A nurse is caring for a client who has an IUD and reports abdominal pain during sexual intercourse.
Which of the following actions should the nurse take first?
Assess for signs of pelvic inflammatory disease
Instruct the client to check the string length
Advise the client to use a backup contraceptive method
Schedule an appointment for IUD removal
The Correct Answer is A
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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice A.Mennorhagia is a contraindication for the use of an intrauterine device (IUD) for contraception because it can cause heavy or prolonged menstrual bleeding.This can lead to anemia, infection, or expulsion of the device.
Choice B is wrong because ovarian cysts are not a contraindication for IUD use.They are usually benign and do not interfere with the placement or function of the device.
Choice C is wrong because fibrocystic breast disease is not a contraindication for IUD use.It is a common condition that causes benign lumps in the breast tissue and does not affect the hormonal balance or the risk of infection.
Choice D is wrong because endometriosis is not a contraindication for IUD use.In fact, some types of IUDs that release progestin can help reduce the symptoms of endometriosis by thinning the endometrial lining and suppressing ovulation.
Correct Answer is B
Explanation
The correct answer is choice B.Spotting and irregular bleeding are potential adverse effects of the copper IUD.The copper IUD works by creating a toxic environment for sperm and eggs in the uterus and cervix, but it does not affect the hormones that regulate the menstrual cycle.Therefore, it can cause changes in bleeding patterns, such as heavier, longer or more painful periods.
Choice A is wrong because decreased bone density is not a side effect of the copper IUD.It is a possible side effect of hormonal IUDs that contain progestin, which can lower estrogen levels and affect bone health.
Choice C is wrong because mood changes are not a side effect of the copper IUD.They are more likely to occur with hormonal methods of birth control that affect the levels of estrogen and progesterone in the body.
Choice D is wrong because headaches are not a side effect of the copper IUD.They are also more common with hormonal methods of birth control, especially those that contain estrogen.
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