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 C
Explanation
The correct answer is choice C. The patient needs further teaching if they think that the implant can be inserted immediately after childbirth.According to Mayo Clinic, the implant should not be inserted until at least 21 days after giving birth, or until the milk supply is well established if breastfeeding.
Inserting the implant too soon may increase the risk of blood clots or decrease milk production.
Choice A is correct because condoms are still needed to protect against STIs, even if using the implant as a birth control method.Choice B is correct because irregular and unpredictable menstruation is a common side effect of the implant.Choice D is correct because the implant can prevent pregnancy for up to three years.
Correct Answer is B
Explanation
The correct answer is choice B. Increased serum potassium level.Oral contraceptives can affect the levels of various electrolytes in the blood, such as sodium, potassium, calcium and magnesium.According to one study, oral contraceptives can increase the levels of serum copper, iron, calcium and cadmium, and decrease the levels of serum zinc, selenium, phosphorus and magnesium.
Therefore, a high serum potassium level can indicate an adverse effect of oral contraceptives on this client.
Choice A is wrong because oral contraceptives do not decrease serum glucose level.In fact, they can increase the plasma glucose level and insulin response, which can impair glucose tolerance and increase the risk of diabetes.
Choice C is wrong because oral contraceptives do not decrease serum triglyceride level.On the contrary, they can increase the fasting triglyceride level by 13 to 75 percent, which can elevate the risk of cardiovascular disease.
Choice D is wrong because oral contraceptives do not increase serum protein level.They can increase the levels of some apolipoproteins, such as A-I, A-II and B, but these are not the same as total protein.
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