A nurse is reviewing the medical record of a client who is requesting an oral contraceptive. Which of the following findings is a contraindication for the use of oral contraceptives?

Anxiety disorder

History of deep-vein thrombosis

Ovarian cysts

client age of 36 years

Answer and Explanation

The Correct Answer is B

A. Anxiety disorder: Anxiety disorder is generally not a contraindication for the use of oral contraceptives. However, it's essential to consider the overall health of the individual and potential interactions with medications used to manage anxiety.
B. History of deep-vein thrombosis (Correct Answer): A history of deep-vein thrombosis (DVT) is a significant contraindication to the use of oral contraceptives. Estrogen-containing contraceptives can increase the risk of blood clot formation, and individuals with a history of DVT are at an elevated risk for thrombotic events.
C. Ovarian cysts: Ovarian cysts alone are not a contraindication for oral contraceptives. In fact, oral contraceptives are sometimes prescribed to help regulate menstrual cycles and prevent the formation of certain types of ovarian cysts.
D. Client age of 36 years: Age alone is not a strict contraindication for oral contraceptives. However, as women age, especially beyond 35 years, healthcare providers may consider other risk factors such as smoking, hypertension, and cardiovascular health when prescribing oral contraceptives.

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Correct Answer is D

Explanation

A. Urine specific gravity 1.020: While this value indicates concentrated urine and can be useful in assessing dehydration, it doesn’t specifically confirm effective treatment. High urine specific gravity suggests dehydration because the kidneys are conserving water, but it doesn’t directly confirm the effectiveness of treatment.
B. BUN 28 mg/dl (Blood Urea Nitrogen): Elevated BUN levels can be seen in dehydration, but it's not a direct marker of effective treatment. It indicates dehydration due to increased urea concentration in the blood but doesn’t confirm if the treatment has been effective or not.
C. Serum hematocrit 55%: In dehydration, the blood becomes more concentrated due to water loss, causing an increase in hematocrit levels. However, while this value might indicate dehydration initially, it may not specifically confirm the effectiveness of treatment once initiated.
D. Serum osmolarity 310 mOsm: Serum osmolarity measures the concentration of particles in the blood. In dehydration, the blood becomes more concentrated, leading to increased serum osmolarity. When treatment is effective, rehydration occurs, diluting the blood and bringing serum osmolarity back toward normal levels. Therefore, a decrease in serum osmolarity towards the normal range (280-300 mOsm) would indicate effective treatment of dehydration

A. Thready pulse B. Decreased bowel sounds C. Bilateral muscle weakness D. Distended neck veins

Correct Answer is D

Explanation

A. Thready pulse:
A thready pulse is more indicative of fluid volume deficit or inadequate cardiac output, not fluid volume excess.
B. Decreased bowel sounds:
Decreased bowel sounds are not a specific sign of fluid volume excess. They may be associated with various gastrointestinal issues but are not directly related to fluid volume status.
C. Bilateral muscle weakness:
Bilateral muscle weakness is not a specific manifestation of fluid volume excess. It may be associated with electrolyte imbalances or other neuromuscular issues.
D. Distended neck veins:
This is the correct answer. Distended neck veins are a classic sign of fluid volume excess or overload. Increased venous pressure from excess fluid can lead to distension of the jugular veins in the neck. This finding is often seen in conditions such as heart failure or renal failure where there is an inability to adequately excrete or distribute fluids.

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A nurse is reviewing the medical record of a client who is requesting an oral contraceptive. Which of the following findings is a contraindication for the use of oral contraceptives?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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