Answer to Question 1
3
Rationale 1: Hot flashes are expected, and not a complication.
Rationale 2: Dyspareunia is a common symptom of endometriosis, and therefore is not a complication.
Rationale 3: Combination oral contraceptive pills contain estrogen. A painful swollen lower extremity can be a sign of deep vein thrombosis, which can cause thromboembolus, which is potentially life-threatening. This is a complication, and must be addressed immediately.
Rationale 4: A lowered voice is one side effect of danazol. This patient is not experiencing a complication.
Answer to Question 2
4
Rationale 1: The Newborns' and Mothers' Health Protection Act, which took effect in January 1998, requires insurance to pay for a 48-hour stay after an uncomplicated birth and a 96-hour stay after cesarean birth. Early discharge became more popular in the 1980s as an alternative to having a home birth.
Rationale 2: The shorter-length-of-stay trend became an insurance company policy to decrease healthcare costs.
Rationale 3: Early discharge became more popular in the 1980s as an alternative to home delivery.
Rationale 4: Even with the current length-of-stay laws, many newborns still do not receive the recommended follow-up care when they go home early.