A nurse is teaching a client about potential adverse effects of oral contraceptives. For which of the following adverse effects should the nurse instruct the client to notify the provider immediately?

Nausea

Persistent headaches

Breast tenderness

Abdominal bloating

Answer and Explanation

The Correct Answer is B

A. Nausea is a common and generally mild side effect of oral contraceptives and does not typically require immediate medical attention.
B. Persistent headaches may indicate an increased risk of stroke or hypertension, especially in clients with other risk factors. This could be a sign of a serious adverse effect and should be reported to the provider immediately.
C. Breast tenderness is a common and usually benign side effect of hormonal contraceptives.
D. Abdominal bloating may occur but is not typically dangerous or an urgent concern.

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Correct Answer is ["B","E"]

Explanation

A. Maternal Rh factor – The mother is O positive. Rh incompatibility is not a concern here because both mother and newborn are likely Rh positive, and no information suggests Rh incompatibility.
B. Gestational age – The newborn was born at 36 weeks and 4 days, which is considered late preterm and places the infant at increased risk for complications such as respiratory distress, jaundice, hypoglycemia, and feeding difficulties.
C. Apgar scores – Scores of 7 at 1 minute and 8 at 5 minutes are within the normal range and not indicative of distress or a complication risk.
D. Weight – A birth weight of 3,062 g (6 lb 12 oz) is appropriate for gestational age and not a risk factor.
E. Type of birth – Operative vaginal birth using a vacuum extractor increases the risk for complications like cephalohematoma, which is noted in the assessment (firm, edematous scalp area with ecchymosis not crossing suture lines). This can contribute to jaundice.
F. Length – A length of 48 cm (19 in) is appropriate for gestational age and not a risk factor.

A. Administer an IV bolus of lactated Ringer's B. Monitor for clonus C. Obtain a prescription for misoprostol D. Restrict daily oral fluid intake.

Correct Answer is B

Explanation

A. IV fluids should be administered cautiously in preeclampsia to avoid fluid overload; an IV bolus is not routinely indicated.
B. Monitoring for clonus is important, as it is a sign of increased neuromuscular irritability and risk of seizure in preeclampsia.
C. Misoprostol is used to manage postpartum bleeding but is not specific to preeclampsia management.
D. Fluid restriction is generally not recommended unless there are signs of fluid overload or other complications.

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A nurse is teaching a client about potential adverse effects of oral contraceptives. For which of the following adverse effects should the nurse instruct the client to notify the provider immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a newborn Exhibits Which findings are risk factors for the newborn to develop a complication? Select all that apply

Correct Answer is ["B","E"]

Explanation

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Correct Answer is B

Explanation

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