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A nurse in a provider's office is reviewing the medical record of a client who is requesting a diaphragm. Which of the following findings in the client's history should the nurse identify as a contraindication for this type of contraception?

A.

Deep-vein thrombosis.

B.

Tobacco use.

C.

Recurrent urinary tract infections.

D.

History of positive group B streptococcus B-hemolytic.

Answer and Explanation

The Correct Answer is A

Choice A rationale

 

Deep-vein thrombosis (DVT) is a contraindication for diaphragm use due to the increased risk of thromboembolic events with estrogen-based contraceptives.

 

Choice B rationale

 

Tobacco use, although a risk factor for cardiovascular disease, is not a direct contraindication for diaphragm use, which is a non-hormonal contraceptive method.

 

Choice C rationale

 

Recurrent urinary tract infections are a contraindication for diaphragm use due to the risk of infection exacerbation from device insertion.

 

Choice D rationale

 

History of positive group B streptococcus B-hemolytic is not a contraindication for diaphragm use; it typically relates to pregnancy and neonatal infection risk.


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View Related questions

Correct Answer is D

Explanation

Choice A rationale

Mongolian spots are common, benign skin markings that some newborns have, but they are not related to rubella exposure during pregnancy.

Choice B rationale

Jaundice is a common condition in newborns, characterized by a yellowing of the skin and eyes, usually due to an immature liver. It's not specifically linked to maternal rubella exposure.

Choice C rationale

Transient strabismus, or temporary misalignment of the eyes, can occur in newborns but is unrelated to rubella. It usually resolves on its own as the newborn's muscles develop.

Choice D rationale

Deafness is a significant risk associated with congenital rubella syndrome. Rubella can damage the developing auditory system in utero, leading to permanent hearing loss in the newborn.

Correct Answer is B

Explanation

Choice A rationale

"Monitor perineal pads for clots.”. This is incorrect because while monitoring for clots is important, it does not address the underlying issue causing the fundal deviation.

Choice B rationale

"Assist the client to empty her bladder.”. This is correct because a full bladder can cause the uterus to deviate and impede uterine involution. Emptying the bladder helps the uterus to contract properly and return to its normal position.

Choice C rationale

"Notify the provider.”. This is incorrect because the immediate action should be to address the potential cause of the deviation (a full bladder), which can be managed by the nurse.

Choice D rationale

"Administer a prescribed analgesic.”. This is incorrect because administering pain relief does not address the cause of the fundal deviation and does not alleviate the potential issue.

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