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A nurse is preparing to insert an IUD for a client who is nulliparous and has a negative pregnancy test.

Which of the following actions should the nurse take before the insertion?

A.

Obtain informed consent from the client

B.

Perform a Pap smear and cervical culture

C.

Administer an analgesic medication

D.

All of the above

Answer and Explanation

The Correct Answer is D

The correct answer is choice D.

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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Related Questions

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

Correct Answer is A

Explanation

The correct answer is choice A.COCs prevent pregnancy byinhibiting the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are responsible for ovulation.

By suppressing ovulation, COCs prevent the release of a mature egg that can be fertilized by sperm.

Choice B is wrong because COCs do not increase the production of prostaglandins that cause uterine contractions.

Prostaglandins are involved in inflammation and pain, and are not directly related to contraception.

Choice C is wrong because COCs do not decrease the permeability of the fallopian tubes to sperm and egg.

The fallopian tubes are the site of fertilization, and COCs do not affect their function.

Choice D is partially correct but not the best answer.COCs do suppress ovulation, but they also have other mechanisms of action, such asthickening cervical mucusandaltering the uterine lining.

These effects make it harder for sperm to reach the egg and for a fertilized egg to implant in the uterus.

Therefore, choice D does not capture the full mechanism of action of COCs.

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