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 D rationale
Unilateral, cramp-like abdominal pain. This is a common symptom of an ectopic pregnancy. The pain usually starts on one side of the abdomen after the early stages of pregnancy and may be accompanied by spotting or vaginal bleeding.
Choice A rationale
Large amount of vaginal bleeding. While vaginal bleeding can occur in an ectopic pregnancy, it’s usually light to moderate, not large. Heavy vaginal bleeding is more commonly associated with miscarriage or other conditions.
Choice B rationale
Severe nausea and vomiting. While some women with an ectopic pregnancy may experience nausea and vomiting, these symptoms are common in early pregnancy and are not specific to ectopic pregnancy.
Choice C rationale
Uterine enlargement greater than expected for gestational age. This is not a typical symptom of an ectopic pregnancy. In fact, because the pregnancy is not in the uterus, the size of the uterus may be smaller than expected for the gestational age.
Correct Answer is C
Explanation
GTPAL calculation:
Step 1 is: Determine Gravida (G) = 4 pregnancies (1 elective abortion, 1 twin birth, 1 spontaneous abortion, 1 current pregnancy) = G4.
Step 2 is: Determine Term (T) births = 0 (no pregnancies reached 37 weeks).
Step 3 is: Determine Preterm (P) births = 1 (twin birth at 36 weeks) = P1.
Step 4 is: Determine Abortion (A) = 2 (1 elective abortion at 9 weeks, 1 spontaneous abortion at 15 weeks) = A2.
Step 5 is: Determine Living (L) children = 2 (twins) = L2.
The GTPAL status is: G4 T0 P1 A2 L2.
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