Nokea
A client taking oral contraceptive drugs complains of occasional bloating of the abdomen. Which of the following instructions should the nurse offer the client to help alleviate the condition?
- A. Limit fluid intake with meals.
- B. Take the drug along with food.
- C. Decrease the intake of salt.
- D. Elevate the legs when sitting.
Correct Answer: A
Rationale: The nurse should instruct the client to limit fluid intake with meals if she experiences bloating of the abdomen after oral contraceptive use. Light to moderate exercise also may be helpful. Taking the drug with food alleviates nausea and GI irritation, and not the bloating of the abdomen. A decrease in salt intake causes a decrease in the intake of sodium, which may be beneficial when there is an excess fluid volume, and not when there is bloating of the abdomen. Elevating the legs when sitting prevents thromboembolism seen with oral contraceptive use. It does not prevent bloating of the abdomen.
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When completing the ongoing assessment of clients receiving estrogen, progestin, or combination products, which of the following would the nurse include? Select all that apply.
- A. Blood pressure
- B. Pulse
- C. Respiratory rate
- D. Temperature
- E. Therapeutic effects
Correct Answer: A,B,C,E
Rationale: The nurse's ongoing assessment of clients receiving estrogen, progestin, or combination products should include blood pressure, pulse, respiratory rate, weight, and questioning about adverse effects and therapeutic effects.
After reviewing the various contraceptive options with a client, the client opts for the etonogestrel/ethinyl estradiol vaginal ring. After teaching the client about this choice, the nurse determines that the teaching was effective when the client states which of the following?
- A. Once I insert the ring, it won't come out.
- B. The ring should stay in place for 3 weeks.
- C. When bleeding starts, that's the signal to change the ring.
- D. I can reuse the ring several times before discarding it.
Correct Answer: B
Rationale: When using the vaginal ring, the client should insert the ring and keep it in place for 3 weeks and then remove it on the same day of the week it was inserted. The ring can be expelled accidentally, such as with straining on defecation or removing a tampon. Typically, bleeding occurs once the ring is removed. The ring should be discarded after each use.
A client with estrogen excess may report which of the following symptoms to the nurse during ongoing assessment during treatment with Ortho-Novum 7/7/7? Select all that apply.
- A. Nausea
- B. Early breakthrough bleeding
- C. Cervical mucorrhea
- D. Edema
- E. Increased spotting
Correct Answer: A,C,D
Rationale: Signs of excess estrogen include nausea, bloating, cervical mucorrhea, polyposis, hypertension, migraine headache, breast fullness or tenderness, and edema.
A client has a levonorgestrel implant contraceptive system inserted. The nurse understands that this type of contraceptive provides protection for how long?
- A. 1 year
- B. 2 years
- C. 5 years
- D. 8 years
Correct Answer: C
Rationale: Levonorgestrel, a progestin, is available as an implant contraceptive system (Norplant System). Six capsules, each containing levonorgestrel, are implanted using local anesthesia in the subdermal (below the skin) tissues of the midportion of the upper arm. The capsules provide contraceptive protection for 5 years but may be removed at any time at the request of the patient.
A nurse should advise a client beginning therapy with testosterone (Androderm) about which of the following adverse effects? Select all that apply.
- A. Impotence
- B. Fluid retention
- C. Male-pattern baldness
- D. Somnolence
- E. Mania
Correct Answer: A,B,C
Rationale: A nurse should advise a client beginning therapy with testosterone (Androderm) of the following adverse effects: gynecomastia, testicular atrophy, inhibition of testicular function, impotence, enlargement of the penis, nausea, vomiting, jaundice, headache, anxiety, male-pattern baldness, acne, depression, and fluid and electrolyte imbalances (which include sodium, water, chloride, potassium, calcium, and phosphate retention).