Nokea
A woman visits a health center requesting oral contraceptives. Which laboratory test is most important for the nurse to assess before the patient begins oral contraceptive therapy?
- A. Complete blood count
- B. Serum potassium level
- C. Vaginal cultures
- D. Pregnancy test
Correct Answer: D
Rationale: A pregnancy test is critical before starting oral contraceptives, as they are category X and can harm a fetus. Other tests are not routinely required for initiation.
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The nurse is providing patient education for a patient taking an oral contraceptive. Which drugs may cause interactions with oral contraceptives? (Select all that apply.)
- A. Cephalexin
- B. Guaifenesin
- C. Warfarin
- D. Ibuprofen
- E. Theophylline
Correct Answer: A,C,E
Rationale: Cephalexin, warfarin, and theophylline can interact with oral contraceptives, reducing their efficacy or altering drug levels. Antibiotics like cephalosporins may decrease contraceptive effectiveness, and contraceptives can affect warfarin and theophylline metabolism.
A 51-year-old woman will be taking selective estrogen receptor modulators (SERMs) as part of treatment for postmenopausal osteoporosis. The nurse reviews potential contraindications, including which condition?
- A. Hypocalcemia
- B. Breast cancer
- C. Stress fractures
- D. Venous thromboembolism
Correct Answer: D
Rationale: SERMs like raloxifene are contraindicated in patients with venous thromboembolism (e.g., DVT, PE) due to increased clotting risk. Hypocalcemia, breast cancer, and stress fractures are not contraindications.
The nurse is preparing to administer the contraceptive form of medroxyprogesterone. What route is appropriate?
- A. Subcutaneous
- B. Intramuscular
- C. Vaginal
- D. Transdermal
Correct Answer: B
Rationale: Medroxyprogesterone (Depo-Provera) as a contraceptive is administered intramuscularly for sustained release. Other routes are not appropriate for this formulation.
The nurse is reviewing the use of uterine tocolytics, such as indomethacin (Indocin). Which statement best describes the indication for these drugs?
- A. Prevention of preterm labor in the 15th week of pregnancy
- B. Prevention of preterm labor in the 22nd week of pregnancy
- C. Stimulation of contractions in prolonged labor
- D. Stimulation of ovulation as part of infertility treatments
Correct Answer: B
Rationale: Tocolytics like indomethacin are used to prevent preterm labor between 20 and 37 weeks, such as at 22 weeks, by relaxing uterine smooth muscle. They do not stimulate contractions or ovulation.
The nurse is administering oxytocin. Which situation is an indication for the use of oxytocin?
- A. Decreased fetal heart rate and movements
- B. Stimulation of contractions during labor
- C. Cervical ripening near term in pregnant patients
- D. To reverse premature onset of labor
Correct Answer: B
Rationale: Oxytocin is used to stimulate uterine contractions during labor to induce or augment labor. It is also used for cervical ripening, but not to reverse preterm labor or address fetal distress.