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?
Combination oral contraceptives.
Depo-Provera.
Barrier methods such as female condoms.
Contraceptive implant.
The Correct Answer is C
Choice A rationale
Combination oral contraceptives are contraindicated for smokers over 35 due to an increased risk of cardiovascular events such as thromboembolism and myocardial infarction. While the client is younger, her smoking habit is still a significant risk factor, and oral contraceptives do not protect against sexually transmitted infections given her multiple partners.
Choice B rationale
Depo-Provera, an injectable progestin, can cause irregular bleeding and potential weight gain, which might not be ideal given the client's existing irregular menstrual cycles and menorrhagia. Furthermore, it does not offer protection against sexually transmitted infections.
Choice C rationale
Barrier methods such as female condoms, when used consistently and correctly, provide protection against both pregnancy and sexually transmitted infections, which is crucial given the client's multiple partners. While they require proper education and may have a higher failure rate than hormonal methods, they address the STI risk directly.
Choice D rationale
A contraceptive implant is a highly effective long-acting reversible contraceptive. However, it does not protect against sexually transmitted infections. Given the client's multiple partners, STI protection is a primary concern that the implant does not address. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
A pre-pregnancy BMI of 23.5 falls within the normal weight range (18.5 to 24.9 kg/m²). For individuals with a normal pre-pregnancy BMI, the recommended total weight gain during pregnancy is 25 to 35 pounds (11.3 to 15.9 kg). This range supports optimal fetal growth without significantly increasing the risk of maternal or fetal complications associated with excessive weight gain.
Choice B rationale
While a gradual weight gain is generally recommended, stating "about 1 pound per week" is an oversimplification and doesn't account for the varying rates of weight gain throughout pregnancy. The rate of weight gain is typically lower in the first trimester and higher in the second and third trimesters. Focusing solely on a weekly gain might cause unnecessary anxiety if the client's weight gain fluctuates slightly.
Choice C rationale
A recommended weight gain of 15 to 25 pounds is appropriate for individuals with an overweight pre-pregnancy BMI (25 to 29.9 kg/m²), not a normal BMI. Recommending this lower range to a client with a normal BMI could lead to inadequate weight gain and potentially compromise fetal development due to insufficient nutrient supply.
Choice D rationale
A recommended weight gain of 11 to 20 pounds is typically advised for individuals with an obese pre-pregnancy BMI (30 kg/m² or higher). Suggesting this lower range to a client with a normal BMI could restrict necessary weight gain for a healthy pregnancy and fetal growth.
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C"}
Explanation
The nurse should be most concerned about preeclampsia, which is a hypertensive disorder of pregnancy that typically occurs after 20 weeks' gestation. Primigravida status (first pregnancy) and being at or near term (like 37 weeks) are known risk factors. Monitoring through a nonstress test is part of evaluating fetal well-being in at-risk pregnancies.
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