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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Tachycardia, or a fast heart rate, is not a common finding in severe preeclampsia. While some women with preeclampsia may experience a slight increase in heart rate, it is not typically a significant or defining feature of the condition. In fact, some women with severe preeclampsia may even experience a slightly decreased heart rate due to increased vagal tone.
Choice B rationale:
Hypotension, or low blood pressure, is also not a typical finding in severe preeclampsia. Blood pressure is often elevated in preeclampsia, and it is one of the key diagnostic criteria. Hypotension would be a concerning finding in a woman with preeclampsia, as it could indicate a serious complication such as placental abruption or HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelet count).
Choice C rationale:
Polyuria, or excessive urination, is not a characteristic finding of severe preeclampsia. In fact, many women with preeclampsia experience oliguria, or decreased urine output, due to decreased kidney function. This is because preeclampsia can cause damage to the blood vessels in the kidneys, impairing their ability to filter blood and produce urine.
Choice D rationale:
Headache is a common and often severe symptom of severe preeclampsia. It is thought to be caused by increased pressure within the brain due to swelling and vasoconstriction of the blood vessels. Headaches in preeclampsia can be very intense and may be accompanied by other symptoms such as blurred vision, nausea, and vomiting. They are often a sign that the preeclampsia is worsening and that delivery may be necessary.
Correct Answer is A
Explanation
Choice A rationale:
Large amount of bright red vaginal bleeding is the cardinal sign of placenta previa. This is because the placenta is abnormally positioned low in the uterus, covering the cervix partially or completely. When the cervix starts to dilate in preparation for labor, it can detach from the uterine wall, leading to significant bleeding. The blood is typically bright red, indicating fresh bleeding, and can be painless.
Severity of bleeding: The amount of bleeding can vary from spotting to massive hemorrhage, and it may start suddenly or gradually. Even a small amount of bleeding can be a sign of placenta previa and should not be ignored.
Risks of hemorrhage: Prompt recognition and management of bleeding are crucial to prevent potentially life-threatening hemorrhage for both the mother and the fetus.
Choice B rationale:
Severe pain with no bleeding is not a typical presentation of placenta previa. While some women with placenta previa may experience mild abdominal pain or cramping, severe pain without bleeding is more suggestive of placental abruption, a condition where the placenta prematurely separates from the uterine wall.
Choice C rationale:
High-grade fever is not a direct symptom of placenta previa. However, if a woman with placenta previa develops a fever, it could indicate an infection, which can further complicate the condition and require immediate medical attention.
Choice D rationale:
Sudden sharp pain in the lower abdomen can be a sign of placental abruption but is not characteristic of placenta previa.
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