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 D
Explanation
(a) "You will not be able to eat or drink anything for 8 hours prior to the test."
There are no fasting requirements for a nonstress test. The client can eat and drink normally before the test. Nonstress tests do not require the same preparation as some other medical tests, such as fasting or dietary restrictions.
(b) "You will be required to lie flat on your back for the duration of the test."
Lying flat on the back can cause supine hypotension syndrome in pregnant women, which can lead to decreased blood flow to the fetus. Instead, clients are typically positioned in a semi-Fowler's or lateral position to avoid this issue.
(c) "You will receive medication through an IV line to stimulate contractions."
This describes a contraction stress test, not a nonstress test. A nonstress test involves monitoring the fetal heart rate in response to natural fetal movements without inducing contractions through medication.
(d) "You will press the provided button when you feel the baby moving during the test."
During a nonstress test, the client is instructed to press a button whenever they feel fetal movement. This helps the healthcare provider correlate fetal movements with changes in the fetal heart rate, which can indicate fetal well-being.
Correct Answer is B
Explanation
(a) "Wear an underwire bra between feedings."
Wearing an underwire bra between feedings can compress breast tissue and impede milk flow, increasing the risk of mastitis. This recommendation is incorrect and could contribute to the development of mastitis rather than preventing it.
(b) "You should use a breast pump if you plan to return to work."
Regularly expressing breast milk with a breast pump, especially if planning to return to work, helps maintain milk supply and prevents engorgement, which can lead to mastitis. This recommendation encourages appropriate breastfeeding practices to prevent mastitis.
(c) "Wash your nipples with soap and water daily."
While maintaining good breast hygiene is important, excessive washing with soap and water can strip the nipples of natural oils and increase the risk of dryness and cracking, which may predispose to mastitis. This recommendation is not the most effective strategy for preventing mastitis.
(d) "Cover your breasts immediately after feedings."
Covering the breasts immediately after feedings may trap moisture and promote bacterial growth, increasing the risk of mastitis. It is important to allow the breasts to air dry after feedings to prevent moisture buildup and promote healing of any cracked nipples. This recommendation is not appropriate for preventing mastitis.
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