A nurse is reviewing contraception options for four clients.
Which client has a contraindication for receiving oral contraceptives?

A 38-year-old client who reports smoking one pack of cigarettes every day.

A 28-year-old client who has a history of pelvic inflammatory disease.

A 32-year-old client who has benign breast disease.

A 26-year-old client who has migraine headaches at the start of each menstrual cycle.

Answer and Explanation

The Correct Answer is A

Choice A rationale

A 38-year-old client who reports smoking one pack of cigarettes every day. Oral contraceptives are contraindicated in women who are over 35 years old and smoke. This is because the combination of oral contraceptives and smoking increases the risk of serious cardiovascular side effects, such as blood clots, stroke, or heart attack. These risks are even higher in women over 35 years old who smoke. Therefore, this client should not receive oral contraceptives due to the increased risk of these serious side effects.

Choice B rationale

A 28-year-old client who has a history of pelvic inflammatory disease. While pelvic inflammatory disease (PID) can lead to complications such as infertility and ectopic pregnancy, it is not a contraindication for the use of oral contraceptives. In fact, oral contraceptives can provide some protection against PID by causing changes in the cervix that make it more resistant to infection.

Choice C rationale

A 32-year-old client who has benign breast disease. Benign breast disease is not a contraindication for the use of oral contraceptives. While some studies have suggested a slightly increased risk of breast cancer in women who have used oral contraceptives, the risk appears to decrease over time once the contraceptives are stopped.

Choice D rationale

A 26-year-old client who has migraine headaches at the start of each menstrual cycle. While migraines can be a contraindication for the use of oral contraceptives, it generally applies to migraines with aura. Women who have migraines with aura have an increased risk of stroke when using oral contraceptives. However, for women who have migraines without aura, the benefits of using oral contraceptives usually outweigh the risks.

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Correct Answer is A

Explanation

Choice A rationale

The nurse should include in the teaching that a client who is 23 weeks pregnant can receive an influenza vaccination during pregnancy. This is because the influenza vaccine is safe and recommended for pregnant women to protect both the mother and the baby from the flu.

Choice B rationale

The rubella vaccine is a live vaccine and is not recommended during pregnancy or while breastfeeding due to the potential risk to the baby. However, it can be given immediately after delivery if the woman is not immune.

Choice C rationale

The varicella vaccine is also a live vaccine and is not recommended during pregnancy. It should be given before pregnancy or immediately after delivery if the woman is not immune.

Choice D rationale

The Tdap (Tetanus, Diphtheria, Pertussis) vaccine is actually recommended during each pregnancy, regardless of the patient’s previous history of receiving the vaccine. The optimal timing for Tdap administration is between 27 and 36 weeks of gestation.

A. A client who is at 38 weeks of gestation and reports a cough and fever. B. A client who is at 14 weeks of gestation and reports nausea and vomiting. C. A client who is at 28 weeks of gestation and reports painless vaginal bleeding. D. A client who has missed a period and reports vaginal spotting.

Correct Answer is C

Explanation

Choice A rationale

A cough and fever in a client at 38 weeks of gestation could indicate an infection, which should be addressed promptly. However, it is not as immediately life-threatening as painless vaginal bleeding at 28 weeks of gestation, which could indicate a serious complication such as placental abruption.

Choice B rationale

Nausea and vomiting at 14 weeks of gestation are common symptoms of early pregnancy and, while uncomfortable, are not usually a sign of a serious problem. This client should be seen, but not before a client with a potentially life-threatening condition like painless vaginal bleeding.

Choice C rationale

Painless vaginal bleeding at 28 weeks of gestation is a serious symptom that could indicate placental abruption, a condition where the placenta detaches from the uterus, which can be life-threatening for both the mother and the baby. This client should be seen first.

Choice D rationale

Vaginal spotting in a client who has missed a period could indicate early pregnancy or a number of other conditions. While this client should be seen to confirm the cause of the spotting, it is not as immediately urgent as painless vaginal bleeding at 28 weeks of gestation.

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A nurse is reviewing contraception options for four clients.Which client has a contraindication for receiving oral contraceptives?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is educating a client who is 23 weeks pregnant about immunizations.Which statement should the nurse include in the teaching?

Correct Answer is A

Explanation

A nurse in an antepartum unit is triaging clients.Which of the following clients should the nurse see first?

Correct Answer is C

Explanation

A nurse is reviewing the health history of a client who has a new prescription for a combined oral contraceptive (COC). The nurse recognizes that which of the following client medications can interfere with the effectiveness of the COC?

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The nurse is planning instructions for a patient desiring to have a tubal ligation.Which information should the nurse emphasize when teaching the patient?

A nurse is evaluating a patient in her third trimester of pregnancy.Which findings should the nurse recognize as expected physiological changes during pregnancy?

A nurse is caring for a patient suspected of having an ectopic pregnancy at 8 weeks of gestation.Which symptoms should the nurse expect to identify as consistent with the diagnosis?

A nurse in a prenatal clinic is caring for a client who is suspected of having a hydatidiform mole. Which of the following findings should the nurse expect to observe in this client?

A nurse is reviewing contraception options for four clients.
Which client has a contraindication for receiving oral contraceptives?