A nurse is assessing a client who is taking ethinyl estradiol and norethindrone for contraception.
Which of the following manifestations should the nurse identify as a potential adverse effect of this medication combination?

Weight loss.

Easy bruising.

Low blood pressure.

Breakthrough bleeding.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Ethinyl estradiol and norethindrone, a common oral contraceptive combination, can sometimes lead to weight gain rather than weight loss. This is often attributed to fluid retention and changes in appetite or metabolism, rather than a catabolic effect causing weight reduction.

Choice B rationale

Easy bruising is not a typical manifestation of ethinyl estradiol and norethindrone use. While some hormonal contraceptives can affect coagulation factors, leading to an increased risk of thrombosis, they do not generally cause increased capillary fragility or platelet dysfunction manifesting as easy bruising.

Choice C rationale

Oral contraceptives containing estrogen, such as ethinyl estradiol, can actually cause a slight increase in blood pressure in some individuals due to their effects on the renin-angiotensin-aldosterone system, leading to sodium and water retention. Low blood pressure is not a common adverse effect.

Choice D rationale

Breakthrough bleeding, or irregular uterine bleeding that occurs during hormone therapy, is a common adverse effect of combined oral contraceptives like ethinyl estradiol and norethindrone, especially during the initial cycles of use. It results from an imbalance in the hormonal effects on the endometrium.

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Free Nursing Study Resources

Correct Answer is ["200"]

Explanation

Step 1 is to determine the total volume to be infused, which is 100 mL.

Step 2 is to determine the infusion time in hours. The infusion time is 30 min, which is 0.5 hours.

Step 3 is to calculate the infusion rate in mL/hr by dividing the total volume by the infusion time in hours: 100 mL ÷ 0.5 hr = 200 mL/hr. The nurse should set the IV infusion pump to deliver 200 mL/hr.

A. It decreases the production of uric acid. B. It increases tophus formation in the joints. C. It lowers calcium levels. D. It reduces joint inflammation.

Correct Answer is A

Explanation

Choice A rationale

Allopurinol is a xanthine oxidase inhibitor. This enzyme is crucial in the purine catabolism pathway, converting xanthine and hypoxanthine into uric acid. By inhibiting xanthine oxidase, allopurinol effectively decreases the de novo synthesis of uric acid, thereby lowering serum uric acid levels. This reduction prevents the formation of uric acid crystals in joints and tissues, which are responsible for the painful manifestations of gout.

Choice B rationale

Tophus formation is a direct consequence of chronic hyperuricemia, where uric acid crystals accumulate in soft tissues, leading to palpable nodules. Allopurinol's primary mechanism of action is to reduce uric acid levels. By achieving this, it prevents further crystal deposition and can even lead to the regression of existing tophi over time. Therefore, it does not increase tophus formation.

Choice C rationale

Allopurinol's mechanism of action is specifically related to uric acid metabolism. It does not directly influence calcium homeostasis in the body. Calcium levels are primarily regulated by parathyroid hormone, calcitonin, and vitamin D, which are distinct physiological pathways unrelated to xanthine oxidase inhibition. Therefore, it does not lower calcium levels.

Choice D rationale

While allopurinol ultimately helps relieve joint inflammation in gout, it does so indirectly. Its primary action is to reduce uric acid production, which then prevents the formation of inflammatory uric acid crystals. The direct reduction of inflammation is typically achieved by anti-inflammatory drugs like NSAIDs or colchicine, which act on inflammatory mediators or pathways, not directly by allopurinol.

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A nurse is assessing a client who is taking ethinyl estradiol and norethindrone for contraception. Which of the following manifestations should the nurse identify as a potential adverse effect of this medication combination?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["200"]

Explanation

A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. Which of the following statements should the nurse make to explain how this medication will help relieve the client's manifestations?

Correct Answer is A

Explanation

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A nurse is assessing a client who is taking ethinyl estradiol and norethindrone for contraception.
Which of the following manifestations should the nurse identify as a potential adverse effect of this medication combination?