A nurse is providing teaching to a client who has a new prescription for oral contraceptives (OCs).

Which of the following statements by the client indicates an understanding of how to initiate OCs?

The correct answer is choice C. The patient needs further teaching if they think that the implant can be inserted immediately after childbirth.According to Mayo Clinic, the implant should not be inserted until at least 21 days after giving birth, or until the milk supply is well established if breastfeeding.

Inserting the implant too soon may increase the risk of blood clots or decrease milk production.

Choice A is correct because condoms are still needed to protect against STIs, even if using the implant as a birth control method.Choice B is correct because irregular and unpredictable menstruation is a common side effect of the implant.Choice D is correct because the implant can prevent pregnancy for up to three years.

The correct answer is choice B. The client has a positive pregnancy test result.

This is a contraindication for bilateral tubal ligation because the procedure is a permanent form of contraception and should not be performed on a pregnant woman.

The client should be counseled about other options for birth control or termination of pregnancy.

Choice A is wrong because a history of pelvic inflammatory disease is not a contraindication for bilateral tubal ligation.It may increase the risk of complications from the surgery, such as infection or adhesions, but it does not prevent the procedure from being performed.

Choice C is wrong because a family history of breast cancer is not a contraindication for bilateral tubal ligation.It may affect the client’s decision to undergo the procedure, as some studies have suggested that tubal ligation may reduce the risk of ovarian cancer, which is associated with breast cancer.

However, this is not a medical reason to avoid the surgery.

Choice D is wrong because a history of endometriosis is not a contraindication for bilateral tubal ligation.

It may cause pelvic pain or infertility, but it does not affect the effectiveness or safety of the procedure.In fact, some studies have shown that tubal ligation may improve the symptoms of endometriosis by reducing retrograde menstruation.