A nurse is caring for a client who is taking an oral contraceptive. The nurse should instruct the client to report which of the following findings to the provider immediately?
Painful intercourse
Vaginal itching
Persistent headaches
Breast tenderness
The Correct Answer is C
A. Painful intercourse: Painful intercourse can have various causes, but it is not typically associated with serious complications related to oral contraceptives. It may be addressed with the healthcare provider during a routine follow-up.
B. Vaginal itching: Vaginal itching may be due to various reasons, including infections, but it is not typically a direct side effect of oral contraceptives. However, if the itching is persistent or severe, the client should report it to the provider for appropriate evaluation.
C. Persistent headaches: Persistent headaches can be a concerning side effect associated with the use of oral contraceptives. It may indicate an increased risk of vascular events, such as stroke or thrombosis. Clients experiencing persistent headaches while on oral contraceptives should report this symptom to the healthcare provider immediately for further evaluation.
D. Breast tenderness: Breast tenderness is a common side effect of hormonal contraceptives, and it is not typically an emergency or a sign of serious complications. However, if the breast tenderness is severe or associated with other concerning symptoms, the client should contact the provider for guidance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Urinary output 40 mL/hr: Decreased urinary output can be an indicator of inadequate fluid intake or other issues, but it is not a specific sign of hemorrhage.
B. Blood pressure 88/40 mm Hg: This is the correct answer. A low blood pressure, especially with a low diastolic pressure, can be indicative of hypovolemic shock, which may result from postpartum hemorrhage. Hemorrhage leads to a decrease in circulating blood volume, causing a drop in blood pressure.
C. Moderate rubra lochia: Lochia is the normal vaginal discharge experienced after childbirth, and moderate rubra lochia is considered within the expected range for the early postpartum period. It is not a specific sign of hemorrhage.
D. Heart rate 90/min: A heart rate of 90 beats per minute is within the normal range for a postpartum client and may not be a specific sign of hemorrhage. However, an increase in heart rate could be an early indicator of hypovolemia due to hemorrhage.
Correct Answer is B
Explanation
Correct Answer: B
B. Administer broad-spectrum antibiotics
Newborns with a leaking myelomeningocele are at a high risk for infection, especially meningitis, due to the exposure of cerebrospinal fluid (CSF). Administering broad-spectrum antibiotics helps reduce the risk of infection until the defect is surgically closed.
Incorrect answers:
A.Monitor the rectal temperature every 4 hr.Taking rectal temperatures is contraindicated in a newborn with a myelomeningocele due to the risk of trauma to the rectum and potential introduction of bacteria near the exposed spinal cord and CSF. Axillary temperatures should be used instead.
C.Prepare for surgical closure after 72 hr.Surgical repair of a myelomeningocele is typically performed within the first 24–48 hours of life to reduce the risk of infection and prevent further nerve damage.
D.Cleanse the site with povidone-iodine. Povidone-iodine is not appropriate for cleansing the exposed myelomeningocele site because it can be too harsh and toxic to neural tissue.
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