# The nurse teaches a client of reproductive potential who takes mycophenolate mofetil and uses an oral contraceptive. Which statement indicates correct understanding?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391874&lang=en  
> language: en  
> subject: Medication Administration  
> category: PPT

## Question

The nurse teaches a client of reproductive potential who takes mycophenolate mofetil and uses an oral contraceptive. Which statement indicates correct understanding?

## Option

1. I can stop contraception when the transplant is stable because fetal risk then ends.
2. If pregnancy occurs, I will stop mycophenolate immediately without contacting my prescriber.
3. I will add an acceptable backup method during therapy and continue contraception for 6 weeks afterward. **✔ Correct answer**
4. I need pregnancy testing at treatment completion but not before starting mycophenolate.

**Correct answer: 3**

## Explanation

Mycophenolate exposure during pregnancy increases the risk of first-trimester pregnancy loss and congenital malformations. A client using oral contraceptive pills should add another acceptable contraceptive method because mycophenolate can reduce hormone levels. Acceptable contraception is required during therapy and for 6 weeks after stopping. Pregnancy testing occurs before treatment and during follow-up. If pregnancy occurs, the client should contact the prescriber immediately rather than stopping transplant immunosuppression independently.

## In-depth explanation

Clinical reasoning
Mycophenolate has major embryo-fetal toxicity, while abrupt unsupervised immunosuppressant withdrawal can endanger the transplanted organ. Prevention and rapid prescriber coordination are both essential.

Decision rule
Complete pregnancy testing and contraceptive counseling before treatment, use an acceptable method throughout therapy and for 6 weeks afterward, and add a backup method when relying on oral contraceptive pills.

## Clinical scenario

Scenario 28-year-old female starting mycophenolate post-kidney transplant. Sexually active, not currently pregnant.

## Key concepts

- **Mycophenolate embryo-fetal toxicity** — A risk of pregnancy loss and congenital malformations associated with mycophenolate exposure during pregnancy.
- **Acceptable contraception** — A REMS-consistent method or combination selected for the client and continued through the required post-treatment interval.
- **GI dose-limiting effect** — Diarrhea is the most common reason for dose reduction or switch.

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