A nurse is assessing a client who has been taking oral contraceptives for the past 6 months. Which of the following findings should the nurse immediately report to the provider?
Persistent headache.
Weight gain 2.3 kg (5 lb).
Frequent nausea.
Breast tenderness.
The Correct Answer is A
Choice A reason: Persistent headache on oral contraceptives may indicate serious complications like stroke or hypertension, requiring immediate reporting to prevent life-threatening events. This is critical for timely intervention, ensuring client safety, and guiding potential medication adjustments in women using hormonal contraception for 6 months.
Choice B reason: Weight gain of 2.3 kg is common with oral contraceptives and not urgent, unlike persistent headache, which signals serious risks. Assuming weight gain requires reporting risks overlooking critical neurological symptoms, critical to avoid in ensuring safe monitoring of contraceptive side effects.
Choice C reason: Frequent nausea is a common contraceptive side effect, typically managed with counseling, not urgent like headache. Assuming nausea is priority risks delaying serious symptom evaluation, critical to prevent in ensuring timely reporting of potentially life-threatening complications in contraceptive users.
Choice D reason: Breast tenderness is a common, non-urgent side effect of oral contraceptives, unlike persistent headache, which may indicate stroke risk. Assuming tenderness is urgent risks missing critical symptoms, critical to avoid in ensuring proper monitoring and safety in clients on hormonal contraception.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Wrapping sterile gauze for bleeding is inappropriate; gentle pressure and provider notification are needed. Petroleum jelly prevents adhesion. Using gauze risks infection or trauma, critical to avoid in ensuring safe circumcision healing, supporting parental care, and preventing complications in newborns post-procedure.
Choice B reason: Removing yellow exudate, a normal healing sign, risks disrupting the circumcision site, causing pain or infection. Petroleum jelly is correct. Assuming removal is needed risks delayed healing, critical to prevent in ensuring proper wound care and parental education for newborns post-circumcision.
Choice C reason: Applying petroleum jelly to the glans with diaper changes prevents diaper adhesion, promotes healing, and reduces discomfort post-circumcision. This instruction is critical for parental care, ensuring infection prevention, supporting newborn comfort, and facilitating proper healing in the sensitive post-procedure period.
Choice D reason: Using soap on the circumcision site risks irritation and delayed healing; gentle water cleansing is preferred. Petroleum jelly is appropriate. Assuming soap is safe risks discomfort or infection, critical to avoid in ensuring proper care and healing for newborns following circumcision procedures.
Correct Answer is D
Explanation
Choice A reason: Aspirin is contraindicated in peptic ulcer disease due to its antiplatelet and gastric irritant effects, risking bleeding or ulcer exacerbation. Acetaminophen is safer. Administering aspirin risks gastrointestinal hemorrhage, critical to avoid in ensuring safe pain management for clients with a history of peptic ulcers.
Choice B reason: Ibuprofen, an NSAID, irritates the gastric mucosa, worsening peptic ulcers and increasing bleeding risk, making it unsuitable. Acetaminophen is preferred. Administering ibuprofen risks ulcer perforation or bleeding, critical to prevent in ensuring safe headache relief for clients with a peptic ulcer history.
Choice C reason: Ketorolac, an NSAID, is contraindicated in peptic ulcer disease due to its potent gastric irritant effects, risking ulcer aggravation or bleeding. Acetaminophen is safe. Administering ketorolac risks severe gastrointestinal complications, critical to avoid in providing safe pain management for clients with peptic ulcer history.
Choice D reason: Acetaminophen is safe for headache relief in peptic ulcer clients, lacking gastric irritant effects, avoiding risks of bleeding or ulcer worsening. Administering it ensures effective pain management, critical for client comfort, preventing gastrointestinal complications, and supporting safe care in clients with a history of peptic ulcers.
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