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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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View Related questions

Correct Answer is A

Explanation

Choice A rationale

Oral contraceptives decrease the risk for endometrial cancer by regulating the menstrual cycle and reducing the frequency of ovulation, which lowers the exposure of the endometrium to estrogen.

Choice B rationale

Combined estrogen-progestin contraceptive pills typically shorten and lighten menstrual periods, rather than causing longer periods.

Choice C rationale

Medroxyprogesterone acetate injections are administered every three months, not once per month.

Choice D rationale

Diaphragms need to be replaced every 1-2 years, not every 4 years, to ensure proper fit and effectiveness.

Correct Answer is D

Explanation

Choice A rationale

Applying a corticosteroid cream is not appropriate for acute perineal pain. It is more suitable for chronic inflammation or skin conditions.

Choice B rationale

Increasing fluid intake is beneficial for overall health, but it does not directly address acute perineal pain.

Choice C rationale

Catheterizing the bladder is not indicated for perineal pain unless there is a specific issue with urinary retention.

Choice D rationale

Offering an ice pack helps reduce swelling and numb the area, providing immediate relief for acute perineal pain. It is a standard intervention for postpartum perineal discomfort.

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