A nurse is reviewing the laboratory results of a client who is taking medroxyprogesterone injections for contraception.

Which of the following findings should the nurse report to the provider?

The correct answer is choice A. Perform a pregnancy test.An IUD is a form of birth control that is inserted into the uterus to prevent pregnancy, but it is not 100% effective.If a client with an IUD misses a menstrual period, the first action the nurse should take is to rule out pregnancy by performing a pregnancy test.This is because pregnancy with an IUD can have serious complications, such as ectopic pregnancy, infection, miscarriage or preterm labor.

Choice B is wrong because palpating for uterine enlargement is not a reliable way to diagnose pregnancy, especially in the early stages.It can also cause discomfort or bleeding for the client.

Choice C is wrong because assessing for signs of ectopic pregnancy is not the first action the nurse should take.

Ectopic pregnancy is a possible complication of pregnancy with an IUD, but it is not very common.The nurse should first confirm if the client is pregnant before looking for signs of ectopic pregnancy, such as abdominal pain, vaginal bleeding or shoulder pain.

Choice D is wrong because instructing the client to remove the IUD is not appropriate or safe.

The client should not attempt to remove the IUD by themselves, as this can cause injury or infection.The nurse should refer the client to an OB-GYN if they are pregnant with an IUD or if they want to remove the IUD for any reason.

The correct answer is choice B.The client should wear scrotal support for at least 48 hours after the procedure to decrease pain and swelling, and protect the wound.

Some possible explanations for the other choices are:

• Choice A is wrong because the client should avoid sexual activity for at least 1 week, not 4 weeks, after the procedure.The client will not be sterile right away and will need to use another form of birth control until the sperm count is zero.
• Choice C is wrong because the client should apply ice packs to the scrotum for at least 2 days, not 72 hours, after the procedure.Ice helps prevent tissue damage and decrease swelling and pain.
• Choice D is wrong because the client should not take aspirin for pain relief after the procedure, as it can increase the risk of bleeding.The client can take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen instead.