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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is choice B. The nurse should advise the client to take the pill at bedtime or with food.This can help reduce nausea, which is a common side effect of COCs.Nausea usually diminishes with continued use of the same method.
Choice A is wrong because taking the pill with a glass of water on an empty stomach may increase nausea.
Choice C is wrong because switching to a different brand of COCs is not effective in treating nausea.There are no significant differences among various COCs in terms of nausea.
Choice D is wrong because stopping the pill and using another method of contraception is not necessary unless the client prefers it.Nausea is not harmful and can be managed with simple measures.
Correct Answer is D
Explanation
The correct answer is choiceD.
All of the above.
Here is why:
- Choice A is correct because obtaining informed consent from the client is a necessary step before any invasive procedure, including IUD insertion.
- Choice B is correct because performing a Pap smear and cervical culture can help screen for cervical cancer and sexually transmitted infections, which are contraindications for IUD use.
- Choice C is correct because administering an analgesic medication can help reduce the pain and discomfort associated with IUD insertion, especially in nulliparous women who have a smaller cervical diameter.
- Choice D is correct because it includes all of the above actions, which are recommended by the American College of Obstetricians and Gynecologists (ACOG) for IUD insertion in nulliparous women.
- Choice A is wrong if it is the only action taken, because it does not address the other aspects of IUD insertion such as screening and pain management.
- Choice B is wrong if it is the only action taken, because it does not ensure the client’s consent and comfort during the procedure.
- Choice C is wrong if it is the only action taken, because it does not verify the client’s eligibility and suitability for IUD use.
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