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 A
Explanation
The correct answer is choice A.The nurse should tell the client that if she misses one pill, she should take the missed pill as soon as possible and continue with the next pill at the usual time.This will ensure that she maintains a continuous hormonal exposure and does not extend the hormone-free interval beyond 7 days.She does not need to use extra contraception.
Choice B is wrong because taking two pills at once and skipping the next pill will disrupt the hormonal balance and may cause side effects such as nausea or breakthrough bleeding.Choice C is wrong because discarding the missed pill and taking the next pill at the usual time will shorten the duration of hormonal exposure and increase the risk of ovulation.Choice D is wrong because stopping taking the pills for the rest of the cycle and using a backup method of contraception will expose the client to an unnecessary hormone-free interval and may compromise her contraceptive efficacy.
COCs are combined oral contraceptives that contain synthetic estrogen and progestin hormones that prevent ovulation and thicken cervical mucus to inhibit sperm penetration.The normal range of COCs dosage is 20 to 35 micrograms of estrogen and 0.1 to 3 milligrams of progestin per pill.
Correct Answer is A
Explanation
The correct answer is choice A.History of migraine headaches with aura is a contraindication for using COCs because it increases the risk of stroke.
Some possible explanations for the other choices are:
- Choice B is wrong because history of dysmenorrhea and menorrhagia is not a contraindication for using COCs.In fact, COCs may help reduce menstrual pain and bleeding.
- Choice C is wrong because history of acne vulgaris and hirsutism is not a contraindication for using COCs.In fact, COCs may help improve acne and hirsutism by reducing androgen levels.
- Choice D is wrong because history of iron-deficiency anemia and fatigue is not a contraindication for using COCs.In fact, COCs may help prevent iron-deficiency anemia by reducing menstrual blood loss.
Normal ranges for relevant parameters are:
- Blood pressure: <140/90 mmHg
- Body mass index: 18.5–24.9 kg/m
- Hemoglobin: 12–16 g/dL for women
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