations should be discussed with a healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is D.
A. Maintain the client NPO throughout the procedure: It is not necessary to maintain the client NPO (nothing by mouth) for a nonstress test. The test primarily involves monitoring fetal heart rate in response to the baby's movements and does not require fasting.
B. Place the client in a supine position: Placing the client in a left lateral position is often preferred for NST to optimize uterine blood flow and fetal oxygenation. The supine position can compromise blood flow to the uterus and is generally avoided, especially in later pregnancy.
C. Instruct the client to massage the abdomen to stimulate fetal movement: While the goal of the NST is to monitor fetal movements, instructing the client to actively stimulate fetal movement through abdominal massage is not a standard part of the procedure. Fetal movements should occur naturally.
D. Instruct the client to press the provided button each time fetal movement is detected: This is the correct action. During a nonstress test, the client is typically provided with a button to press whenever she feels fetal movement. This helps correlate fetal movements with changes in the fetal heart rate on the monitor, providing valuable information about the baby's well-being.
Correct Answer is B
Explanation
A. Fetal lie being longitudinal is a normal and common fetal lie. It refers to the long axis of the fetus being parallel to the long axis of the mother.
B. Fetal position being persistent occiput posterior is a potential contributing cause.
Occiput posterior position (OP) can result in a more challenging and prolonged labor. This position, where the back of the baby's head is facing the mother's spine, is associated with increased back pain during labor.
C. Fetal attitude in general flexion is a favorable presentation for labor. Flexion allows for a smaller presenting diameter of the fetal head, facilitating descent through the birth canal.
D. Maternal pelvis being gynecoid is a favorable pelvic type for childbirth. The gynecoid pelvis is typically associated with easier labor and delivery.
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