Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is reviewing contraception options for four clients.
The nurse should identify that which of the following clients has a contraindication for receiving oral contraceptives?
A. A 25-year-old client who has migraine headaches with aura.
This is because migraine headaches with aura are a contraindication for receiving oral contraceptives, as they increase the risk of stroke and other cardiovascular complications. Normal ranges for oral contraceptive doses are: Estrogen: 10 to 35 mcg of ethinyl estradiol or estradiol valerate Progestin: varies depending on the type and brand of oral contraceptive
B. A 32-year-old client who has endometriosis.
This is not a contraindication for receiving oral contraceptives, as they can actually help reduce the symptoms of endometriosis by suppressing ovulation and reducing menstrual bleeding.
C. A 28-year-old client who has polycystic ovary syndrome
This is not a contraindication for receiving oral contraceptives, as they can help regulate the menstrual cycle and lower the levels of androgens (male hormones) that cause acne, hirsutism (excess hair growth), and other problems in women with PCOS.
D. A 22-year-old client who has irregular menstrual cycles.
This is not a contraindication for receiving oral contraceptives, as they can help normalize the menstrual cycle and prevent unintended pregnancy.
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Full Explanation
This is because migraine headaches with aura are a contraindication for receiving oral contraceptives, as they increase the risk of stroke and other cardiovascular complications.
Some possible explanations for the other choices are:
Choice B: A 32-year-old client who has endometriosis.
This is not a contraindication for receiving oral contraceptives, as they can actually help reduce the symptoms of endometriosis by suppressing ovulation and reducing menstrual bleeding.
Choice C: A 28-year-old client who has polycystic ovary syndrome (PCOS).
This is not a contraindication for receiving oral contraceptives, as they can help regulate the menstrual cycle and lower the levels of androgens (male hormones) that cause acne, hirsutism (excess hair growth), and other problems in women with PCOS.
Choice D: A 22-year-old client who has irregular menstrual cycles.
This is not a contraindication for receiving oral contraceptives, as they can help normalize the menstrual cycle and prevent unintended pregnancy.
Normal ranges for oral contraceptive doses are:
Estrogen: 10 to 35 mcg of ethinyl estradiol or estradiol valerate
Progestin: varies depending on the type and brand of oral contraceptive
Similar Questions
A client is scheduled for a transvaginal ultrasound in two weeks.
The client asks the nurse what they should do to prepare for the test.
What is the best response by the nurse?
A. “The patient should have a full bladder for a transabdominal US and an empty bladder for a transvaginal US.”.
“The patient should have a full bladder for a transabdominal US and an empty bladder for a transvaginal US.”1 This is because a full bladder helps to lift the uterus and improve the visibility of the pelvic organs in a transabdominal US, while an empty bladder prevents distortion of the image in a transvaginal US.
B. “The patient should wear tight-fitting clothing and lie prone on an examination table.”.
Tight-fitting clothing is not necessary and lying prone on an examination table is uncomfortable and may interfere with the insertion of the vaginal probe.
C. “The patient should wear loose-fitting clothing and lie supine on an examination table.”.
Loose-fitting clothing is not necessary and lying supine on an examination table may cause supine hypotension syndrome in pregnant women.
D. “The patient should wear loose-fitting clothing and lie prone on an examination table.”.
Loose-fitting clothing is not necessary and lying prone on an examination table is uncomfortable and may interfere with the insertion of the vaginal probe.
Full Explanation
“The patient should have a full bladder for a transabdominal US and an empty bladder for a transvaginal US.”1 This is because a full bladder helps to lift the uterus and improve the visibility of the pelvic organs in a transabdominal US, while an empty bladder prevents distortion of the image in a transvaginal US.
Choice B is wrong because tight-fitting clothing is not necessary and lying prone on an examination table is uncomfortable and may interfere with the insertion of the vaginal probe.
Choice C is wrong because loose-fitting clothing is not necessary and lying supine on an examination table may cause supine hypotension syndrome in pregnant women.
Choice D is wrong because loose-fitting clothing is not necessary and lying prone on an examination table is uncomfortable and may interfere with the insertion of the vaginal probe.
A nurse is caring for a client who is scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation.
The nurse provides which of the following explanations about this test to the client?
A. It is a diagnostic test for spinal defects in the fetus.
It says that the test is a diagnostic test for spinal defects in the fetus, which is not true.
B. It is a screening test for spinal defects in the fetus.
A maternal serum alpha-fetoprotein test is a type of prenatal blood test that measures the levels of MSAFP in the blood of a pregnant person. The test helps the healthcare provider assess the baby’s risk of certain medical conditions, such as neural tube defects and chromosomal abnormalities. The test is usually done between 15 and 20 weeks of pregnancy. A screening test means that it does not diagnose any health conditions, but only indicates the probability of having them. A positive test means that the baby has a higher risk of having a birth defect, but it does not confirm it. A negative test means that the baby has a lower risk of having a birth defect, but it does not rule it out. Further tests are needed to confirm or exclude the diagnosis. A diagnostic test means that it can provide a definite diagnosis of a health condition. A maternal serum alpha-fetoprotein test is not a diagnostic test for spinal defects or chromosomal abnormalities in the fetus. Normal ranges for MSAFP vary depending on the gestational age and the laboratory methods used. Generally, MSAFP levels increase until about 32 weeks of pregnancy and then decrease until delivery. High levels of MSAFP may indicate neural tube defects, multiple pregnancies, incorrect dating of pregnancy, or other conditions. Low levels of MSAFP may indicate Down syndrome, other chromosomal abnormalities, or other conditions.
C. It is a diagnostic test for chromosomal abnormalities in the fetus.
It says that the test is a diagnostic test for chromosomal abnormalities in the fetus, which is not true.
D. It is a screening test for chromosomal abnormalities in the fetu.
It says that the test is a screening test for chromosomal abnormalities in the fetus, which is only partially true. The test can screen for some chromosomal abnormalities, such as Down syndrome, but not all of them. The test also screens for neural tube defects, which are not chromosomal abnormalities.
Full Explanation
A maternal serum alpha-fetoprotein test is a type of prenatal blood test that measures the levels of MSAFP in the blood of a pregnant person. The test helps the healthcare provider assess the baby’s risk of certain medical conditions, such as neural tube defects and chromosomal abnormalities. The test is usually done between 15 and 20 weeks of pregnancy.
A screening test means that it does not diagnose any health conditions, but only indicates the probability of having them.
A positive test means that the baby has a higher risk of having a birth defect, but it does not confirm it.
A negative test means that the baby has a lower risk of having a birth defect, but it does not rule it out. Further tests are needed to confirm or exclude the diagnosis.
A diagnostic test means that it can provide a definite diagnosis of a health condition. A maternal serum alpha-fetoprotein test is not a diagnostic test for spinal defects or chromosomal abnormalities in the fetus.
Statement A is wrong because it says that the test is a diagnostic test for spinal defects in the fetus, which is not true.
Statement C is wrong because it says that the test is a diagnostic test for chromosomal abnormalities in the fetus, which is not true.
Statement D is wrong because it says that the test is a screening test for chromosomal abnormalities in the fetus, which is only partially true. The test can screen for some chromosomal abnormalities, such as Down syndrome, but not all of them.
The test also screens for neural tube defects, which are not chromosomal abnormalities.
Normal ranges for MSAFP vary depending on the gestational age and the laboratory methods used. Generally, MSAFP levels increase until about 32 weeks of pregnancy and then decrease until delivery.
High levels of MSAFP may indicate neural tube defects, multiple pregnancies, incorrect dating of pregnancy, or other conditions. Low levels of MSAFP may indicate Down syndrome, other chromosomal abnormalities, or other conditions.
A nurse is discussing the risks associated with a Contraction Stress Test (CST) with a pregnant client.
Which complication should the nurse mention?
A. Preterm labor.
A contraction stress test (CST) is a test that simulates labor contractions to see how the baby’s heart rate responds to the stress of uterine contractions. The biggest risk of the test is that it may cause the pregnant person to go into labor before their due date.
B. Premature rupture of membranes.
This is a condition where the amniotic sac breaks before labor begins. It can increase the risk of infection and cord prolapse, but it is not a direct complication of CST.
C. Infection.
This is a possible risk of any invasive procedure, but CST is usually done with external fetal monitoring and oxytocin infusion, which do not require breaking the skin or entering the uterus.
D. Bleeding.
This is a potential risk of CST for people who have placenta previa, a condition where the placenta covers the cervix and can detach during contractions. However, CST is not recommended for people who have placenta previa or other conditions that increase the risk of uterine rupture or bleeding.
Full Explanation
A contraction stress test (CST) is a test that simulates labor contractions to see how the baby’s heart rate responds to the stress of uterine contractions.
The biggest risk of the test is that it may cause the pregnant person to go into labor before their due date.
Some possible explanations for the other choices are:
Choice B. Premature rupture of membranes.
This is a condition where the amniotic sac breaks before labor begins.
It can increase the risk of infection and cord prolapse, but it is not a direct complication of CST.
Choice C. Infection.
This is a possible risk of any invasive procedure, but CST is usually done with external fetal monitoring and oxytocin infusion, which do not require breaking the skin or entering the uterus.
Choice D. Bleeding.
This is a potential risk of CST for people who have placenta previa, a condition where the placenta covers the cervix and can detach during contractions.
However, CST is not recommended for people who have placenta previa or other conditions that increase the risk of uterine rupture or bleeding.