A nurse is reviewing contraception options for four clients.
Which client has a contraindication for receiving oral contraceptives?
A 38-year-old client who reports smoking one pack of cigarettes every day.
A 28-year-old client who has a history of pelvic inflammatory disease.
A 32-year-old client who has benign breast disease.
A 26-year-old client who has migraine headaches at the start of each menstrual cycle.
The Correct Answer is A
Choice A rationale
A 38-year-old client who reports smoking one pack of cigarettes every day. Oral contraceptives are contraindicated in women who are over 35 years old and smoke. This is because the combination of oral contraceptives and smoking increases the risk of serious cardiovascular side effects, such as blood clots, stroke, or heart attack. These risks are even higher in women over 35 years old who smoke. Therefore, this client should not receive oral contraceptives due to the increased risk of these serious side effects.
Choice B rationale
A 28-year-old client who has a history of pelvic inflammatory disease. While pelvic inflammatory disease (PID) can lead to complications such as infertility and ectopic pregnancy, it is not a contraindication for the use of oral contraceptives. In fact, oral contraceptives can provide some protection against PID by causing changes in the cervix that make it more resistant to infection.
Choice C rationale
A 32-year-old client who has benign breast disease. Benign breast disease is not a contraindication for the use of oral contraceptives. While some studies have suggested a slightly increased risk of breast cancer in women who have used oral contraceptives, the risk appears to decrease over time once the contraceptives are stopped.
Choice D rationale
A 26-year-old client who has migraine headaches at the start of each menstrual cycle. While migraines can be a contraindication for the use of oral contraceptives, it generally applies to migraines with aura. Women who have migraines with aura have an increased risk of stroke when using oral contraceptives. However, for women who have migraines without aura, the benefits of using oral contraceptives usually outweigh the risks.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Inserting an indwelling urinary catheter is not the priority nursing action in this situation. While it may be necessary later in the care process, it is not the immediate concern when the client is experiencing a large amount of painless, bright red vaginal bleeding at 38 weeks of gestation. The priority is to stabilize the client and ensure the well-being of the fetus.
Choice B rationale
Witnessing the signature for informed consent for surgery is an important step before any surgical procedure. However, it is not the priority nursing action in this situation. The client’s condition could deteriorate rapidly due to the bleeding, and immediate medical interventions are necessary to stabilize the client and fetus.
Choice C rationale
Preparing the abdominal and perineal areas may be necessary if the client requires a surgical intervention. However, this is not the priority nursing action. The client is experiencing significant bleeding, and the priority is to stabilize the client’s condition.
Choice D rationale
Initiating IV access is the priority nursing action in this situation. The client is experiencing a large amount of painless, bright red vaginal bleeding, which could lead to hypovolemia and shock. IV access allows for the rapid administration of fluids and medications to stabilize the client’s condition.
Correct Answer is D
Explanation
Choice A rationale
Iron is an important nutrient during pregnancy as it helps to make the extra blood (hemoglobin) you need to supply oxygen to the baby. However, while iron is important for both mother and baby during pregnancy, it does not specifically help to prevent neural tube defects in the fetus.
Choice B rationale
Calcium is crucial during pregnancy as it helps to build your baby’s bones and teeth. However, calcium does not specifically help to prevent neural tube defects.
Choice C rationale
Vitamin C is important for the growth and repair of tissues in all parts of your body during pregnancy. It helps the body to make collagen, an important protein used to make skin, cartilage, tendons, ligaments, and blood vessels. However, Vitamin C does not specifically help to prevent neural tube defects.
Choice D rationale
Folic acid is the synthetic form of folate, a type of B vitamin. It’s very important for all people, including pregnant women. It can help prevent major birth defects of the baby’s brain and spine (neural tube defects). Women who are planning to become pregnant should take a multivitamin with 400 micrograms of folic acid every day.
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