A nurse is reviewing contraception options for four clients.
The nurse should identify which of the following clients as having a contraindication to oral contraceptives?

A client who has a blood pressure of 100/60.

A 15-year-old client who has acne.

A client who has a hematocrit of 39.

A client who has a menstrual cycle every 14 days.

Answer and Explanation

The Correct Answer is B

Choice A rationale:
A blood pressure of 100/60 is within the normal range and does not pose a contraindication to oral contraceptives. While hypertension (high blood pressure) can be a contraindication, a blood pressure of 100/60 is not considered hypertensive.
However, it's essential to monitor blood pressure regularly in individuals using oral contraceptives, as some may experience a slight increase in blood pressure.

Choice B rationale:
Age is a significant factor when considering oral contraceptive use.
Adolescents under 16 years of age are generally not recommended to use oral contraceptives due to several concerns: Their reproductive systems are still developing, and hormonal contraceptives could potentially disrupt normal growth and development.
Younger adolescents may have more difficulty adhering to a strict daily medication regimen, which is crucial for the effectiveness of oral contraceptives.
They may be at a higher risk of certain side effects, such as irregular bleeding patterns and mood changes.
Acne treatment is often a primary reason for considering oral contraceptives in adolescents. However, alternative acne treatments that are more suitable for younger individuals are available.

Choice C rationale:
A hematocrit of 39 is within the normal range for females and does not contraindicate oral contraceptive use.
Hematocrit measures the proportion of red blood cells in the blood. Oral contraceptives can sometimes cause slight changes in hematocrit levels, but these changes are typically not clinically significant.

Choice D rationale:
A menstrual cycle of 14 days is considered a normal variation and does not pose a contraindication to oral contraceptives. Oral contraceptives can often regulate irregular menstrual cycles, so they may even be beneficial for individuals with shorter or longer cycles.

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Correct Answer is C

Explanation

Choice A, 42022:
This option incorrectly counts the elective abortion as a term birth. Elective abortions, regardless of gestational age, are not considered term births in the GTPAL system. They are classified under abortions (A).

Including the elective abortion as a term birth would overestimate the client's parity, leading to inaccurate assessment of her reproductive history.

Choice B, 20022:
This option incorrectly excludes the elective abortion from the GTPAL calculation. Elective abortions are considered pregnancies and are included in the gravida (G) count.
Omitting the elective abortion would underestimate the client's overall pregnancy history and potentially overlook relevant factors related to her reproductive health.

Choice D, 20222:
This option incorrectly counts the spontaneous abortion as a preterm birth. Spontaneous abortions that occur before 20 weeks of gestation are not classified as preterm births in the GTPAL system. They are categorized as abortions (A).
Classifying the spontaneous abortion as a preterm birth would misrepresent the client's obstetric history and potentially lead to inappropriate care decisions.

Choice C, 40122:
This option accurately reflects the client's parity based on the GTPAL system:
Gravida (G): 4 (total pregnancies, including elective abortion, spontaneous abortion, twin birth, and current pregnancy) Term (T): 0 (no previous term births)
Preterm (P): 1 (twin birth at 36 weeks, considered preterm as it occurred before 37 weeks) Abortions (A): 2 (elective abortion and spontaneous abortion)
Living children (L): 2 (twins from the previous pregnancy)

A. You will start to feel the baby move at 24 weeks B. Sex of the baby is determined by week 8 C. The baby’s heartbeat is audible by a Doppler stethoscope at 12 weeks D. Very fine hairs called lanugo cover your baby’s entire body by 36 weeks

Correct Answer is C

Explanation

Choice A:
It is incorrect to state that all women will start to feel the baby move at 24 weeks. While this is a common timeframe, the exact timing of when a woman first feels fetal movements, known as quickening, can vary. Some women may feel movement as early as 16 weeks, while others may not feel it until closer to 25 weeks. Factors such as the position of the placenta, the woman's body size, and whether it is her first pregnancy can influence when she first perceives movement.
Choice B:
While the baby's sex is genetically determined at conception, it is not typically visible on ultrasound until around 18-20 weeks of gestation. This is due to the development of the external genitalia, which occurs between 11 and 14 weeks. It is not accurate to state that the sex is always definitively determined by week 8.
Choice D:
Lanugo, the fine hair that covers a fetus's body, is typically present between 14 and 20 weeks of gestation. It starts to disappear around 32-36 weeks, and most babies are born without it. Therefore, it is incorrect to say that lanugo covers the entire body at 36 weeks.
Choice C:
The fetal heartbeat can be detected by a Doppler stethoscope as early as 10-12 weeks of gestation. This is often a reassuring milestone for pregnant women, as it provides audible confirmation of the baby's presence and well-being. It is a common practice for healthcare providers to use a Doppler stethoscope during prenatal visits to assess the fetal heart rate and monitor fetal development.

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A nurse is reviewing contraception options for four clients. The nurse should identify which of the following clients as having a contraindication to oral contraceptives?

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A nurse is reviewing contraception options for four clients.
The nurse should identify which of the following clients as having a contraindication to oral contraceptives?