A nurse is providing discharge instructions to a client who has just received her first medroxyprogesterone injection for contraception.

Which of the following information should the nurse include in the teaching?

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.

The correct answer is choice B.History of uterine prolapse is a contraindication for the use of a diaphragm as a contraceptive method.Uterine prolapse is a condition where the uterus descends into the vagina, which can interfere with the proper placement and seal of the diaphragm.

Choice A is wrong because history of cervical cancer is not a contraindication for diaphragm use.

Cervical cancer is a malignant tumor of the cervix, which can be treated with surgery, radiation, or chemotherapy.

Diaphragm use does not affect the risk or treatment of cervical cancer.

Choice C is wrong because history of ovarian cysts is not a contraindication for diaphragm use.

Ovarian cysts are fluid-filled sacs that develop in or on the ovaries, which can cause pain, bloating, or irregular periods.

Diaphragm use does not affect the formation or rupture of ovarian cysts.

Choice D is wrong because history of menopause is not a contraindication for diaphragm use.

Menopause is the natural cessation of menstrual cycles and fertility, which occurs around age 50 in most women.

Diaphragm use does not affect the hormonal changes or symptoms of menopause.