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 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.
Correct Answer is B
Explanation
Answer: B. Determine the newborn's respiratory rate.
Rationale:
A. Weigh the newborn's wet diaper:
While monitoring fluid output is important in assessing hydration status and overall health, it is not the immediate priority. In the context of a newborn with neonatal abstinence syndrome (NAS), the respiratory status takes precedence, especially given that withdrawal can affect respiratory function.
B. Determine the newborn's respiratory rate:
Assessing the respiratory rate is crucial, as newborns with NAS may experience respiratory distress, including increased respiratory effort or apnea. Identifying any respiratory issues early allows for prompt intervention, which is vital for the newborn's safety and well-being. Ensuring adequate respiratory function is a priority in this population.
C. Auscultate the newborn's bowel sounds:
While assessing bowel sounds is relevant to monitoring gastrointestinal function and potential withdrawal symptoms, it is not the immediate priority. Changes in bowel sounds may occur due to the syndrome, but respiratory assessment should come first to ensure stability.
D. Swaddle the newborn in blankets:
Swaddling can provide comfort to a newborn with NAS; however, it is not the first action to take. Comfort measures are important, but they should follow critical assessments of the newborn's respiratory and overall clinical status to ensure safety.
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