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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

A. IV fluids should be administered cautiously in preeclampsia to avoid fluid overload; an IV bolus is not routinely indicated.
B. Monitoring for clonus is important, as it is a sign of increased neuromuscular irritability and risk of seizure in preeclampsia.
C. Misoprostol is used to manage postpartum bleeding but is not specific to preeclampsia management.
D. Fluid restriction is generally not recommended unless there are signs of fluid overload or other complications.

A. Vitamin B12 level B. Fatigue C. Ferritin level D. Orthostatic hypotension

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A,B,C"},"C":{"answers":"B"},"D":{"answers":"A,B,C"}}

Explanation

Vitamin B12 level: A B12 level of 159 pg/mL is below normal and consistent with pernicious anemia. This condition is caused by a lack of intrinsic factor, impairing B12 absorption in the gut. The client’s vegan diet may further reduce B12 intake, worsening deficiency.
Fatigue: Fatigue results from decreased oxygen delivery to tissues due to low hemoglobin in all anemias. In sickle cell disease, abnormally shaped RBCs impair perfusion. Iron and B12 deficiencies impair RBC production, further contributing to fatigue.
Ferritin level: Ferritin reflects the body’s iron storage, and a level of 8 ng/mL is below the normal range. Low ferritin confirms iron depletion, a hallmark of iron deficiency anemia. This can result from dietary lack or chronic inflammation, like in rheumatoid arthritis.
Orthostatic hypotension: Orthostatic hypotension may occur with all anemias due to reduced circulating volume and poor oxygenation. Low hemoglobin and hematocrit lead to impaired vascular tone and autonomic response, causing dizziness or lightheadedness when standing.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who is 1 hr postpartum and has preeclampsia without severe features. Which of the following actions should the nurse plan to take?

Correct Answer is B

Explanation

A nurse in a provider's office is caring for a client. Exhibits For each client's finding, click to specify if the assessment finding is consistent with sickle cell disease, iron deficiency anemia, and/or pernicious anemia. Each finding may support more than 1 disease process.

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A,B,C"},"C":{"answers":"B"},"D":{"answers":"A,B,C"}}

Explanation

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