On prescription of oral pills to the user, the health worker will ask about all of the following except one

UPPSC 2017

Medium

Appeared in: UPPSC 2017

Explanation

The number of live children is a demographic or social factor, not a medical contraindication for prescribing oral contraceptive pills.
While important for family planning counseling and choosing a long-term method, it does not determine the medical safety of OCPs for the patient.
The health worker's screening questions focus on identifying personal or family medical history that could increase the risk of adverse effects from the hormones in the pills.

Option B: Calf tenderness is a critical symptom to ask about as it can indicate Deep Vein Thrombosis (DVT), a serious and potentially fatal side effect of OCPs.
Option C: Asking about severe or focal headaches is essential because they can be a symptom of an impending stroke or other cerebrovascular events, the risk of which is increased by OCPs.
Option D: Swelling of the feet (edema) can be a sign of underlying cardiovascular problems like heart failure or severe hypertension, which are absolute contraindications to OCP use.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Screening for contraindications of oral contraceptive pills (OCPs) as background academic context rather than a clinical decision trigger.
A nurse's role in prescribing or dispensing OCPs includes a thorough patient assessment and education. Failing to screen for contraindications can lead to life-threatening events like pulmonary embolism or stroke.
Patient education is crucial. The nurse should teach the patient the warning signs of complications (ACHES: Abdominal pain, Chest pain, Headaches, Eye problems, Severe leg pain) and instruct them to seek immediate medical attention if they occur.
What if? If a 36-year-old patient who smokes 15 cigarettes a day requests OCPs, the nurse must explain that combined pills are contraindicated due to the high risk of cardiovascular events and discuss safer, progestin-only or non-hormonal alternatives.

How to Approach the Question

First, understand the question's negative framing ('except one'). This means you are looking for the outlier among the options.
Analyze the options to find a common theme. Options B, C, and D (calf tenderness, headache, swelling of feet) are all potential symptoms of medical conditions.
Consider the context: prescribing oral contraceptive pills. These symptoms are known warning signs for serious side effects of OCPs, such as blood clots and cardiovascular issues.
Evaluate the remaining option, 'Number of live children'. This is a demographic or social factor, not a medical symptom or contraindication.
Conclude that the number of live children is the item a health worker would not need to ask about for the specific purpose of medical safety screening, making it the correct answer.

Concept Tested & Keywords

Concept Tested: Screening for contraindications of oral contraceptive pills (OCPs)
Stem keywords: oral pills, prescription, health worker, ask about
Lead-in keywords: except one
Negative lead-in flag: The question uses the word 'except', which means you must identify the option that is NOT a standard screening question for medical contraindications to oral contraceptives.

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