A nurse is assessing a client to identify contraindications of hormonal contraceptive use.
Which of the following Questions should the nurse ask the client? (Select All that Apply.)

Choice A rationale

An alpha-fetoprotein (AFP) test is a blood test that measures the levels of AFP in the maternal serum. This test does not require any specific dietary restrictions, such as fasting. Therefore, advising the client to abstain from food or drink for 8 hours before the test is not based on physiological necessity for accurate AFP measurement.

Choice B rationale

Test results are influenced by various factors, including gestational age, multiple pregnancies, and certain fetal anomalies. While chronic illnesses can impact overall health, they do not directly determine the outcome of an AFP screening test, which primarily assesses the risk of neural tube defects or chromosomal abnormalities.

Choice C rationale

An AFP test is a simple blood draw and is not an invasive procedure. Therefore, there is no physiological need for bed rest following the test. Clients can resume their normal activities immediately after the blood sample is collected, as there are no associated post-procedure complications requiring immobility.

Choice D rationale

The AFP test is a screening tool, meaning it identifies individuals who may be at an increased risk for certain conditions, such as neural tube defects or Down syndrome. It does not provide a definitive diagnosis. Abnormal screening results necessitate further diagnostic testing, such as amniocentesis or high-resolution ultrasound, for confirmation.

Choice A rationale

Offering privacy and allowing gradual self-expression respects the adolescent's developmental stage, which often includes a need for autonomy and fear of judgment. Providing a non-threatening environment can reduce anxiety and build trust, fostering a sense of security that encourages the patient to open up when they feel ready, without feeling pressured or overwhelmed.

Choice B rationale

Encouraging immediate discussion with parents might be premature and perceived as a lack of understanding by the adolescent. Adolescents often value peer relationships and may find it difficult to express sensitive emotions to parents, especially after a traumatic event like an injury. This approach could increase their withdrawal and reluctance to communicate.

Choice C rationale

Focusing solely on physical care neglects the psychological and emotional needs of the adolescent, which are crucial for holistic recovery. Emotional distress can hinder physical healing and overall well-being. Avoiding emotional support can make the patient feel invalidated and isolated, potentially prolonging their withdrawal and emotional distress.

Choice D rationale

Assigning a withdrawn adolescent to a shared room without prior assessment or consent can exacerbate their anxiety and discomfort. While socialization is important, forcing it upon a patient who is already withdrawn can be counterproductive, potentially leading to increased stress and a further retreat into themselves rather than improving their social engagement.