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 C
Explanation
Choice A rationale
While it’s important for the nurse to provide reassurance and support during the exam, this statement alone doesn’t address the client’s specific concerns or provide any useful information.
Choice B rationale
Telling the client to relax doesn’t address her concerns or provide any useful information. It’s normal to feel nervous before a pelvic exam, especially if it’s the first one.
Choice C rationale
Asking the client what part of the exam makes her most nervous allows the nurse to provide specific information and reassurance, which can help alleviate the client’s anxiety.
Choice D rationale
While a pelvic exam is often part of the process when starting oral contraceptives, it’s not always required. The need for a pelvic exam can depend on the client’s age, sexual history, and other factors.
Correct Answer is D
Explanation
Choice A rationale
While iron-rich foods are important for overall health and preventing anemia, they do not specifically minimize the risk of having a newborn with a neural tube defect.
Choice B rationale
Limiting alcohol consumption is crucial during pregnancy as it can lead to fetal alcohol syndrome. However, it does not specifically target the prevention of neural tube defects.
Choice C rationale
Aspartame, an artificial sweetener, has been a topic of debate regarding its safety during pregnancy. While it’s generally considered safe in moderation, avoiding foods containing aspartame does not specifically prevent neural tube defects.
Choice D rationale
Consuming foods fortified with folic acid is the most effective way to prevent neural tube defects. Folic acid is a B vitamin that is crucial for proper brain and spine development in the early stages of pregnancy.
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