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 A
Explanation
Choice A rationale
The statement “I will use only nonprescription medications while pregnant” indicates a need for further teaching. Not all nonprescription (over-the-counter) medications are safe to use during pregnancy. Some may have effects on the fetus and others may affect the course of the pregnancy.
Choice B rationale
It’s important for pregnant women to discuss any home remedies for nausea or other symptoms with their doctor, as some remedies may not be safe during pregnancy.
Choice C rationale
Monitoring weight gain during pregnancy is important as excessive or insufficient weight gain can lead to complications such as gestational diabetes, hypertension, or growth issues for the baby.
Choice D rationale
Reducing stress levels during pregnancy is beneficial for both the mother and the baby’s health. High levels of stress can lead to complications such as preterm labor and low birth weight.
Correct Answer is A
Explanation
Choice A rationale
Feeling the baby move, also known as quickening, is a presumptive sign of pregnancy. Presumptive signs are those that suggest a woman could be pregnant, but they’re not definitive. Quickening is often described as a fluttering sensation and is usually felt between 16 and 25 weeks of gestation.
Choice B rationale
Positive signs of pregnancy are those that can only be explained by pregnancy. These include hearing the baby’s heartbeat, visualizing the fetus on ultrasound, and feeling the baby move by a healthcare provider.
Choice C rationale
Probable signs of pregnancy are those that are strongly suggestive of pregnancy but could be caused by other conditions. These include changes in the uterus, changes in the cervix, and positive pregnancy tests.
Choice D rationale
There is no classification of “possible” signs of pregnancy in medical terminology.
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