When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle?

Choice A: A 26-year-old client who has migraine headaches at the start of each menstrual cycle is not the correct answer because they do not have a contraindication for receiving oral contraceptives. Oral contraceptives are pills that contain synthetic hormones (estrogen and progestin) that prevent ovulation and pregnancy. They can also help reduce menstrual cramps, bleeding, and migraines in some women. However, oral contraceptives may increase the risk of stroke in women who have migraines with aura (visual disturbances), so they should be used with caution and under medical supervision.

Choice B: A 28-year-old client who has a history of pelvic inflammatory disease is not the correct answer because they do not have a contraindication for receiving oral contraceptives. Pelvic inflammatory disease is an infection that affects the female reproductive organs, such as the uterus, fallopian tubes, or ovaries. It can be caused by various bacteria, such as chlamydia or gonorrhea, and can lead to infertility, ectopic pregnancy, or chronic pelvic pain if left untreated. Oral contraceptives can help prevent pelvic inflammatory disease by creating a thick cervical mucus that blocks the entry of bacteria into the uterus.

Choice C: A 32-year-old client who has benign breast disease is not the correct answer because they do not have a contraindication for receiving oral contraceptives. Benign breast disease is a term that refers to various noncancerous conditions that affect the breast tissue, such as fibrocystic changes, fibroadenomas, or mastitis. They can cause symptoms such as breast pain, tenderness, or lumps. Oral contraceptives can help reduce the symptoms of benign breast disease by regulating the hormonal fluctuations that influence breast tissue growth.

Choice D: A 38-year-old client who reports smoking one pack of cigarettes every day is the correct answer because they have a contraindication for receiving oral contraceptives. Smoking is a habit that involves inhaling tobacco smoke, which contains harmful substances such as nicotine, tar, or carbon monoxide. Smoking can increase the risk of various diseases such as lung cancer, chronic obstructive pulmonary disease (COPD), or cardiovascular disease. Oral contraceptives can further increase the risk of cardiovascular disease in smokers, especially those who are over 35 years old, by increasing blood pressure, cholesterol levels, and clotting factors. Therefore, oral contraceptives are not recommended for smokers and alternative methods of contraception should be used instead.

Choice A: Cardiac complications are not the correct answer because they are not the main cause of the high infant mortality rate. Cardiac complications are problems that affect the heart or blood vessels of the newborn, such as congenital heart defects, arrhythmias, or heart failure. They can cause serious symptoms such as cyanosis, difficulty breathing, or poor feeding. However, they account for only about 5% of all infant deaths in the United States.

Choice B: Necrotizing enterocolitis is the correct answer because it is the main cause of the high infant mortality rate. Necrotizing enterocolitis is a condition that causes inflammation and death of the intestinal tissue of the newborn, leading to infection, perforation, or sepsis. It can cause symptoms such as abdominal distension, bloody stools, or shock. It is more common in premature or low birth weight infants and accounts for about 10% of all neonatal deaths.

Choice C: Viral infections are not the correct answer because they are not the main cause of the high infant mortality rate. Viral infections are diseases that are caused by viruses that invade the cells of the newborn, such as respiratory syncytial virus (RSV), cytomegalovirus (CMV), or herpes simplex virus (HSV). They can cause symptoms such as fever, cough, rash, or blisters. However, they account for only about 2% of all infant deaths in the United States.

Choice D: Prematurity is the correct answer because it is the main cause of the high infant mortality rate. Prematurity is a condition that occurs when a baby is born before 37 weeks of gestation, which is considered full-term. Premature babies are at risk of developing various complications such as respiratory distress syndrome, intraventricular hemorrhage, or retinopathy of prematurity. Prematurity accounts for about 35% of all infant deaths in the United States.

Choice E: Sudden infant death syndrome is the correct answer because it is the main cause of the high infant mortality rate. Sudden infant death syndrome is a condition that causes the unexpected and unexplained death of an apparently healthy baby during sleep. The exact cause of sudden infant death syndrome is unknown, but some risk factors include sleeping on the stomach, overheating, smoking exposure, or soft bedding. Sudden infant death syndrome accounts for about 15% of all infant deaths in the United States.

Choice F: Low birth weight is the correct answer because it is the main cause of the high infant mortality rate. Low birth weight is a condition that occurs when a baby is born weighing less than 2,500 grams (5 pounds 8 ounces). Low birth weight babies are at risk of developing various complications such as hypothermia, hypoglycemia, or jaundice. Low birth weight accounts for about 25% of all infant deaths in the United States.