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.

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Correct Answer is A

Explanation

A. The client's vaginal pH may increase during menopause – During menopause, estrogen levels decrease, leading to a higher vaginal pH. This disrupts the normal vaginal flora, making the client more susceptible to infections and irritation.

B. The client's dietary habits and fluid intake – While nutrition and hydration affect overall health, they are not the primary cause of menopausal vaginal symptoms and infections.

C. The client's genitourinary disorder will be alleviated over time – Without treatment (e.g., vaginal estrogen therapy or lubricants), menopausal atrophic changes usually persist or worsen, rather than resolve over time.

D. The client's history of sexually transmitted infections – While STIs can cause vaginal discomfort, the client’s symptoms are more likely due to menopausal changes rather than a past history of STIs.

A. Presence of late decelerations with each contraction during monitoring B. Increased fetal movement between contractions C. Fetal heart rate of 160 beats per minute with moderate variability D. Fetal heart rate consistently below 120 beats per minute with no accelerations

Correct Answer is C

Explanation

A. "Presence of late decelerations with each contraction during monitoring."
Late decelerations indicate uteroplacental insufficiency, which can lead to fetal hypoxia and distress. This is not a reassuring sign.

B. "Increased fetal movement between contractions."
While fetal movement is a positive sign, it is not the best indicator of fetal well-being in labor. Continuous FHR monitoring provides a better assessment.

C. "Fetal heart rate of 160 beats per minute with moderate variability."
A normal fetal heart rate (FHR) is 110–160 bpm, and moderate variability (6–25 bpm fluctuations) indicates a well-oxygenated fetus with an intact autonomic nervous system.

D. "Fetal heart rate consistently below 120 beats per minute with no accelerations."
A persistent FHR below 110 bpm (bradycardia) or minimal variability suggests possible fetal compromise.

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is A

Explanation

While caring for a client in labor, which assessment finding best indicates fetal well-being to the nurse?

Correct Answer is C

Explanation

A nurse is reviewing the different signs of pregnancy with a client who is in her first trimester. Which of the following symptoms should the nurse classify as a positive sign of pregnancy?

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

Which assessment findings might raise the nurse's suspicion of endometriosis in the client they are evaluating?

G1P1, 37 weeks' gestation patient with a scheduled nonstress test (NST) Complete the following sentence using the drop-down options. The nurse's greatest concern is the client's risk of developing __i_____ and related to __ii____ and ___iii____.

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 male client reports to the nurse that he took sildenafil for erectile dysfunction but did not achieve an erection. Which of the following considerations should the nurse evaluate to determine possible reasons for the lack of response?

A nurse is admitting a client who is at 30 weeks of gestation and is in preterm labor. The client has a new prescription for betamethasone and asks the nurse about the purpose of this medication. The nurse should provide which of the following explanations?

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?