A 22-year-old woman visits the clinic requesting birth control. Her medical history includes dysmenorrhea, irregular menstrual cycles, and menorrhagia. She smokes half a pack of cigarettes daily and reports being sexually active with multiple partners. Which birth control method is most appropriate for this client?

Depo-Provera

Contraceptive implant

Combination oral contraceptives

Barrier methods such as female condoms

Answer and Explanation

The Correct Answer is D

A. "Depo-Provera."
Depo-Provera (medroxyprogesterone injection) is effective for contraception, but it may worsen menstrual irregularities and cause bone density loss with long-term use, making it less ideal.

B. "Contraceptive implant."
While progestin-only implants (e.g., Nexplanon) are effective, they do not protect against STIs. Additionally, irregular bleeding is a common side effect, which may not be ideal for someone with menorrhagia and irregular cycles.

C. "Combination oral contraceptives."
Estrogen-containing contraceptives (e.g., combined oral contraceptive pills) are contraindicated in women who smoke and are ≥35 years old due to the increased risk of venous thromboembolism (VTE). While this client is 22 years old, smoking still makes this option less preferable.

D. "Barrier methods such as female condoms."
Barrier methods reduce the risk of sexually transmitted infections (STIs), which is crucial for this client with multiple sexual partners. Additionally, they do not contain hormones, making them safer for smokers.

Nursing Test Bank

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Correct Answer is B

Explanation

A. Retained placental fragments
This is incorrect because retained placental fragments are more commonly associated with prolonged third-stage labor or incomplete placental expulsion, rather than fetal macrosomia.

B. Uterine atony
This is correct because a large baby (macrosomia) causes overdistension of the uterus, increasing the risk of uterine atony (failure of the uterus to contract effectively). This can lead to postpartum hemorrhage.

C. Puerperal infection
This is incorrect because puerperal infection is usually related to prolonged rupture of membranes, poor hygiene, or invasive procedures, rather than fetal size alone.

D. Thrombophlebitis
While pregnancy increases the risk of clot formation, the most immediate concern for this client is uterine atony and postpartum hemorrhage.

A. Passage of fetal tissue B. Bright red vaginal bleeding C. Severe cramping and pelvic pain D. Closed cervix upon examination E. Mild to moderate lower abdominal cramping

Correct Answer is ["B","D","E"]

Explanation

A. Passage of fetal tissue – This finding is more consistent with an incomplete or complete abortion, not a threatened abortion.

B. Bright red vaginal bleeding – A threatened abortion involves vaginal bleeding during the first 20 weeks of pregnancy, often bright red in color. The cervix remains closed, and fetal cardiac activity may still be present.

C. Severe cramping and pelvic pain – Severe pain is more typical of an inevitable or incomplete abortion rather than a threatened abortion.

D. Closed cervix upon examination – In a threatened abortion, the cervix remains closed. If the cervix opens, the risk of progressing to an inevitable abortion increases.

E. Mild to moderate lower abdominal cramping – Mild cramping or lower abdominal discomfort is common in a threatened abortion due to uterine contractions. However, severe cramping and passage of fetal tissue would indicate a more advanced pregnancy loss.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is 5 hr postpartum following a vaginal birth of a newborn weighing 9 lb 6 oz. (4252 g). The nurse should recognize that this client is at risk for which of the following postpartum complications?

Correct Answer is B

Explanation

A client is admitted with a threatened abortion. Which assessment findings would the nurse expect? Select all that apply. (Select All that Apply.)

Correct Answer is ["B","D","E"]

Explanation

G1P1, 37 weeks' gestation patient with a scheduled nonstress test (NST) Identify which of the following findings is a priority concern or not for the patient.

A 56-year-old menopausal woman reports to the registered nurse that she has been experiencing vaginal itching, burning, and an increase in vaginal infections over the past 3 years. What important factor should the nurse consider before responding to the client's concerns?

A nurse on the postpartum unit is caring for a group of clients with an assistive personnel (AP). Which of the following tasks should the nurse plan to delegate to the AP?

A nurse is caring for a client who is at 37 weeks of gestation and has placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

Which of the following gravid clients is most appropriate for a charge nurse to assign to a new nurse with no obstetric (OB) experience?

A nurse is assessing a postpartum client for signs of postpartum depression. Which of the following symptoms is most indicative of postpartum depression rather than normal postpartum adjustment?

Based on the clients assessment on 2/11 at 1200, indicate if the client's condition is improving, worsening or not related based on the condition.

G1P1, 37 weeks' gestation patient with a scheduled nonstress test (NST) The nurse will implement the following interventions based on the fetal heart rate.(Select All that Apply.)