A nurse is teaching a patient about the use of spermicide.

Which of the following is an adverse effect of some spermicides that contain nonoxynol-9 (N-9)?

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 C. Increased risk of HIV transmission.According to some sources, spermicide that contains nonoxynol-9 (N-9) can irritate sensitive genital tissues, especially if used several times a day.

This irritation can increase the risk of HIV and other sexually transmitted infections by giving infections an easy pathway into the body.

Choice A is wrong because vaginal dryness is not a common side effect of spermicide.

Choice B is wrong because bacterial vaginosis is not directly linked to spermicide use.

Choice D is wrong because cervical cancer is not caused by spermicide use.

Spermicide is a type of contraceptive that works by stopping sperm from reaching an egg.

It comes in different forms such as gels, creams, foams, films or suppositories.It needs to be inserted into the vagina before sex and used correctly every time for it to be effective.