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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 D

Explanation

Choice A rationale

Amniotic fluid with meconium noted can indicate fetal distress, but it is not the most immediate priority compared to fetal heart tones.

Choice B rationale

A maternal temperature of 38.3°C (101°F) can indicate infection, but it is not the most immediate priority compared to fetal heart tones.

Choice C rationale

Foul-smelling vaginal discharge can indicate infection, but it is not the most immediate priority compared to fetal heart tones.

Choice D rationale

Fetal heart tones of 98/min indicate fetal bradycardia, which is a sign of fetal distress and requires immediate intervention to ensure the well-being of the fetus.

Correct Answer is C

Explanation

Choice A rationale

Agitation is not a common adverse effect of magnesium sulfate therapy. It is more likely to be caused by other factors.

Choice B rationale

Polyuria, or excessive urination, is not a common adverse effect of magnesium sulfate therapy. It is more likely to be caused by other factors.

Choice C rationale

Hyporeflexia, or diminished reflexes, is a significant adverse effect of magnesium sulfate therapy. It indicates magnesium toxicity and requires immediate attention.

Choice D rationale

Tachypnea, or rapid breathing, is not a common adverse effect of magnesium sulfate therapy. It is more likely to be caused by other factors.

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