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A nurse in an obstetric clinic is caring for four clients.The nurse should identify that an intrauterine device is contraindicated for which of the following clients?

A.

A client who has a positive pregnancy test.

B.

A client who has a history of gallbladder disease.

C.

A client who smokes one pack of cigarettes per day.

D.

A client who is nulliparous.

Answer and Explanation

The Correct Answer is A

Choice A rationale

 

An intrauterine device (IUD) is contraindicated for a client who has a positive pregnancy test. Inserting an IUD during pregnancy can lead to complications such as infection, miscarriage, and preterm birth. It is crucial to confirm the absence of pregnancy before IUD insertion.

 

Choice B rationale

 

A history of gallbladder disease does not contraindicate the use of an IUD. IUDs are primarily contraindicated in cases of active pelvic infection, certain uterine abnormalities, and confirmed pregnancy, but not gallbladder disease.

 

Choice C rationale

 

While smoking is a significant risk factor for many health issues, including cardiovascular disease, it is not a direct contraindication for the use of an IUD. However, smokers should be counseled about the risks of smoking and offered support to quit.

 

Choice D rationale

 

Being nulliparous (having never given birth) is not a contraindication for IUD use. IUDs can be safely used by nulliparous women, though some might have a slightly higher risk of expulsion or insertion-related discomfort compared to women who have given birth.


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Correct Answer is C

Explanation

Choice A rationale

Assessing the client’s socioeconomic status is important for understanding their overall health and access to resources, but it is not directly related to providing information about contraception.

Choice B rationale

Selecting the best method of contraception for the client is not the nurse’s role. The decision should be made by the client based on their individual preferences and health considerations.

Choice C rationale

Performing unbiased teaching is essential for providing accurate and comprehensive information about available methods of contraception. The nurse should present all options without imposing personal beliefs or preferences.

Choice D rationale

Providing information on all available methods is important, but it should be done in an unbiased manner. The nurse should ensure that the client has all the necessary information to make an informed decision.

Correct Answer is D

Explanation

Choice A rationale

Placing a newborn in the right lateral position is not recommended as it increases the risk of suffocation and sudden infant death syndrome (SIDS)4.

Choice B rationale

Placing a newborn in the left lateral position is also not recommended for the same reasons as the right lateral position.

Choice C rationale

Placing a newborn in the prone position (on their stomach) significantly increases the risk of SIDS and is not recommended.

Choice D rationale

Placing a newborn in the supine position (on their back) is the safest position for sleep and is recommended to reduce the risk of SIDS4.

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