A woman will be taking oral contraceptives using a 28-day pack. What advice should the nurse provide to protect this client from an unintended pregnancy?

Correct Answer: C

Rationale: Taking one pill at the same time each day ensures consistent hormone levels, enhancing contraceptive effectiveness. Missing pills or inconsistent timing can reduce efficacy. Antibiotics do not strongly affect oral contraceptives, and throwing away the pack is unnecessary unless multiple pills are missed.

Correct Answer: D

Rationale: In pharmacology, it is crucial for nurses to understand the non-contraceptive medical effects of combination oral contraceptives (COCs) to provide safe and effective care to their patients. Option D, "Effectiveness of COCs can be altered by some over-the-counter medications and herbal supplements," is the correct answer. This is important because certain medications and supplements, such as antibiotics, antifungals, St. John's Wort, can reduce the efficacy of COCs, leading to potential contraceptive failure. Option A, "COCs can cause TSS if the prescription is wrong," is incorrect as Toxic Shock Syndrome (TSS) is associated with tampon use and bacterial toxin release, not with COCs. Option B, "Hormonal withdrawal bleeding is usually a little more profuse than in normal menstruation and lasts a week for those who use COCs," is incorrect as withdrawal bleeding with COCs is typically lighter and shorter in duration compared to a normal menstrual period. Option C, "COCs increase the risk of endometrial and ovarian cancers," is incorrect. In fact, COCs have been shown to decrease the risk of ovarian and endometrial cancers over time. Understanding these nuances is essential for nurses to educate patients on the proper use of COCs and to recognize potential interactions that may affect their efficacy.

Correct Answer: C

Rationale: In the context of a patient who has experienced a stillbirth, the most appropriate testing to offer is placental pathology (Option C). Placental pathology examination can provide crucial insights into the cause of the stillbirth, such as identifying abnormalities in the placenta that could have contributed to the tragic event. By analyzing the placenta, healthcare providers can gather valuable information that may help in understanding the underlying reasons for the stillbirth and guide future management or counseling. Option A, NIPTs (Non-Invasive Prenatal Testing), is not typically indicated in the evaluation of stillbirth. NIPTs are primarily used for prenatal screening in pregnancies that are ongoing to assess the risk of chromosomal abnormalities such as Down syndrome. Option B, ultrasound, may have been helpful during the pregnancy to monitor fetal development and well-being but is less likely to provide detailed information post-stillbirth compared to placental pathology. Option D, blood crossmatch, is not directly relevant to investigating the cause of a stillbirth. Blood crossmatching is a test done to determine compatibility between blood donor and recipient before a transfusion, and it does not play a role in evaluating a stillbirth. Understanding the importance of appropriate testing in different clinical scenarios is essential for healthcare providers, especially in sensitive situations like stillbirth, where thorough investigation is crucial for both emotional closure and future pregnancy planning. Placental pathology stands out in this scenario due to its direct relevance in providing insights into the cause of the adverse outcome.

Correct Answer: A

Rationale: In the context of providing education on care after a second-trimester loss, providing a list of local perinatal support groups is an example of effective discharge education because it addresses the emotional and psychological needs of the patient and her family during this difficult time. Connecting patients with support groups can offer them a sense of community, understanding, and resources to cope with their grief and navigate the complexities of their situation. Option B, consent for manual removal of placenta, is incorrect as it is more related to a medical procedure rather than discharge education. While important, this topic would typically be covered by the healthcare provider prior to the procedure itself. Option C, signs and symptoms of chorioamnionitis, is also incorrect as it pertains to a different medical condition that may not be directly relevant to the patient's immediate needs post second-trimester loss. Option D, how to donate breast milk, is not directly relevant to the educational needs of a patient experiencing a second-trimester loss. While breastfeeding and milk donation are important topics, they are not the priority in this specific scenario. In an educational context, it is crucial to provide information and support that is tailored to the patient's current situation and needs. Addressing emotional well-being and providing resources for support can significantly impact the patient's overall recovery and coping process after a second-trimester loss.

Correct Answer: B

Rationale: In an incident involving potential patient harm (IPFD), nurses may experience various emotional and physical responses. Option B, stating that some nurses may complain of physical tension, headache, and insomnia during the debriefing, is correct. This response is aligned with typical stress reactions following a critical incident, known as Critical Incident Stress Debriefing (CISD). Option A is incorrect because discussing fault is not the primary aim of a debriefing after an IPFD. The focus is on emotional support, reflection, and learning, not assigning blame. Option C is incorrect as the nurse caring for the patient should not have to defend herself to the healthcare provider during a debriefing session. Option D is also incorrect as while discussing documentation may be important, the primary goal of a debriefing is not solely to prevent a lawsuit but to support staff well-being and promote learning. Educationally, it is crucial for nurse managers and healthcare professionals to understand the principles of debriefing after critical incidents to support staff resilience, emotional well-being, and professional growth. By recognizing and addressing the emotional and physical responses of staff post-incident, nurse managers can foster a supportive and learning-oriented environment within their teams.