A nurse in a provider's office is reviewing the medical record of a client who is requesting a diaphragm. Which of the following findings in the client's history should the nurse identify as a contraindication for this type of contraception?
Recurrent urinary tract infections
Tobacco use
History of positive group B streptococcus B-hemolytic
Deep-vein thrombosis
The Correct Answer is A
A. Recurrent urinary tract infections are a contraindication for using a diaphragm because the presence of a foreign object in the vagina can increase the risk of UTIs.
B. Tobacco use is a risk factor for cardiovascular issues with hormonal contraceptives but not for barrier methods like diaphragms.
C. History of positive group B streptococcus B-hemolytic is a concern for newborn care and labor management, but it is not a contraindication for the use of a diaphragm.
D. Deep-vein thrombosis is a contraindication for hormonal contraceptives due to an increased risk of clotting but does not affect the use of diaphragms, which are a barrier method of contraception.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Placing a rolled blanket behind the newborn’s neck is unsafe and can cause improper positioning in the car seat. The newborn should be positioned properly according to the car seat manufacturer's instructions to ensure safety during travel.
B. The car seat should be positioned at a 45° angle to keep the newborn’s airway open and prevent slumping. This angle supports proper head and neck alignment, which is essential for the baby’s safety and comfort during travel.
C. The retainer clip should be positioned at the level of the newborn’s armpits, not the umbilicus. Proper placement of the retainer clip ensures that the harness is secure and correctly positioned over the baby’s shoulders.
D. Newborns should be placed in a rear-facing position in the car seat for optimal safety. Forward-facing car seats are used later, but infants should always be in a rear-facing car seat until they meet the age, weight, and height requirements for transitioning.
Correct Answer is C
Explanation
A. Blood pressure 156/80 mm Hg is incorrect. While this blood pressure reading is elevated, hypertension is not a typical immediate sign of postpartum hemorrhage. Hemorrhage is more commonly associated with hypotension (low blood pressure) due to fluid loss.
B. Temperature 38.3° C (101° F) is incorrect. A mild fever may be common in the first 24 hours postpartum due to normal inflammatory responses. It is not specifically indicative of postpartum hemorrhage, though a persistent fever could indicate an infection.
C. Respiratory rate 32/min is correct. An increased respiratory rate can be a sign of hypovolemia (due to significant blood loss), which may occur with postpartum hemorrhage. The body compensates for decreased blood volume by increasing the respiratory rate.
D. Apical pulse 66/min is incorrect. A heart rate of 66/min is within normal limits and would not be indicative of postpartum hemorrhage. In fact, a tachycardic (elevated) heart rate is more concerning in the case of hemorrhage as the body tries to compensate for blood loss.
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