A nurse in a family planning clinic is reviewing the health histories for several clients. Which of the following clients should the nurse notify the provider as having a potential contraindication to combined oral contraceptives?

A client who has a history of menorrhagia

A client who is scheduled for orthopedic surgery in 3 weeks

A client who is 4 months postpartum

A client who has a history of renal disease

Answer and Explanation

The Correct Answer is B

A. A client who has a history of menorrhagia: Combined oral contraceptives can actually help manage menorrhagia by regulating menstrual cycles and reducing blood loss, making this condition a therapeutic indication rather than a contraindication.

B. A client who is scheduled for orthopedic surgery in 3 weeks: Combined oral contraceptives increase the risk of thromboembolism. Surgery and postoperative immobility further elevate this risk, so the provider should be notified, and the medication may need to be discontinued before surgery.

C. A client who is 4 months postpartum: By 4 months postpartum, the risk of thromboembolism has decreased significantly, and combined oral contraceptives can typically be used safely, especially if the client is not breastfeeding.

D. A client who has a history of renal disease: While renal disease requires careful monitoring, it is not an absolute contraindication to combined oral contraceptive use. The primary concern remains the increased risk of clot formation in high-risk situations such as surgery or immobility.

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Correct Answer is D

Explanation

A. A client who is transported to radiology: Transporting a client to radiology is a temporary transfer for diagnostic purposes, not a change in level of care or medication responsibility. Medication reconciliation is not required in this situation.

B. A client who has a consultation for physical therapy: A physical therapy consultation does not involve medication administration or changes, so medication reconciliation is unnecessary in this case.

C. A client who has a referral for social services: Social services referrals address psychosocial or discharge needs, not medication management. Therefore, medication reconciliation is not performed at this point.

D. A client who is transferred to a step-down unit: Medication reconciliation must be completed during any transition of care, including transfers between units. This process ensures continuity, prevents omissions or duplications, and identifies potential medication errors.

A. "Once you stop taking disulfiram, you may resume alcohol consumption." B. "You must avoid even small amounts of alcohol while taking disulfiram." C. "It is common for you to develop an intractable headache when you first take disulfiram." D. "Disulfiram works by changing the way that alcohol tastes."

Correct Answer is B

Explanation

A. "Once you stop taking disulfiram, you may resume alcohol consumption.": While alcohol can be consumed after discontinuing disulfiram, this does not address the ongoing risk during therapy. Clients must understand that alcohol consumption while on disulfiram can cause severe reactions.

B. "You must avoid even small amounts of alcohol while taking disulfiram.": Disulfiram inhibits aldehyde dehydrogenase, causing accumulation of acetaldehyde when alcohol is consumed. Even small amounts of alcohol can trigger nausea, vomiting, hypotension, and flushing, so strict avoidance is essential.

C. "It is common for you to develop an intractable headache when you first take disulfiram.": Headaches are not a typical expected reaction when initiating disulfiram. Adverse effects mainly occur if alcohol is consumed concurrently, rather than spontaneously from the medication itself.

D. "Disulfiram works by changing the way that alcohol tastes.": Disulfiram does not alter the taste of alcohol; it produces a physiological reaction when alcohol is ingested, serving as a deterrent rather than changing flavor perception.

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A nurse in a family planning clinic is reviewing the health histories for several clients. Which of the following clients should the nurse notify the provider as having a potential contraindication to combined oral contraceptives?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a newly licensed nurse about medication reconciliation. The nurse should instruct the newly licensed nurse to perform medication reconciliation for which of the following clients?

Correct Answer is D

Explanation

A nurse in an outpatient clinic is providing education to a client who has alcohol use disorder and a prescription for disulfiram. Which of the following statements should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse is teaching a newly licensed nurse about administering sodium polystyrene sulfonate to a client. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

A nurse is teaching a newly licensed nurse about expired medications. Which of the following instructions should the nurse include in the teaching?

A nurse is assessing a client who has heart failure and is receiving furosemide BID via IV bolus. Which of the following findings should the nurse identify as an adverse effect of the medication?

A nurse is caring for a client who received epidural anesthesia during hip surgery. Which of the following manifestations should the nurse monitor as an adverse reaction?

A nurse is assessing a client who is taking combination oral contraceptives. Which of the following findings should the nurse report to the provider immediately?

A nurse is preparing to administer a dose of ampicillin to a client. The nurse scans the medication and the client's identification band and realizes the client has a penicillin allergy. Which of the following should the nurse use to document the incident?

A nurse is caring for a client who is receiving 0.9% sodium chloride solution to treat dehydration. Which of the following findings should the identify as an adverse effect of the infusion?

A nurse is caring for a client who has cancer and reports moderate pain. Which of the following medications should the nurse expect to administer?