The nurse is preparing to discharge a client newly prescribed a progestin-only pill (POP) for contraceptive prevention. Which contraindication associated with POP would the nurse alert the healthcare provider?
The client has a BMI of >30
The client is currently taking Ginger
The client has a history of hypertension
The client has no intention of conceiving within the year
The Correct Answer is C
A. A BMI greater than 30 is a consideration, but it is not an absolute contraindication for the use of POPs.
B. Ginger does not interact adversely with progestin-only pills and is not a contraindication.
C. A history of hypertension can increase the risk of cardiovascular events, and while POPs are generally safer than combined hormonal contraceptives for women with hypertension, it should still be monitored and reported to the healthcare provider.
D. Having no intention of conceiving is not a contraindication; in fact, it is a common reason for using contraceptive methods like POPs.
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Correct Answer is D
Explanation
A. Hypertension is not a direct adverse effect of febuxostat; monitoring blood pressure is important but not the primary concern with this medication.
B. Malignant hyperthermia is a rare condition typically associated with certain anesthetic agents and is not related to febuxostat.
C. Steven's Johnson Syndrome is a serious skin reaction that can occur with some medications, but it is not specifically associated with febuxostat.
D. Renal impairment is a known risk with febuxostat, and the nurse should monitor renal function closely, as gout can also be exacerbated by kidney issues and febuxostat is primarily excreted by the kidneys.
Correct Answer is B
Explanation
A. A high first-pass effect means that a significant amount of the drug is metabolized by the liver before reaching systemic circulation, making oral administration less effective.
B. Morphine with a high first-pass effect will be more effective when administered via non-enteral routes, such as IV or subcutaneous, to bypass the liver's initial metabolism.
C. The first-pass effect does not influence the kidney’s rate of excretion but rather the liver’s initial metabolism of the drug.
D. The liver, not the kidneys, is responsible for the first-pass metabolism, which occurs before the drug reaches systemic circulation when taken orally.