What does the nurse know about postcoital emergency contraception with Ella or Next Choice?

requires that the first dose be taken within 72 hours of unprotected intercourse

requires that the woman take second and third doses at 24 and 36 hours after the first dose

must be taken in conjunction with an IUD insertion

most states require the woman to have a valid prescription

Answer and Explanation

The Correct Answer is D

A. Requires that the first dose be taken within 72 hours of unprotected intercourse: While some emergency contraceptives like Plan B are most effective within 72 hours, Ella (ulipristal acetate) can be effective up to 120 hours after unprotected intercourse, so the 72-hour limitation does not apply universally.

B. Requires that the woman take second and third doses at 24 and 36 hours after the first dose: This dosing schedule applies to older multi-dose regimens of levonorgestrel, not to single-dose emergency contraceptives like Ella or the one-dose Next Choice, which do not require multiple follow-up doses.

C. Must be taken in conjunction with an IUD insertion: Emergency contraceptive pills function independently to prevent ovulation or fertilization and do not require an IUD insertion. IUDs can also be used as emergency contraception, but they are a separate method.

D. Most states require the woman to have a valid prescription: Ella is prescription-only in many states, and the requirement for a prescription differentiates it from over-the-counter emergency contraceptives like Plan B, making this the accurate regulatory consideration for its use.

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Correct Answer is B

Explanation

A. Pulmonary function test: Pulmonary function tests measure lung volumes, capacities, and airflow to assess chronic respiratory conditions. They are not practical or rapid for assessing acute hypoxia in a child presenting with tachycardia and tachypnea.

B. Pulse oximetry: Pulse oximetry provides a noninvasive, immediate measurement of arterial oxygen saturation, allowing rapid detection of hypoxemia. It is highly useful in evaluating the extent of hypoxia in an acutely ill child and guiding supplemental oxygen therapy.

C. Peak expiratory flow: Peak expiratory flow monitoring measures the speed of exhalation, primarily used to monitor asthma control. It does not directly quantify oxygenation or hypoxia.

D. Chest radiograph: A chest X-ray can identify structural or pathological lung changes, such as pneumonia or atelectasis, but it does not provide direct or real-time information about oxygen saturation or the severity of hypoxia.

A. The right arm B. The left arm C. All four extremities D. Both arms while the child is crying

Correct Answer is C

Explanation

A. The right arm: Measuring blood pressure in only one arm can miss important pressure discrepancies that occur with certain congenital heart defects, particularly those involving obstruction of systemic blood flow. Upper-extremity readings alone do not provide a complete hemodynamic picture.

B. The left arm: While the left arm may reflect systemic circulation, isolated measurement does not allow comparison between upper and lower extremities, which is essential for detecting defects such as coarctation of the aorta. A single-site reading limits diagnostic value.

C. All four extremities: Congenital heart defects, especially coarctation of the aorta, often cause higher blood pressure in the arms and lower pressure in the legs due to narrowing of the aorta distal to the subclavian arteries. Measuring all four extremities allows detection of pressure gradients that strongly suggest CHDs.

D. Both arms while the child is crying: Crying can falsely elevate blood pressure due to sympathetic stimulation and does not provide reliable or comparative data. Additionally, measuring only the arms fails to assess lower-extremity perfusion differences critical in CHD evaluation.

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What does the nurse know about postcoital emergency contraception with Ella or Next Choice?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is examining an 8-year-old boy with tachycardia and tachypnea. The nurse anticipates which test as most helpful in determining the extent of the child's hypoxia?

Correct Answer is B

Explanation

When assessing a child for possible congenital heart defects (CHDsl, where should the nurse measure blood pressure?

Correct Answer is C

Explanation

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