A nurse is caring for a client who is currently 34-weeks gestation. Which of the following medications would be avoided due to its category X classification?
morphine
famotidine (Pepcid)
misoprostol (Cytotec)
ibuprofen (Advil)
The Correct Answer is C
A. Morphine is a category C medication, which means it may be used if the benefits outweigh the risks; it is not contraindicated in pregnancy.
B. Famotidine (Pepcid) is also a category B medication and is generally considered safe to use during pregnancy.
C. Misoprostol (Cytotec) is classified as category X due to its association with causing uterine contractions and the potential for fetal harm; thus, it should be avoided during pregnancy.
D. Ibuprofen (Advil) is a category C medication, and while it is not typically recommended in the third trimester, it is not classified as category X.
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Correct Answer is A
Explanation
A. Following the insertion of the Nexplanon rod, it is important to inform the client that backup contraception methods are needed for the first 24 hours to ensure pregnancy prevention while the implant becomes effective.
B. While smoking cessation is advised due to the increased risk of thrombotic events with hormonal contraceptives, it is not the priority instruction immediately following the insertion of Nexplanon.
C. The statement regarding weight loss is incorrect; Nexplanon is more commonly associated with weight gain rather than loss, so advising clients on calorie consumption is misleading.
D. Although Nexplanon has a high efficacy rate in preventing pregnancy, stating a prevention rate of 100% is inaccurate and misleading, as no contraceptive method is completely foolproof.
Correct Answer is D
Explanation
A. Hydralazine is a vasodilator that does not directly replace ACE inhibitors and is not the preferred alternative for managing hypertension or heart failure.
B. Metoprolol is a beta-blocker that is used for different indications and is not a direct substitute for ACE inhibitors.
C. Furosemide is a loop diuretic used for fluid management, not as an alternative to ACE inhibitors.
D. Losartan is an angiotensin II receptor blocker (ARB) and serves as a suitable alternative to ACE inhibitors for patients who experience a cough from them, as ARBs do not typically cause this side effect.