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NurseDive Free Nursing Practice Question
A nurse is caring for a client who has an IUD and reports abdominal pain during sexual intercourse.
Which of the following actions should the nurse take first?
A. Assess for signs of pelvic inflammatory disease
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.
B. Instruct the client to check the string length
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.
C. Advise the client to use a backup contraceptive method
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.
D. Schedule an appointment for IUD removal
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.
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Full Explanation
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.
Similar Questions
A nurse is caring for a client who desires an intrauterine device (IUD) for contraception.
Which of the following findings is a contraindication for the use of this device?
A. Mennorhagia
Mennorhagia is a contraindication for the use of an intrauterine device (IUD) for contraception because it can cause heavy or prolonged menstrual bleeding.This can lead to anemia, infection, or expulsion of the device.
B. Ovarian cysts
Ovarian cysts are not a contraindication for IUD use.They are usually benign and do not interfere with the placement or function of the device.
C. Fibrocystic breast disease
Fibrocystic breast disease is not a contraindication for IUD use.It is a common condition that causes benign lumps in the breast tissue and does not affect the hormonal balance or the risk of infection.
D. Endometriosis
Endometriosis is not a contraindication for IUD use.In fact, some types of IUDs that release progestin can help reduce the symptoms of endometriosis by thinning the endometrial lining and suppressing ovulation
Full Explanation
The correct answer is choice A. Mennorhagia is a contraindication for the use of an intrauterine device (IUD) for contraception because it can cause heavy or prolonged menstrual bleeding. This can lead to anemia, infection, or expulsion of the device.
Choice B is wrong because ovarian cysts are not a contraindication for IUD use. They are usually benign and do not interfere with the placement or function of the device.
Choice C is wrong because fibrocystic breast disease is not a contraindication for IUD use. It is a common condition that causes benign lumps in the breast tissue and does not affect the hormonal balance or the risk of infection.
Choice D is wrong because endometriosis is not a contraindication for IUD use. In fact, some types of IUDs that release progestin can help reduce the symptoms of endometriosis by thinning the endometrial lining and suppressing ovulation.
A nurse is caring for a client who has an intrauterine device (IUD) in place and reports lower abdominal pain and fever for 2 days.
Which of the following actions should the nurse take?
A. Instruct the client to take ibuprofen for pain relief
Ibuprofen may not be enough to relieve the pain and may mask the signs of infection.
B. Advise the client to avoid sexual intercourse until symptoms resolve
Avoiding sexual intercourse will not treat the underlying cause of the symptoms and may delay seeking medical help.
C. Obtain a urine specimen for culture and sensitivity
A urine specimen may not be sufficient to diagnose the problem and may miss other possible causes of lower abdominal pain and fever, such as ectopic pregnancy or appendicitis.
D. Refer the client to a provider for evaluation
Lower abdominal pain and fever for 2 days can indicate a serious complication of IUD use, such as pelvic inflammatory disease (PID) or perforation of the uterus. These conditions require prompt medical attention and possible removal of the IUD.
Full Explanation
The correct answer is choice D. Refer the client to a provider for evaluation. Lower abdominal pain and fever for 2 days can indicate a serious complication of IUD use, such as pelvic inflammatory disease (PID) or perforation of the uterus.
These conditions require prompt medical attention and possible removal of the IUD.
Choice A is wrong because ibuprofen may not be enough to relieve the pain and may mask the signs of infection.
Choice B is wrong because avoiding sexual intercourse will not treat the underlying cause of the symptoms and may delay seeking medical help.
Choice C is wrong because a urine specimen may not be sufficient to diagnose the problem and may miss other possible causes of lower abdominal pain and fever, such as ectopic pregnancy or appendicitis.
A nurse is reinforcing teaching with a client who has an intrauterine device (IUD) in place and asks how it prevents pregnancy.
Which of the following responses should the nurse make?
A. “It releases hormones that thicken cervical mucus and prevent ovulation.”.
B. “It creates a local inflammatory response that impairs implantation.”.
This means that the IUD makes the lining of the uterus less suitable for a fertilized egg to attach to it.
C. “It alters tubal motility and interferes with sperm transport.”.
It describes how tubal ligation works, not IUDs.Tubal ligation is a surgical procedure that blocks or cuts the fallopian tubes, which prevents sperm from reaching an egg.
D. All of the above
It implies that all of the above choices are correct, which they are not.
Full Explanation
The correct answer is choice B. It creates a local inflammatory response that impairs implantation. This means that the IUD makes the lining of the uterus less suitable for a fertilized egg to attach to it.
Choice A is wrong because it describes how hormonal IUDs work, not copper IUDs. Hormonal IUDs release hormones that thicken cervical mucus and prevent ovulation.
Choice C is wrong because it describes how tubal ligation works, not IUDs. Tubal ligation is a surgical procedure that blocks or cuts the fallopian tubes, which prevents sperm from reaching an egg.
Choice D is wrong because it implies that all of the above choices are correct, which they are not.
Only choice B is correct for copper IUDs.