A nurse is reviewing laboratory results for a female client who takes oral contraceptives (OCs).
Which of the following findings should indicate to the nurse that OCs are having an adverse effect on this client?
Decreased serum glucose level
Increased serum potassium level
Decreased serum triglyceride level
Increased serum protein level
The Correct Answer is B
The correct answer is choice B. Increased serum potassium level. Oral contraceptives can affect the levels of various electrolytes in the blood, such as sodium, potassium, calcium and magnesium. According to one study, oral contraceptives can increase the levels of serum copper, iron, calcium and cadmium, and decrease the levels of serum zinc, selenium, phosphorus and magnesium.
Therefore, a high serum potassium level can indicate an adverse effect of oral contraceptives on this client.
Choice A is wrong because oral contraceptives do not decrease serum glucose level. In fact, they can increase the plasma glucose level and insulin response, which can impair glucose tolerance and increase the risk of diabetes.
Choice C is wrong because oral contraceptives do not decrease serum triglyceride level. On the contrary, they can increase the fasting triglyceride level by 13 to 75 percent, which can elevate the risk of cardiovascular disease.
Choice D is wrong because oral contraceptives do not increase serum protein level. They can increase the levels of some apolipoproteins, such as A-I, A-II and B, but these are not the same as total protein.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice A. Perform a pregnancy test.An IUD is a form of birth control that is inserted into the uterus to prevent pregnancy, but it is not 100% effective.If a client with an IUD misses a menstrual period, the first action the nurse should take is to rule out pregnancy by performing a pregnancy test.This is because pregnancy with an IUD can have serious complications, such as ectopic pregnancy, infection, miscarriage or preterm labor.
Choice B is wrong because palpating for uterine enlargement is not a reliable way to diagnose pregnancy, especially in the early stages.It can also cause discomfort or bleeding for the client.
Choice C is wrong because assessing for signs of ectopic pregnancy is not the first action the nurse should take.
Ectopic pregnancy is a possible complication of pregnancy with an IUD, but it is not very common.The nurse should first confirm if the client is pregnant before looking for signs of ectopic pregnancy, such as abdominal pain, vaginal bleeding or shoulder pain.
Choice D is wrong because instructing the client to remove the IUD is not appropriate or safe.
The client should not attempt to remove the IUD by themselves, as this can cause injury or infection.The nurse should refer the client to an OB-GYN if they are pregnant with an IUD or if they want to remove the IUD for any reason.
Correct Answer is D
Explanation
The nurse should include all of the following information in the teaching:
- The typical failure rate for IUDs is 1% to 3% per year.
- This means that out of 100 women who use an IUD for a year, one to three may get pregnant.
- The risk of pelvic inflammatory disease (PID) is highest in the first 6 weeks after insertion.
- PID is an infection of the reproductive organs that can cause infertility, chronic pain, or ectopic pregnancy.
- The risk of PID is higher if the woman or her partner has multiple sexual partners or a sexually transmitted infection (STI).
- The IUD can be inserted at any time during the menstrual cycle.
- However, some doctors may prefer to insert it during or right after the period, when the cervix is more open and the chance of pregnancy is lower.
Choice A is wrong because it only states one piece of information that the nurse should include in the teaching.
Choice B is wrong because it only states one piece of information that the nurse should include in the teaching.
Choice C is wrong because it only statesone piece of information that the nurse should include in the teaching
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