A nurse is reviewing the medical history of a client who is considering using COCs as a method of contraception.

The nurse should identify that which of the following conditions is a contraindication for using COCs?

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 A.“You need to have a sperm count test to confirm your sterility.”

A sperm count test is a semen analysis that measures the number of sperm in the ejaculate.

It is the only way to verify that a vasectomy has been successful and that the man is sterile.A man is considered sterile when his sperm count is zero or below 100,000 non-motile sperm per sample.

Choice B is wrong because the number of ejaculations does not guarantee sterility.Some sperm may still be present in the severed vas deferens for months after a vasectomy.

Choice C is wrong because the duration of contraception use after a vasectomy depends on the sperm count test results, not on a fixed time period.It may take more or less than 3 months for a man to become sterile after a vasectomy.

Choice D is wrong because a repeat vasectomy is unnecessary and ineffective to ensure sterility.A vasectomy is a permanent birth control method that rarely fails or reverses.