A nurse is caring for a client who has an intrauterine device (IUD) in place and reports lower abdominal pain and fever for 2 days.
Which of the following actions should the nurse take?
Instruct the client to take ibuprofen for pain relief
Advise the client to avoid sexual intercourse until symptoms resolve
Obtain a urine specimen for culture and sensitivity
Refer the client to a provider for evaluation
The Correct Answer is D
The correct answer is choice D. Refer the client to a provider for evaluation. Lower abdominal pain and fever for 2 days can indicate a serious complication of IUD use, such as pelvic inflammatory disease (PID) or perforation of the uterus.
These conditions require prompt medical attention and possible removal of the IUD.
Choice A is wrong because ibuprofen may not be enough to relieve the pain and may mask the signs of infection.
Choice B is wrong because avoiding sexual intercourse will not treat the underlying cause of the symptoms and may delay seeking medical help.
Choice C is wrong because a urine specimen may not be sufficient to diagnose the problem and may miss other possible causes of lower abdominal pain and fever, such as ectopic pregnancy or appendicitis.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is A
Explanation
The correct answer is choice A. The nurse should assess for signs of pelvic inflammatory disease (PID), which is an infection of the female reproductive organs that can be caused by sexually transmitted bacteria.PID can cause abdominal pain during sexual intercourse, as well as other symptoms such as fever, unusual vaginal discharge, and bleeding between periods.PID can lead to serious complications such as infertility and ectopic pregnancy if left untreated.
Choice B is wrong because checking the string length of the IUD is not a priority action.The string length may change due to normal variations in the position of the uterus and cervix, and does not indicate a problem with the IUD.However, if the string is missing or longer than usual, it may suggest that the IUD has moved or expelled, and the client should see a provider.
Choice C is wrong because advising the client to use a backup contraceptive method is not a priority action.The IUD is a highly effective form of birth control that does not require additional methods unless the client wants to prevent STIs.However, if the client has an STI that causes PID, using a condom may help prevent further infection and transmission.
Choice D is wrong because scheduling an appointment for IUD removal is not a priority action.The IUD does not cause PID, but it may increase the risk of infection shortly after insertion, especially if the client has an STI.The risk of PID from IUD use is very low (less than 1%) and usually disappears after 3 weeks of placement.Removing the IUD may not cure PID and may expose the client to unwanted pregnancy.
Correct Answer is A
Explanation
The correct answer is choice A. Elevated liver enzymes.Medroxyprogesterone injections can cause liver damage and impair its function.Elevated liver enzymes are a sign of liver injury and should be reported to the provider immediately.
Choice B is wrong because decreased hemoglobin is not a common side effect of medroxyprogesterone injections.
Decreased hemoglobin can indicate anemia, which can have many causes unrelated to medroxyprogesterone injections.
Choice C is wrong because increased platelets are not a common side effect of medroxyprogesterone injections.
Increased platelets can indicate inflammation, infection, or cancer, which can have many causes unrelated to medroxyprogesterone injections.
Choice D is wrong because decreased potassium is not a common side effect of medroxyprogesterone injections.
Decreased potassium can indicate dehydration, diarrhea, vomiting, or diuretic use, which can have many causes unrelated to medroxyprogesterone injections.
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