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) Restrict fluids to 1,000 mL/day:
Restricting fluids may lead to dehydration, which can exacerbate nausea and other symptoms of morning sickness. It is important for pregnant individuals to stay hydrated, so fluid restriction is not recommended unless otherwise directed by a healthcare provider.
(B) Take an over-the-counter antacid:
While antacids may provide relief for heartburn or indigestion, they are not typically recommended as a first-line treatment for nausea associated with morning sickness. Antacids may have limited effectiveness in managing nausea, and their use should be guided by a healthcare provider.
(C) Increase intake of fresh fruits:
While fresh fruits are nutritious and provide essential vitamins and minerals, they may not be well-tolerated by individuals experiencing morning sickness, especially if they have strong flavors or odors. Encouraging the client to eat bland foods in the morning may be more effective in managing nausea during early pregnancy.
(D) Eat dry, bland foods in the morning:
Encouraging the client to eat dry, bland foods in the morning can help alleviate nausea associated with morning sickness. These foods are generally easier on the stomach and less likely to trigger nausea compared to richer or spicier foods. Examples include crackers, toast, or dry cereal. Eating small, frequent meals throughout the day can also help manage nausea associated with pregnancy.
Correct Answer is C
Explanation
(a) Serum bilirubin:
While serum bilirubin can provide useful information about liver function, it is not the most immediate concern for a client with hyperemesis gravidarum. This condition primarily involves severe nausea and vomiting, which can lead to dehydration and ketosis.
(b) Liver enzymes:
Liver enzymes can be elevated in hyperemesis gravidarum, but they are not the primary concern. The immediate priority is to assess the extent of dehydration and metabolic disturbances.
(c) Urinalysis for ketones:
This test is the priority because it helps determine the extent of dehydration and ketosis. In hyperemesis gravidarum, severe vomiting can lead to significant fluid and electrolyte imbalances and ketosis, which need to be identified and corrected promptly to prevent further complications.
(d) CBC:
A complete blood count (CBC) provides useful information about overall health and can identify anemia or infection, but it is not the priority for immediate assessment of hyperemesis gravidarum. The immediate need is to evaluate hydration status and ketosis, which is best done through urinalysis for ketones.
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