A nurse in a clinic is caring for a client who has been taking oral contraceptives for several months and reports frequent breakthrough bleeding during her cycle.
Which of the following actions should the nurse take?
Instruct the client to take two pills daily until bleeding stops
Advise the client to stop taking oral contraceptives immediately
Tell the client to avoid smoking while taking oral contraceptives
Suggest that the client switch to a higher-dose formulation
The Correct Answer is D
The correct answer is choice D. The client should switch to a higher-dose formulation of oral contraceptives. Breakthrough bleeding is a common side effect of low-dose birth control pills, especially in the first months of use. It may indicate that the estrogen dose is too low to suppress the growth of the endometrium.
A higher-dose formulation may reduce or eliminate breakthrough bleeding by providing more estrogen.
Choice A is wrong because taking two pills daily until bleeding stops is not a recommended way to manage breakthrough bleeding.
It may cause side effects such as nausea, headache, or breast tenderness. It may also increase the risk of blood clots.
Choice B is wrong because stopping oral contraceptives immediately is not advisable unless there is a medical reason to do so.
Stopping oral contraceptives may cause irregular bleeding, ovulation, and pregnancy.
The client should consult with their provider before discontinuing any medication.
Choice C is wrong because smoking does not cause breakthrough bleeding, but it does increase the risk of serious complications from oral contraceptives, such as stroke, heart attack, or blood clots. The client should avoid smoking while taking any hormonal contraceptive, regardless of whether they experience breakthrough bleeding or not.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice C. OCs can decrease menstrual blood loss and cramps.This is because OCs prevent ovulation and thin the lining of the uterus, which reduces the amount of bleeding and cramping during menstruation.
Choice A is wrong because OCs do not provide protection against STIs.The only contraceptive methods that can prevent STIs are barrier methods, such as condoms.
Choice B is wrong because OCs can have variable effects on libido and sexual satisfaction.
Some women may experience an increase, while others may experience a decrease or no change at all.This depends on individual factors, such as hormone levels, mood, and relationship quality.
Choice D is wrong because OCs can also have variable effects on mood and depression.
Some women may experience an improvement, while others may experience a worsening or no change at all.This also depends on individual factors, such as hormone sensitivity, stress, and history of mental health problems.
Correct Answer is C
Explanation
The correct answer is choice C.Foul-smelling vaginal discharge is a sign of a possible infection, which can be a complication of using a copper IUD.
The nurse should instruct the client to report this symptom and seek medical attention.
Choice A is wrong because increased menstrual pain and bleeding are common side effects of copper IUDs, especially in the first 3-6 months after insertion.
They are not necessarily signs of a complication.
Choice B is wrong because irregular spotting or bleeding are also common side effects of copper IUDs.
They are not necessarily signs of a complication.
Choice D is wrong because a change in string length is not a sign of a complication.
The string length may vary depending on the position of the cervix and uterus.The client should check the string length regularly and report any missing or protruding strings, which could indicate displacement of the IUD.
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