A 25-year-old woman is considering starting oral contraceptives. Which of the following conditions are contraindications for her to use combination oral contraceptives? (Select all that apply.)

Smoking and age over 35 years

Migraine headaches with aura

History of blood clots (deep vein thrombosis)

Family history of breast cancer

Controlled hypertension

Answer and Explanation

Correct Answer : A,B,C

A. Smoking and age over 35 years is correct because women over 35 who smoke have a significantly increased risk of cardiovascular events, such as myocardial infarction and stroke, when taking estrogen-containing oral contraceptives.

B. Migraine headaches with aura is correct because migraine with aura increases the risk of stroke, and estrogen-containing oral contraceptives can further increase thromboembolic and cerebrovascular risk.

C. History of blood clots (deep vein thrombosis) is correct because estrogen-containing contraceptives increase the risk of venous thromboembolism. Women with a history of DVT or pulmonary embolism should avoid combined oral contraceptives.

D. Family history of breast cancer is incorrect because a family history alone is not an absolute contraindication for oral contraceptives. While caution may be advised, combined oral contraceptives are not contraindicated solely based on family history.

E. Controlled hypertension is incorrect because mild, well-controlled hypertension is not an absolute contraindication. The risk increases in women with uncontrolled or severe hypertension, making oral contraceptives unsafe in that context.

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Correct Answer is A

Explanation

A. Sweat chloride test is correct because it is the gold standard diagnostic test for cystic fibrosis. In CF, mutations in the CFTR gene lead to abnormal chloride transport in epithelial cells. This results in elevated chloride levels in sweat, typically ≥60 mmol/L in children, which confirms the diagnosis.

B. Genetic testing for CFTR mutations is incorrect as the sole diagnostic tool because not all CF mutations are detectable, and testing may identify carriers or atypical variants. While genetic testing is useful for confirmation or family counseling, it is not the first-line diagnostic test.

C. Chest x-ray is incorrect because, although it may reveal hyperinflation, bronchiectasis, or infiltrates indicative of chronic lung disease in CF, it cannot confirm the diagnosis. Imaging is supportive but not diagnostic.

D. Pulmonary function tests (PFTs) are incorrect because these tests assess lung function and airflow limitation, but they are not diagnostic for CF, especially in young children who may not be able to perform the tests reliably.

A. Estrogen B. Progesterone C. Human Chorionic Gonadotropin (hCG) D. Relaxin

Correct Answer is B

Explanation

A. Estrogen is incorrect because, while estrogen promotes uterine growth, blood flow, and development of the mammary glands, it does not primarily maintain the uterine lining or prevent contractions. Estrogen actually increases toward the end of pregnancy and can help sensitize the uterus to oxytocin, promoting labor.

B. Progesterone is correct because it maintains the endometrial lining, supporting implantation and early fetal development, and inhibits uterine contractions throughout pregnancy. By relaxing smooth muscle in the uterus, progesterone helps prevent premature labor and miscarriage. Its levels remain high during most of pregnancy and decrease near term to allow labor to begin.

C. Human Chorionic Gonadotropin (hCG) is incorrect because hCG’s primary role is to signal the corpus luteum to continue producing progesterone during early pregnancy. While essential in the first trimester, it does not directly maintain the uterine lining or prevent contractions throughout pregnancy.

D. Relaxin is incorrect because relaxin primarily relaxes the ligaments of the pelvis and softens the cervix to prepare for labor. It does not maintain the endometrium or inhibit uterine contractions.

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A 25-year-old woman is considering starting oral contraceptives. Which of the following conditions are contraindications for her to use combination oral contraceptives? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is teaching a prenatal patient about pregnancy hormones, Which hormone is primarily responsible for maintaining the uterine lining and preventing contractions during pregnancy?

Correct Answer is B

Explanation

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A 25-year-old woman is considering starting oral contraceptives. Which of the following conditions are contraindications for her to use combination oral contraceptives? (Select all that apply.)