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 B
Explanation
Choice A rationale
While follow-up testing is important for individuals diagnosed with chlamydia, retesting is typically recommended 3 months after treatment, not 6 months.
Choice B rationale
This is the correct statement. Chlamydia is treated with antibiotics, and a single dose of azithromycin is one of the recommended treatments.
Choice C rationale
This statement is incorrect. Even if a sexual partner of a person diagnosed with chlamydia has no symptoms, they still need to be tested and treated if necessary. Chlamydia can be asymptomatic, and untreated chlamydia can lead to serious health problems.
Choice D rationale
While abstaining from sexual relations until treatment is complete is recommended, it is not the only necessary step. The client’s sexual partners also need to be informed, tested, and treated if necessary.
Correct Answer is B
Explanation
Choice A rationale
While bile does play a role in digestion, it is not retained in the liver. Instead, it is produced by the liver and stored in the gallbladder. When food enters the small intestine, the gallbladder releases bile to aid in the digestion of fats. However, this process is not directly related to heartburn during pregnancy.
Choice B rationale
During pregnancy, the body produces large amounts of the hormones progesterone and relaxin. These hormones tend to relax smooth muscle tissues throughout the body, including those in the gastrointestinal (GI) tract. As a result, food sometimes moves more slowly through the system, resulting in indigestion issues of all kinds, from that bloated, gassy feeling to heartburn. This is the correct answer because increased progesterone production does indeed cause decreased motility of smooth muscle, which can lead to heartburn.
Choice C rationale
While estrogen levels do increase during pregnancy, they do not directly cause an increase in the secretion of hydrochloric acid. Instead, the relaxation of the lower esophageal sphincter due to pregnancy hormones can allow stomach acid to flow back up into the esophagus, causing heartburn.
Choice D rationale
While it is true that the growing uterus can displace the stomach, especially in later stages of pregnancy, this is not the primary cause of heartburn. Heartburn is primarily caused by the relaxation of the lower esophageal sphincter, allowing stomach acid to flow back up into the esophagus.
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