A nurse is caring for a patient who uses a contraceptive vaginal ring.

Which of the following symptoms should the nurse instruct the patient to report immediately?

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.

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.