A nurse is teaching a client who is starting medroxyprogesterone injections for contraception.

Which of the following statements by the client indicates a need for further teaching?

The correct answer is choice A. The nurse should assess for signs of pelvic inflammatory disease (PID), which is an infection of the female reproductive organs that can be caused by sexually transmitted bacteria.PID can cause abdominal pain during sexual intercourse, as well as other symptoms such as fever, unusual vaginal discharge, and bleeding between periods.PID can lead to serious complications such as infertility and ectopic pregnancy if left untreated.

Choice B is wrong because checking the string length of the IUD is not a priority action.The string length may change due to normal variations in the position of the uterus and cervix, and does not indicate a problem with the IUD.However, if the string is missing or longer than usual, it may suggest that the IUD has moved or expelled, and the client should see a provider.

Choice C is wrong because advising the client to use a backup contraceptive method is not a priority action.The IUD is a highly effective form of birth control that does not require additional methods unless the client wants to prevent STIs.However, if the client has an STI that causes PID, using a condom may help prevent further infection and transmission.

Choice D is wrong because scheduling an appointment for IUD removal is not a priority action.The IUD does not cause PID, but it may increase the risk of infection shortly after insertion, especially if the client has an STI.The risk of PID from IUD use is very low (less than 1%) and usually disappears after 3 weeks of placement.Removing the IUD may not cure PID and may expose the client to unwanted pregnancy.

The correct answer is choice C) “No, you should avoid activities that could cause straining or trauma until healing occurs.” This is because a vasectomy is a surgical procedure that involves cutting and sealing the tubes that carry sperm from the testicles to the semen.It requires some time for recovery and healing, and strenuous activities like hunting could increase the risk of bleeding, infection, or reopening the incisions.

Choice A) “Yes, this activity level will be fine.” is wrong because it contradicts the medical advice to rest and avoid heavy lifting or exercise for at least a week after a vasectomy.

Choice B) “No, you should avoid sexual intercourse until your follow-up visit.” is wrong because it is too restrictive.Sexual intercourse can be resumed after a few days or when the pain and swelling subside, as long as contraception is used until the semen is confirmed to be sperm-free.

Choice D) “Yes, but you should wear tight-fitting underwear.” is wrong because it is not enough to prevent complications.Tight-fitting underwear can help support the scrotum and reduce discomfort, but it does not eliminate the need to avoid activities that could cause straining or trauma.