A nurse is assessing a client who is requesting a combined oral contraceptive (COC). Which of the following findings should indicate to the nurse that the client has a contraindication to COC use?
The client drinks 240 mL (8 oz) of wine per day.
The client is breastfeeding their 4-week-old newborn.
The client weighs 115 kg (254 lb).
The client is 25 years old.
The Correct Answer is B
A. Moderate alcohol intake is not a contraindication to COC use.
B. Breastfeeding in the first 6 weeks postpartum is a contraindication to combined oral contraceptives because estrogen can reduce milk supply and increase the risk of thrombosis.
C. High body weight is not an absolute contraindication, though efficacy may be reduced.
D. Age 25 alone is not a contraindication to COCs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. History of ovarian cysts is not an absolute contraindication to oral contraceptives.
B. Hypotension is not a contraindication for oral contraceptives.
C. Migraine with aura is a contraindication due to increased risk of stroke associated with combined oral contraceptives in these clients.
D. Dysmenorrhea is often improved by oral contraceptive use and is not a contraindication.
Correct Answer is {"A":{"answers":"B,C"},"B":{"answers":"B,C"},"C":{"answers":"A,C"},"D":{"answers":"B,C"},"E":{"answers":"C"}}
Explanation
|
Assessment findings |
Placenta previa |
Preterm labor |
Abruption placenta |
|
Cervical dilation |
✓ |
✓ |
|
|
Uterine contractions |
✓ |
✓ |
|
|
Vaginal bleeding |
✓ |
✓ |
|
|
Client reports low back pain |
✓ |
✓ |
|
|
Abdominal tenderness |
✓ |
Rationale
- Cervical dilation: Present in preterm labor and abruption due to uterine activity and cervical changes; not typical in placenta previa unless labor begins.
- Uterine contractions: Present in preterm labor and abruption; placenta previa usually painless without contractions.
- Vaginal bleeding: In placenta previa, bleeding is usually painless; in abruption, bleeding is often accompanied by pain; preterm labor usually does not involve bleeding.
- Low back pain: Common in preterm labor and abruption due to contractions or placental separation; not typical in placenta previa.
- Abdominal tenderness: Present in abruption because of bleeding behind the placenta causing uterine irritation; absent in placenta previa and preterm labor.
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