A nurse is caring for a client who has a history of breast cancer and cardiovascular disease and is seeking advice on contraception.
Which of the following contraceptive methods should the nurse recommend as the safest option for this client?
Injectable progestins
Contraceptive vaginal ring
Copper intrauterine device
Combined oral contraceptives
The Correct Answer is C
The correct answer is choice C. Copper intrauterine device. This is because copper intrauterine devices do not contain hormones and are therefore safe for women with a history of breast cancer and cardiovascular disease.
Some possible explanations for the other choices are:
- Choice A. Injectable progestins. This is wrong because injectable progestins may increase the risk of breast cancer in women with the BRCA1 gene and may also worsen hypertension and dyslipidemia.
- Choice B. Contraceptive vaginal ring. This is wrong because contraceptive vaginal rings contain estrogen and progestin, which may increase the risk of thromboembolic events, stroke, and myocardial infarction in women with cardiovascular disease.
- Choice D. Combined oral contraceptives. This is wrong because combined oral contraceptives also contain estrogen and progestin, which have the same risks as contraceptive vaginal rings for women with cardiovascular disease. Additionally, combined oral contraceptives may interact with some medications used to treat chronic conditions and reduce their effectiveness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choice D.“You should wait until your baby is 6 weeks old before starting the injections.” This is because medroxyprogesterone may pass into breast milk and cause side effects in a child who is breastfed.The product labeling states that it should be started no sooner than 6 weeks postpartum, based on data submitted for product approval.
The World Health Organization also recommends that injectable depot medroxyprogesterone acetate should not be used before 6 weeks postpartum.
Choice A is wrong because starting the injections immediately after delivery could interfere with the exclusivity or duration of lactation, and could affect the newborn infant adversely because of slower metabolism of the drug than older infants.
Choice B is wrong because waiting until the baby is 6 months old is unnecessary and could expose the mother to a higher risk of unintended pregnancy.
Choice C is wrong because medroxyprogesterone has not been known to cause any decrease in milk supply while using the injections
Correct Answer is A
Explanation
The correct answer is choice A.History of migraine headaches with aura is a contraindication for using COCs because it increases the risk of stroke.
Some possible explanations for the other choices are:
- Choice B is wrong because history of dysmenorrhea and menorrhagia is not a contraindication for using COCs.In fact, COCs may help reduce menstrual pain and bleeding.
- Choice C is wrong because history of acne vulgaris and hirsutism is not a contraindication for using COCs.In fact, COCs may help improve acne and hirsutism by reducing androgen levels.
- Choice D is wrong because history of iron-deficiency anemia and fatigue is not a contraindication for using COCs.In fact, COCs may help prevent iron-deficiency anemia by reducing menstrual blood loss.
Normal ranges for relevant parameters are:
- Blood pressure: <140/90 mmHg
- Body mass index: 18.5–24.9 kg/m
- Hemoglobin: 12–16 g/dL for women
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