A nurse is caring for a client who has a history of breast cancer and cardiovascular disease and is seeking advice on contraception.

Which of the following contraceptive methods should the nurse recommend as the safest option for this client?

The correct answer is choice B.History of uterine prolapse is a contraindication for the use of a diaphragm as a contraceptive method.Uterine prolapse is a condition where the uterus descends into the vagina, which can interfere with the proper placement and seal of the diaphragm.

Choice A is wrong because history of cervical cancer is not a contraindication for diaphragm use.

Cervical cancer is a malignant tumor of the cervix, which can be treated with surgery, radiation, or chemotherapy.

Diaphragm use does not affect the risk or treatment of cervical cancer.

Choice C is wrong because history of ovarian cysts is not a contraindication for diaphragm use.

Ovarian cysts are fluid-filled sacs that develop in or on the ovaries, which can cause pain, bloating, or irregular periods.

Diaphragm use does not affect the formation or rupture of ovarian cysts.

Choice D is wrong because history of menopause is not a contraindication for diaphragm use.

Menopause is the natural cessation of menstrual cycles and fertility, which occurs around age 50 in most women.

Diaphragm use does not affect the hormonal changes or symptoms of menopause.

The correct answer is choice A. Perform a pregnancy test.An IUD is a form of birth control that is inserted into the uterus to prevent pregnancy, but it is not 100% effective.If a client with an IUD misses a menstrual period, the first action the nurse should take is to rule out pregnancy by performing a pregnancy test.This is because pregnancy with an IUD can have serious complications, such as ectopic pregnancy, infection, miscarriage or preterm labor.

Choice B is wrong because palpating for uterine enlargement is not a reliable way to diagnose pregnancy, especially in the early stages.It can also cause discomfort or bleeding for the client.

Choice C is wrong because assessing for signs of ectopic pregnancy is not the first action the nurse should take.

Ectopic pregnancy is a possible complication of pregnancy with an IUD, but it is not very common.The nurse should first confirm if the client is pregnant before looking for signs of ectopic pregnancy, such as abdominal pain, vaginal bleeding or shoulder pain.

Choice D is wrong because instructing the client to remove the IUD is not appropriate or safe.

The client should not attempt to remove the IUD by themselves, as this can cause injury or infection.The nurse should refer the client to an OB-GYN if they are pregnant with an IUD or if they want to remove the IUD for any reason.