Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
28. A woman has chosen a patch applied to her skin as her method to deliver contraceptive medication. A nurse should instruct the client to call the clinic immediately if the client experiences:
Select all that apply.
. Mild to moderate nausea during the day following the application of the patch.
. Chloasma.
. Pain in the legs while walking.
. Headache unrelieved by acetaminophen.
. Swelling of the feet and hands.
Test-Taking Tip
The question asks for immediate notification; think life-threatening complications. Three options ( Answers 1, 2, and 5) are annoying, but not life threatening, results of increased hormones. Two options (Answers 3 and 4) are potentially life threatening; choose these options.
Content Area: Adult Health, Genitourinary; Integrated Process: Nursing Process, Implementation; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Adverse Effects/Contraindications/Interactions
Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
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Answer 1 is incorrect because nausea may occur as the body adjusts to the increasing hormone levels released by the patch. Answer 2 is incorrect because chloasma is hyperpigmentation caused by the increased hormone levels. Answer 3 is correct because pain in the legs while walking can be a sign of thrombophlebitis, a life-threatening complication of hypercoagulability caused by the increased hormone levels. Answer 4 is correct because a headache unrelieved by analgesics can be a symptom of a blood clot in the brain, another life-threatening complication of hypercoagulability caused by the increased hormone levels. Answer 5 is incorrect because swelling of the feet and hands is caused by fluid retention, under the influence of increased hormone levels. Do not confuse this swelling with symptoms of preeclampsia, which also involves swelling of the extremities, but requires immediate intervention.