Family Nurse Practitioner Exam

Which of the following is not a relative contraindication for oral contraceptive pills?

1. Active hepatitis A infection

2. Thrombosis related to an IV needle

3. Undiagnosed vaginal bleeding

4. Migraine headache without focal aura

The correct answer is: Thrombosis related to an IV needle

Oral contraceptive pills (OCPs) have several relative contraindications that can affect their safety and effectiveness for certain individuals. Understanding these is essential for safe prescribing. The choice of thrombosis related to an IV needle is not typically classified as a relative contraindication for OCPs. While a history of thrombosis, particularly in the deep veins or pulmonary arteries, can raise concerns about potential complications from hormonal contraceptives, thrombosis that is directly associated with an IV needle—such as superficial thrombophlebitis—does not generally carry the same risk for women using OCPs. This distinction is important because it suggests that the circumstances surrounding the thrombosis may not pose a significant risk when considering the use of OCPs. In contrast, active hepatitis A infection, undiagnosed vaginal bleeding, and migraine headaches with focal aura present more significant concerns. Hepatitis A can lead to liver dysfunction, which can be exacerbated by the metabolic effects of estrogens in OCPs. Undiagnosed vaginal bleeding could indicate a serious underlying condition, potentially masking more serious issues like endometrial cancer or other pathologies that require investigation before starting OCPs. Migraine headaches with aura are particularly concerning because they significantly increase the risk