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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Non-Hodgkin's lymphoma is more commonly associated with painless, enlarged lymph nodes than Hodgkin's lymphoma is incorrect because both HL and NHL can present with painless lymphadenopathy, so this is not a distinguishing feature.
B. Hodgkin's lymphoma presents with a more aggressive course than Non-Hodgkin's lymphoma is incorrect because, in children, Non-Hodgkin’s lymphoma generally has a more aggressive and rapid course compared with Hodgkin’s lymphoma, which usually progresses more slowly.
C. Non-Hodgkin's lymphoma typically involves the Reed-Sternberg cells is incorrect because Reed-Sternberg cells are characteristic of Hodgkin’s lymphoma, not Non-Hodgkin’s lymphoma. Their presence is a key diagnostic feature of HL.
D. Hodgkin's lymphoma usually has a more predictable and localized spread than Non-Hodgkin's lymphoma is correct. Hodgkin’s lymphoma tends to spread in a contiguous, orderly fashion from one lymph node group to another, often starting in cervical or supraclavicular nodes. Non-Hodgkin’s lymphoma, in contrast, tends to spread more diffusely and rapidly, involving extranodal sites such as the gastrointestinal tract, mediastinum, and bone marrow.
Correct Answer is D
Explanation
A. Urinary tract infection is incorrect because while UTIs can cause dysuria, urgency, and sometimes hematuria, they rarely follow a strep throat infection and do not typically cause periorbital edema or tea-colored urine in otherwise healthy children.
B. Nephrotic syndrome is incorrect because nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia, hyperlipidemia, and generalized edema, rather than the hematuria, mild periorbital edema, and tea-colored urine seen here.
C. Acute tubular necrosis is incorrect because ATN is usually associated with ischemic or nephrotoxic injury and presents with oliguria and elevated creatinine, not a history of recent streptococcal infection or classic tea-colored urine.
D. Acute post-streptococcal glomerulonephritis (APSGN) is correct because APSGN typically occurs 1–2 weeks after a streptococcal pharyngitis or skin infection. Classic manifestations include periorbital edema, hematuria (tea- or cola-colored urine), mild proteinuria, decreased urine output, and hypertension. This child’s history of recent strep throat followed by these renal symptoms is highly indicative of APSGN.
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