A nurse is providing teaching to a client who has a new prescription for oral contraceptives (OCs).

Which of the following statements by the client indicates an understanding of how to initiate OCs?

The correct answer is choice A.COCs can reduce the risk of endometrial, ovarian and colon cancer.This is because COCs suppress ovulation and reduce inflammation in the genital tract, which may lower the exposure to carcinogens and mutagens.

Choice B is wrong because COCs do not increase bone density or prevent osteoporosis.In fact, some studies have suggested that COCs may have a negative effect on bone mineral density.

Choice C is wrong because COCs do not enhance fertility or improve menstrual regularity.

COCs prevent pregnancy by inhibiting ovulation, which means that they temporarily suppress fertility.COCs may also cause irregular bleeding or amenorrhea in some women.

Choice D is wrong because COCs do not lower blood pressure or cholesterol levels.On the contrary, COCs may increase the risk of hypertension and dyslipidemia in some women, especially those who smoke, are obese, or have a family history of cardiovascular disease.

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.