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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
(a) Offer an ice pack to the client during the first 24 hr.
Offering an ice pack is an appropriate intervention for managing perineal pain and swelling in the immediate postpartum period. Ice helps to reduce inflammation and numb the area, providing pain relief. This is a standard recommendation for managing perineal pain after vaginal delivery.
(b) Apply a corticosteroid cream to the perineal area twice daily.
Applying a corticosteroid cream is not typically recommended for perineal pain immediately after delivery. These creams are generally used for inflammatory skin conditions and not for the acute management of perineal pain and swelling after childbirth.
(c) Increase the client's fluid intake for 48 hr.
While maintaining adequate hydration is important for overall recovery, increasing fluid intake specifically does not address the client's perineal pain. This intervention would not provide immediate pain relief for the perineal area.
(d) Catheterize the client's bladder.
Catheterizing the bladder is not a standard intervention for perineal pain. It is typically done if the client has urinary retention or difficulty voiding, not for managing pain. This action would not directly alleviate the perineal pain the client is experiencing.
Correct Answer is B
Explanation
(a) "I will need to start chemotherapy immediately."
Chemotherapy is not typically the first line of treatment for a molar pregnancy unless there is evidence of persistent gestational trophoblastic disease (GTD) or choriocarcinoma, which requires further evaluation and monitoring before making such a decision. This statement indicates a misunderstanding of the typical course of treatment after a molar pregnancy.
(b) "I will need to attend a support group when I get home."
Attending a support group can provide emotional support and coping strategies for individuals recovering from a molar pregnancy. It reflects an understanding of the importance of psychosocial support during recovery.
(c) "I will need an amniocentesis within 1 month."
Amniocentesis is not a routine follow-up procedure for a molar pregnancy. Follow-up typically includes serial measurements of hCG levels to ensure they return to normal and remain stable, which helps in monitoring for potential malignancy. This statement indicates a misunderstanding of the follow-up care required after a molar pregnancy.
(d) "I will need home palliative services after I am discharged from the hospital."
Home palliative services are generally not needed for patients recovering from a molar pregnancy, as the condition does not usually necessitate end-of-life care. This statement indicates a misunderstanding of the recovery process and the type of care required after a molar pregnancy.
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