A woman who has recently begun taking a combination oral contraceptive calls the clinic to report breakthrough bleeding. The nurse will
a. advise her to use a backup method of contraception.
b. counsel her to continue taking the contraceptive as prescribed.
c. recommend discussing an alternative contraceptive with her provider.
d. suggest that she perform a home pregnancy test to rule out pregnancy.
ANS: B
Breakthrough bleeding is more common at the start of COC use, and there is no evidence that an episode of bleeding is associated with a decrease in the COC's effectiveness as long as the patient continues to take the pill as prescribed. She does not need to use backup contraception. Unless the bleeding continues and is problematic, there is no need to change products. A pregnancy test is not indicated.
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