A nurse is caring for a client who is crying after receiving a terminal cancer diagnosis. Which of the following responses should the nurse make?

Rationale:

A. "You should have a sputum examination every 4 weeks.": Monthly sputum samples are necessary to monitor treatment effectiveness and determine when the client is no longer infectious. Clients typically need three consecutive negative sputum cultures to be considered non-contagious.

B. "You should obtain a chest x-ray every 3 months.": Chest x-rays are not routinely used for frequent follow-up during treatment. They may be used at diagnosis or treatment completion, but monthly sputum cultures are more reliable for monitoring active infection.

C. "You should schedule a tuberculin skin test every 6 months.": A tuberculin skin test is not useful for clients with active TB or for monitoring treatment response. Once a person has tested positive, repeat testing is not recommended due to persistent reactivity.

D. "You should stop taking your antituberculin medication after 2 weeks.": TB treatment requires a prolonged course typically 6 to 12 months. Stopping medication after 2 weeks increases the risk of treatment failure, relapse, and drug resistance, even if symptoms improve.

Rationale:

A. Headaches with aura: Headaches accompanied by aura are a strong contraindication to oral contraceptive use due to the significantly increased risk of thromboembolic events, particularly ischemic stroke. Estrogen-containing contraceptives can further exacerbate this vascular risk, making alternative forms of birth control necessary.

B. Gastroesophageal reflux disease: GERD is a gastrointestinal condition that does not affect the safety or efficacy of oral contraceptives. Although hormonal fluctuations can sometimes influence gastric symptoms, GERD is not a contraindication to contraceptive use.

C. History of mononucleosis 1 year ago: A past infection with mononucleosis does not impact liver function long-term in most cases and does not interfere with hormonal contraceptive use. It does not pose any increased risk related to estrogen or progesterone components.

D. Irregular menstrual cycles: While irregular cycles are a common reason for initiating oral contraceptives, they are not a contraindication. In fact, hormonal contraceptives are often used therapeutically to regulate menstrual patterns and reduce cycle variability.