Correct Answer: A

Rationale: Taking combined oral contraceptives at the same time each day helps maintain consistent hormone levels and maximizes effectiveness in preventing pregnancy.
Choice B is wrong because a backup method of contraception is recommended for the first 7 days only if the pills are started after the first day of the menstrual cycle; if started on the first day, no backup is needed.
Choice C is wrong because headaches are a common side effect, but stopping the pills abruptly is not advised; the client should consult the provider if headaches are severe or persistent.
Choice D is wrong because taking an extra pill after missing a dose can increase the risk of side effects; the correct action depends on the timing and number of missed pills, typically involving taking the missed pill as soon as remembered and using a backup method.

Correct Answer: B

Rationale: Checking the client's blood glucose level is the first action to take, as shakiness and sweating suggest hypoglycemia (blood glucose typically <70 mg/dL) in a client with type 1 diabetes, and the glucose level will guide treatment (e.g., administering 15 g of fast-acting carbohydrates).
Choice A is wrong because administering insulin would worsen hypoglycemia; insulin is used to lower blood glucose, not treat low levels.
Choice C is wrong because a high-protein snack is not appropriate for treating hypoglycemia; fast-acting carbohydrates (e.g., juice, glucose tabs) are needed first to rapidly raise blood glucose.
Choice D is wrong because encouraging rest does not address the urgent need to correct hypoglycemia, which can progress to confusion, seizures, or unconsciousness if untreated.

Correct Answer: C

Rationale: Reporting constipation is important with amitriptyline due to anticholinergic effects. Sleepiness is expected, it's taken at night, and mood improvement takes weeks.

Correct Answer: D

Rationale: Monitoring for signs of serotonin syndrome (e.g., agitation, tremors, hyperthermia) is critical with fluoxetine, an SSRI, as it increases serotonin levels, and overdose or drug interactions can cause this life-threatening condition.
Choice A is incorrect because fluoxetine is typically taken in the morning, but this is not the priority instruction compared to safety monitoring.
Choice B is incorrect because fluoxetine takes 4-6 weeks to reduce OCD symptoms, not immediate relief.
Choice C is incorrect because fluoxetine should not be discontinued abruptly, even if compulsions stop, to avoid withdrawal or relapse; it requires provider guidance.

Correct Answer: C

Rationale:
Choice A is wrong because it is not a common complication of amniocentesis. Epigastric pain is more likely to be associated with preeclampsia, a condition that causes high blood pressure and proteinuria in pregnancy. Epigastric pain can indicate severe preeclampsia or HELLP syndrome (hemolysis, elevated liver enzymes, low platelets), which are life-threatening complications that require immediate medical attention.
Choice B is wrong because it is not a direct result of amniocentesis. Hypertension can occur in pregnancy due to various factors, such as chronic hypertension, gestational hypertension, preeclampsia, or eclampsia. Hypertension can increase the risk of complications such as placental abruption, fetal growth restriction, preterm birth, and maternal stroke. According to the flashcards from Quizlet, a nurse should monitor a client who is at 33 weeks of gestation following an amniocentesis for contractions, as they are a sign of preterm labor and possible uterine rupture. An amniocentesis is a procedure that involves inserting a needle into the amniotic sac to obtain a sample of amniotic fluid for testing. It can cause complications such as bleeding, infection, leakage of fluid, and injury to the fetus or placenta.
Choice D is wrong because it is not a typical complication of amniocentesis. Vomiting can occur in pregnancy due to various causes, such as morning sickness, gastroenteritis, food poisoning, or hyperemesis gravidarum. Vomiting can lead to dehydration, electrolyte imbalance, weight loss, and malnutrition if not treated properly.