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 smokes one pack of cigarettes per day

A client who has a history of gallbladder disease

A client who has a positive pregnancy test

A client who is nulliparous

Answer and Explanation

The Correct Answer is C

(A) A client who smokes one pack of cigarettes per day:
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 intrauterine device (IUD). However, smokers should be counseled about the risks of smoking and offered support to quit.

(B) A client who has a history of gallbladder disease:
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.

(C) A client who has a positive pregnancy test:
An IUD should not be inserted in 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.

(D) A client who is nulliparous:
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 A

Explanation

(D) "I might be experiencing preterm labor if walking stops my contractions."
Walking or changing positions may temporarily alleviate contractions in some cases, but this does not necessarily indicate preterm labor. In fact, true preterm labor contractions typically continue despite activity changes. Therefore, this statement does not demonstrate an accurate understanding of preterm labor signs.

A. Apply elastic stockings before the client gets out of bed B. Have the client ambulate as often as possible. C. Apply warm, moist packs to the client's lower legs D. Administer NSAIDs every 4 to 6 hr.

Correct Answer is B

Explanation

(A) Apply elastic stockings before the client gets out of bed:
While elastic stockings can help prevent thrombophlebitis by promoting venous return and reducing the risk of blood pooling in the legs, applying them before the client gets out of bed may not be as effective as ambulation in preventing stasis and clot formation.

(B) Have the client ambulate as often as possible:
Ambulation helps prevent thrombophlebitis (inflammation of a vein with clot formation) by promoting blood circulation in the lower extremities. Moving the legs and walking encourage the calf muscles to contract, which aids in pushing blood back towards the heart, reducing the risk of blood stasis and clot formation.

(C) Apply warm, moist packs to the client's lower legs:
Applying warm, moist packs to the lower legs may provide comfort and relaxation, but it is not a primary measure for preventing thrombophlebitis. In fact, warm compresses may dilate blood vessels and potentially increase the risk of thrombosis in some cases.

(D) Administer NSAIDs every 4 to 6 hr:
Nonsteroidal anti-inflammatory drugs (NSAIDs) are not typically used for preventing thrombophlebitis. While NSAIDs can help manage pain and inflammation, they do not directly address the underlying mechanisms of thrombus formation or prevent blood stasis. Additionally, frequent administration of NSAIDs may carry risks of gastrointestinal bleeding and renal complications.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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