A nurse is reviewing the medical history of a client who is considering using COCs as a method of contraception.

The nurse should identify that which of the following conditions is a contraindication for using COCs?

History of migraine headaches with aura

History of dysmenorrhea and menorrhagia

History of acne vulgaris and hirsutism

History of iron-deficiency anemia and fatigue

Answer and Explanation

The Correct Answer is A

The correct answer is choice A. History of migraine headaches with aura is a contraindication for using COCs because it increases the risk of stroke.

Some possible explanations for the other choices are:

Choice B is wrong because history of dysmenorrhea and menorrhagia is not a contraindication for using COCs. In fact, COCs may help reduce menstrual pain and bleeding.
Choice C is wrong because history of acne vulgaris and hirsutism is not a contraindication for using COCs. In fact, COCs may help improve acne and hirsutism by reducing androgen levels.
Choice D is wrong because history of iron-deficiency anemia and fatigue is not a contraindication for using COCs. In fact, COCs may help prevent iron-deficiency anemia by reducing menstrual blood loss.

Normal ranges for relevant parameters are:

Blood pressure: <140/90 mmHg
Body mass index: 18.5–24.9 kg/m
Hemoglobin: 12–16 g/dL for women

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Correct Answer is D

Explanation

The correct answer is choice D. Choice D is wrong because it implies that the IUD affects fertility, which is not true.According to the NHS website, “Your fertility will return to normal as soon as the IUD is taken out.” The other choices are correct because:

Choice A is correct because the copper IUD does not contain any hormones and can be used by people who cannot or do not want to use hormonal methods of contraception.
Choice B is correct because a pregnancy test is needed before inserting an IUD to make sure that the person is not already pregnant.
Choice C is correct because the hormonal IUD can reduce menstrual pain and heavy bleeding by thinning the lining of the uterus and thickening the cervical mucus.

Therefore, choice D indicates a need for further teaching.

A. Assess for signs of pelvic inflammatory disease B. Instruct the client to check the string length C. Advise the client to use a backup contraceptive method D. Schedule an appointment for IUD removal

Correct Answer is A

Explanation

The correct answer is choice A. The nurse should assess for signs of pelvic inflammatory disease (PID), which is an infection of the female reproductive organs that can be caused by sexually transmitted bacteria.PID can cause abdominal pain during sexual intercourse, as well as other symptoms such as fever, unusual vaginal discharge, and bleeding between periods.PID can lead to serious complications such as infertility and ectopic pregnancy if left untreated.

Choice B is wrong because checking the string length of the IUD is not a priority action.The string length may change due to normal variations in the position of the uterus and cervix, and does not indicate a problem with the IUD.However, if the string is missing or longer than usual, it may suggest that the IUD has moved or expelled, and the client should see a provider.

Choice C is wrong because advising the client to use a backup contraceptive method is not a priority action.The IUD is a highly effective form of birth control that does not require additional methods unless the client wants to prevent STIs.However, if the client has an STI that causes PID, using a condom may help prevent further infection and transmission.

Choice D is wrong because scheduling an appointment for IUD removal is not a priority action.The IUD does not cause PID, but it may increase the risk of infection shortly after insertion, especially if the client has an STI.The risk of PID from IUD use is very low (less than 1%) and usually disappears after 3 weeks of placement.Removing the IUD may not cure PID and may expose the client to unwanted pregnancy.

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A nurse is reviewing the medical history of a client who is considering using COCs as a method of contraception. The nurse should identify that which of the following conditions is a contraindication for using COCs?

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Explanation

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Correct Answer is A

Explanation

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A nurse is reviewing the medical history of a client who is considering using COCs as a method of contraception.

The nurse should identify that which of the following conditions is a contraindication for using COCs?