A nurse is reviewing the medical record of a client who is scheduled for a bilateral tubal ligation.

Which of the following findings is a contraindication for this procedure?

The client has a history of pelvic inflammatory disease

The client has a positive pregnancy test result

The client has a family history of breast cancer

The client has a history of endometriosis

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. The client has a positive pregnancy test result.

This is a contraindication for bilateral tubal ligation because the procedure is a permanent form of contraception and should not be performed on a pregnant woman.

The client should be counseled about other options for birth control or termination of pregnancy.

Choice A is wrong because a history of pelvic inflammatory disease is not a contraindication for bilateral tubal ligation. It may increase the risk of complications from the surgery, such as infection or adhesions, but it does not prevent the procedure from being performed.

Choice C is wrong because a family history of breast cancer is not a contraindication for bilateral tubal ligation. It may affect the client’s decision to undergo the procedure, as some studies have suggested that tubal ligation may reduce the risk of ovarian cancer, which is associated with breast cancer.

However, this is not a medical reason to avoid the surgery.

Choice D is wrong because a history of endometriosis is not a contraindication for bilateral tubal ligation.

It may cause pelvic pain or infertility, but it does not affect the effectiveness or safety of the procedure. In fact, some studies have shown that tubal ligation may improve the symptoms of endometriosis by reducing retrograde menstruation.

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Correct Answer is B

Explanation

The correct answer is choice B. The client should start taking oral contraceptives (OCs) on day one of their menstrual cycle, which is the first day of their period.This way, they will be protected from pregnancy right away and do not need to use a back-up contraceptive method.

Choice A is wrong because starting OCs on Sunday after the period begins may leave a gap of several days when the client is not protected from pregnancy.They would need to use a back-up method for the first seven days of taking OCs.

Choice C is wrong because starting OCs on day five of the menstrual cycle may also leave a gap of unprotected days.The client would need to use a back-up method for the first seven days of taking OCs.

Choice D is wrong because starting OCs on day fourteen of the menstrual cycle is too late and may not prevent ovulation.The client would need to use a back-up method for the first seven days of taking OCs.

A. Instruct the client to take two pills daily until bleeding stops B. Advise the client to stop taking oral contraceptives immediately C. Tell the client to avoid smoking while taking oral contraceptives D. Suggest that the client switch to a higher-dose formulation

Correct Answer is D

Explanation

The correct answer is choice D. The client should switch to a higher-dose formulation of oral contraceptives.Breakthrough bleeding is a common side effect of low-dose birth control pills, especially in the first months of use.It may indicate that the estrogen dose is too low to suppress the growth of the endometrium.

A higher-dose formulation may reduce or eliminate breakthrough bleeding by providing more estrogen.

Choice A is wrong because taking two pills daily until bleeding stops is not a recommended way to manage breakthrough bleeding.

It may cause side effects such as nausea, headache, or breast tenderness.It may also increase the risk of blood clots.

Choice B is wrong because stopping oral contraceptives immediately is not advisable unless there is a medical reason to do so.

Stopping oral contraceptives may cause irregular bleeding, ovulation, and pregnancy.

The client should consult with their provider before discontinuing any medication.

Choice C is wrong because smoking does not cause breakthrough bleeding, but it does increase the risk of serious complications from oral contraceptives, such as stroke, heart attack, or blood clots.The client should avoid smoking while taking any hormonal contraceptive, regardless of whether they experience breakthrough bleeding or not.

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A nurse is reviewing the medical record of a client who is scheduled for a bilateral tubal ligation. Which of the following findings is a contraindication for this procedure?

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A nurse is reviewing the medical record of a client who is scheduled for a bilateral tubal ligation.

Which of the following findings is a contraindication for this procedure?