A37-year-old female patient who smokes 20 cigarettes a day is prescribed oral contraceptives. Which nursing action is the priority based on the patient's history and medication?
Encourage the patient to take oral contraceptives at the same time every day to improve effectiveness
Advise the patient to quit smoking before starting oral contraceptives due to increased risk of blood dots, MI, and stroke.
Instruct the patient to monitor fair signs of nausea and mood changes as common side effects of oral contraceptives
Recommend the patent increase fat intake to reduce the risk of blood clots while taking oral contraceptives
The Correct Answer is B
A. Encourage the patient to take oral contraceptives at the same time every day to improve effectiveness: Taking oral contraceptives at the same time each day improves contraceptive effectiveness and maintains stable hormone levels. However, consistent timing does not address the significant cardiovascular and thromboembolic risk associated with heavy cigarette smoking. Safety considerations take priority over effectiveness teaching in this scenario.
B. Advise the patient to quit smoking before starting oral contraceptives due to increased risk of blood clots, myocardial infarction, and stroke: Smoking 20 cigarettes per day significantly increases the risk of venous thromboembolism, myocardial infarction, and stroke when combined with estrogen-containing oral contraceptives. Counseling on smoking cessation is a priority to reduce life-threatening complications.
C. Instruct the patient to monitor for signs of nausea and mood changes as common side effects of oral contraceptives: Nausea and mood changes are common side effects of oral contraceptives but are generally mild and non–life-threatening. Monitoring for these effects does not address the patient’s elevated risk for serious cardiovascular events. Priority nursing actions focus on preventing severe adverse outcomes.
D. Recommend the patient increase fat intake to reduce the risk of blood clots while taking oral contraceptives: Increasing dietary fat does not reduce the risk of thromboembolism and may worsen cardiovascular risk factors. There is no evidence supporting fat intake as a protective measure against blood clots. This recommendation contradicts evidence-based cardiovascular health guidance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Administering additional sodium supplements:Furosemide increases sodium excretion in the urine. Adding sodium supplements would counteract the diuretic effect and may worsen fluid retention or blood pressure control.
B. Monitoring serum potassium levels regularly:Furosemide is a loop diuretic that causes potassium loss through the kidneys. Hypokalemia can lead to muscle weakness and dangerous cardiac dysrhythmias. Regular potassium monitoring is essential to detect and prevent this complication.
C. Encouraging increased fluid intake:Excessive fluid intake may reduce the effectiveness of diuresis and worsen edema or heart failure symptoms. Fluid intake should be guided by the patient’s clinical condition, not routinely increased.
D. Assess for episodes of hypertension:Furosemide lowers blood pressure rather than causing hypertension. The nurse should monitor for hypotension instead, making this option less relevant to preventing medication-related complications.
Correct Answer is D
Explanation
A. Complete blood count:A CBC can indicate infection through elevated white blood cell count, but it does not identify the specific organism or determine which antibiotic is effective. It provides general information rather than targeted guidance.
B. Urinalysis:A urinalysis evaluates urinary tract function and infections, not wound infections. It is unrelated to identifying the pathogen in a non-healing wound.
C. X-ray of the wound:An X-ray can assess for bone involvement or foreign bodies but does not identify the causative microorganism or guide antibiotic selection. Imaging is supportive, not diagnostic for pathogen type.
D. Wound culture and sensitivity:A wound culture identifies the specific organism causing the infection, and sensitivity testing determines which antibiotics will effectively treat it. This diagnostic is essential when a wound is not healing and the causative pathogen is unknown.
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