A nurse is caring for a client who inquires about a cervical cap for contraception. The nurse should identify that which of the following manifestations is a contraindication for the use of a cervical cap?
History of methicillin-resistant Staphylococcus aureus.
History of thrombophlebitis.
History of toxic shock syndrome.
Type 1 diabetes mellitus.
The Correct Answer is C
Choice A rationale
History of methicillin-resistant Staphylococcus aureus (MRSA) is not directly related to the use of a cervical cap. The main concern with a cervical cap is infection, but MRSA history alone doesn't make it a contraindication for this form of contraception.
Choice B rationale
History of thrombophlebitis is more of a concern with hormonal contraceptives due to the risk of blood clots. A cervical cap does not involve hormones, so this condition is not a direct contraindication.
Choice C rationale
History of toxic shock syndrome (TSS) is a contraindication for the use of a cervical cap because the cap can increase the risk of developing TSS again. TSS is associated with prolonged use of barrier contraceptives, which can create an environment that fosters the growth of bacteria responsible for TSS.
Choice D rationale
Type 1 diabetes mellitus is not a direct contraindication for the use of a cervical cap. The concern with diabetes is often related to blood glucose control and potential infections, but it doesn't specifically contraindicate the use of cervical caps.
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Correct Answer is D
Explanation
Choice A rationale
This statement is incorrect because a Papanicolaou test, or Pap smear, is not used for the removal of uterine fibroids. Fibroid removal typically involves surgical procedures like myomectomy.
Choice B rationale
This statement is incorrect because a Pap smear is not used to determine ovulation status. Ovulation can be monitored through methods like basal body temperature tracking or hormone assays.
Choice C rationale
This statement is incorrect because a Pap smear does not detect endometriosis. Endometriosis is usually diagnosed through laparoscopy or imaging studies like ultrasound or MRI.
Choice D rationale
This statement is correct because a Papanicolaou test is specifically designed to detect the presence of cervical cancer and precancerous changes in the cervical cells.
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.