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 client who has a positive pregnancy test.
A client who has a history of gallbladder disease.
A client who smokes one pack of cigarettes per day.
A client who is nulliparous.
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 B
Explanation
Choice A rationale
Not wanting to call the baby by name until the baby is born can be a cultural or personal preference and does not necessarily indicate effective adaptation to the new role. It may reflect a cautious approach to the pregnancy but does not provide evidence of active preparation or involvement.
Choice B rationale
Starting to paint the baby’s room is a proactive behavior that indicates the partner is preparing for the baby’s arrival. It shows that the partner is taking steps to create a welcoming environment for the baby, which is a positive sign of adaptation to the new role.
Choice C rationale
Looking forward to sharing hobbies with the child in the future is a positive indication of the partner’s excitement and anticipation for the baby’s growth and development. However, it does not directly reflect immediate preparation or involvement in the pregnancy.
Choice D rationale
Waiting until the baby is born to share the news with coworkers may reflect a cautious approach to the pregnancy but does not indicate active involvement or preparation for the baby’s arrival. It may be a personal preference but does not demonstrate effective adaptation to the new role.
Correct Answer is D
Explanation
Choice A rationale
Diuresis, or increased urine production, is not a common adverse effect of nalbuphine hydrochloride. This medication is an opioid analgesic used for pain relief during labor.
Choice B rationale
Fever is not a typical adverse effect of nalbuphine hydrochloride. Fever may indicate an infection or other underlying condition that needs to be addressed separately.
Choice C rationale
Diarrhea is not a common adverse effect of nalbuphine hydrochloride. Opioids, including nalbuphine, are more likely to cause constipation rather than diarrhea.
Choice D rationale
Sedation is a known adverse effect of nalbuphine hydrochloride. As an opioid analgesic, it can cause drowsiness and sedation, which is important to monitor in laboring clients to ensure their safety and well-being.