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?

The correct answer is choice A.The nurse should tell the client that if she misses one pill, she should take the missed pill as soon as possible and continue with the next pill at the usual time.This will ensure that she maintains a continuous hormonal exposure and does not extend the hormone-free interval beyond 7 days.She does not need to use extra contraception.

Choice B is wrong because taking two pills at once and skipping the next pill will disrupt the hormonal balance and may cause side effects such as nausea or breakthrough bleeding.Choice C is wrong because discarding the missed pill and taking the next pill at the usual time will shorten the duration of hormonal exposure and increase the risk of ovulation.Choice D is wrong because stopping taking the pills for the rest of the cycle and using a backup method of contraception will expose the client to an unnecessary hormone-free interval and may compromise her contraceptive efficacy.

COCs are combined oral contraceptives that contain synthetic estrogen and progestin hormones that prevent ovulation and thicken cervical mucus to inhibit sperm penetration.The normal range of COCs dosage is 20 to 35 micrograms of estrogen and 0.1 to 3 milligrams of progestin per pill.

The correct answer is choice C.Foul-smelling vaginal discharge is a sign of a possible infection, which can be a complication of using a copper IUD.

The nurse should instruct the client to report this symptom and seek medical attention.

Choice A is wrong because increased menstrual pain and bleeding are common side effects of copper IUDs, especially in the first 3-6 months after insertion.

They are not necessarily signs of a complication.

Choice B is wrong because irregular spotting or bleeding are also common side effects of copper IUDs.

They are not necessarily signs of a complication.

Choice D is wrong because a change in string length is not a sign of a complication.

The string length may vary depending on the position of the cervix and uterus.The client should check the string length regularly and report any missing or protruding strings, which could indicate displacement of the IUD.