A nurse is assessing a client who is requesting a combined oral contraceptive (COC). Which of the following findings should indicate to the nurse that the client has a contraindication to COC use?

The client drinks 240 mL (8 oz) of wine per day.

The client is breastfeeding their 4-week-old newborn.

The client weighs 115 kg (254 lb).

The client is 25 years old.

Answer and Explanation

The Correct Answer is B

A. Moderate alcohol intake is not a contraindication to COC use.
B. Breastfeeding in the first 6 weeks postpartum is a contraindication to combined oral contraceptives because estrogen can reduce milk supply and increase the risk of thrombosis.
C. High body weight is not an absolute contraindication, though efficacy may be reduced.
D. Age 25 alone is not a contraindication to COCs.

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Correct Answer is C

Explanation

A. Assessing for tachysystole is important, but intervention is needed immediately to improve fetal oxygenation.
B. Internal monitoring may provide more accurate data, but it does not address the immediate fetal distress.
C. The first action should be to reposition the client to a left lateral position to improve uteroplacental blood flow and oxygenation to the fetus.
D. Increasing IV fluids can help with placental perfusion, but positioning is faster and more immediately effective.

A. The newborn's cord stump is still attached after 1 week. B. The newborn sleeps 16 hr a day. C. The newborn has fewer than four wet diapers in 24 hr D. The newborn has loose stools.

Correct Answer is C

Explanation

A. It is normal for the newborn’s cord stump to remain attached for up to 1-2 weeks.
B. Newborns typically sleep 16-20 hours per day, so this is expected.
C. Fewer than four wet diapers in 24 hours can indicate inadequate hydration or feeding and requires immediate evaluation.
D. Loose stools are common in breastfed newborns and are generally not concerning.

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A nurse is assessing a client who is requesting a combined oral contraceptive (COC). Which of the following findings should indicate to the nurse that the client has a contraindication to COC use?

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