Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is counseling a client who is breastfeeding and wants to use medroxyprogesterone injections for contraception.
Which of the following statements should the nurse make?
A. "You can start the injections immediately after delivery.".
Starting the injections immediately after delivery could interfere with the exclusivity or duration of lactation, and could affect the newborn infant adversely because of slower metabolism of the drug than older infants.
B. "You should wait until your baby is 6 months old before starting the injections.".
Waiting until the baby is 6 months old is unnecessary and could expose the mother to a higher risk of unintended pregnancy.
C. "You may notice a decrease in your milk supply while using the injections.".
Medroxyprogesterone has not been known to cause any decrease in milk supply while using the injections
D. "You should wait until your baby is 6 weeks old before starting the injections.".
Medroxyprogesterone may pass into breast milk and cause side effects in a child who is breastfed.The product labeling states that it should be started no sooner than 6 weeks postpartum, based on data submitted for product approval. The World Health Organization also recommends that injectable depot medroxyprogesterone acetate should not be used before 6 weeks postpartum.
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Full Explanation
The correct answer is choice D. “You should wait until your baby is 6 weeks old before starting the injections.” This is because medroxyprogesterone may pass into breast milk and cause side effects in a child who is breastfed. The product labeling states that it should be started no sooner than 6 weeks postpartum, based on data submitted for product approval.
The World Health Organization also recommends that injectable depot medroxyprogesterone acetate should not be used before 6 weeks postpartum.
Choice A is wrong because starting the injections immediately after delivery could interfere with the exclusivity or duration of lactation, and could affect the newborn infant adversely because of slower metabolism of the drug than older infants .
Choice B is wrong because waiting until the baby is 6 months old is unnecessary and could expose the mother to a higher risk of unintended pregnancy.
Choice C is wrong because medroxyprogesterone has not been known to cause any decrease in milk supply while using the injections
Similar Questions
Here are some possible ATI nursing school MCQ questions with a long stem of at least 15 words, from the text you provided:.
A nurse is caring for a client who has a copper IUD for contraception.
The nurse should instruct the client to report which of the following signs of a possible complication?
A. Increased menstrual pain and bleeding
Increased menstrual pain and bleeding are common side effects of copper IUDs, especially in the first 3-6 months after insertion. They are not necessarily signs of a complication.
B. Irregular spotting or bleeding
Irregular spotting or bleeding are also common side effects of copper IUDs. They are not necessarily signs of a complication.
C. Foul-smelling vaginal discharge
Foul-smelling vaginal discharge is a sign of a possible infection, which can be a complication of using a copper IUD. The nurse should instruct the client to report this symptom and seek medical attention.
D. Change in string length
A change in string length is not a sign of a complication. The string length may vary depending on the position of the cervix and uterus.The client should check the string length regularly and report any missing or protruding strings, which could indicate displacement of the IUD.
Full Explanation
The correct answer is choice C. Foul-smelling vaginal discharge is a sign of a possible infection, which can be a complication of using a copper IUD.
The nurse should instruct the client to report this symptom and seek medical attention.
Choice A is wrong because increased menstrual pain and bleeding are common side effects of copper IUDs, especially in the first 3-6 months after insertion.
They are not necessarily signs of a complication.
Choice B is wrong because irregular spotting or bleeding are also common side effects of copper IUDs.
They are not necessarily signs of a complication.
Choice D is wrong because a change in string length is not a sign of a complication.
The string length may vary depending on the position of the cervix and uterus. The client should check the string length regularly and report any missing or protruding strings, which could indicate displacement of the IUD.
A nurse is reinforcing teaching with a client who is considering a progestin-releasing IUD for contraception.
Which of the following benefits should the nurse include in the teaching?
A. It can prevent Asherman’s syndrome
It can prevent Asherman’s syndrome. Asherman’s syndrome is a condition where scar tissue forms in the uterus, which can cause infertility or miscarriage. Progestin IUDs do not prevent this condition.
B. It can decrease menstrual loss and dysmenorrhea
According to, progestin IUDs can make your periods lighter and less painful. This is a benefit for women who have heavy or painful periods.
C. It can remain in the uterus for up to 10 years
It can remain in the uterus for up to 10 years. Progestin IUDs have different durations of effectiveness depending on the type and brand.For example, Liletta can last up to 8 years, Mirena up to 7 years, and Skyla/Kyleena up to 5 years.
D. It can protect against sexually transmitted infections
It can protect against sexually transmitted infections. Progestin IUDs do not protect against STIs. You should use condoms with new partners to prevent STIs
Full Explanation
The correct answer is choice B. It can decrease menstrual loss and dysmenorrhea. According to , progestin IUDs can make your periods lighter and less painful.
This is a benefit for women who have heavy or painful periods.
Choice A is wrong because it can prevent Asherman’s syndrome.
Asherman’s syndrome is a condition where scar tissue forms in the uterus, which can cause infertility or miscarriage.
Progestin IUDs do not prevent this condition.
Choice C is wrong because it can remain in the uterus for up to 10 years.
Progestin IUDs have different durations of effectiveness depending on the type and brand. For example, Liletta can last up to 8 years, Mirena up to 7 years, and Skyla/Kyleena up to 5 years .
Choice D is wrong because it can protect against sexually transmitted infections.
Progestin IUDs do not protect against STIs.
You should use condoms with new partners to prevent STIs
A nurse is preparing to insert an IUD for a client who is nulliparous and has a negative pregnancy test.
Which of the following actions should the nurse take before the insertion?
A. Obtain informed consent from the client
Obtaining informed consent from the client is a necessary step before any invasive procedure, including IUD insertion.
B. Perform a Pap smear and cervical culture
Performing a Pap smear and cervical culture can help screen for cervical cancer and sexually transmitted infections, which are contraindications for IUD use.
C. Administer an analgesic medication
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.
D. All of the above
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.
Full Explanation
The correct answer is choice D.
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.