A nurse in an obstetric clinic is caring for four clients. The nurse should identify that an intrauterine device is contraindicated for which of the following clients?

A client who smokes one pack of cigarettes per day

A client who has a history of gallbladder disease

A client who has a positive pregnancy test

A client who is nulliparous

Answer and Explanation

The Correct Answer is C

(A) A client who smokes one pack of cigarettes per day:
While smoking is a significant risk factor for many health issues, including cardiovascular disease, it is not a direct contraindication for the use of an intrauterine device (IUD). However, smokers should be counseled about the risks of smoking and offered support to quit.

(B) A client who has a history of gallbladder disease:
A history of gallbladder disease does not contraindicate the use of an IUD. IUDs are primarily contraindicated in cases of active pelvic infection, certain uterine abnormalities, and confirmed pregnancy, but not gallbladder disease.

(C) A client who has a positive pregnancy test:
An IUD should not be inserted in a client who has a positive pregnancy test. Inserting an IUD during pregnancy can lead to complications such as infection, miscarriage, and preterm birth. It is crucial to confirm the absence of pregnancy before IUD insertion.

(D) A client who is nulliparous:
Being nulliparous (having never given birth) is not a contraindication for IUD use. IUDs can be safely used by nulliparous women, though some might have a slightly higher risk of expulsion or insertion-related discomfort compared to women who have given birth.

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Free Nursing Study Resources

Correct Answer is D

Explanation

(a) "I should place my baby in the car seat at a 90-degree angle."
The baby should not be placed in the car seat at a 90-degree angle. Instead, the car seat should be reclined at a 30- to 45-degree angle to keep the baby's airway open and reduce the risk of suffocation.

(b) "I will place a thick, soft pad behind my baby's back."
Using a thick, soft pad behind the baby’s back is not recommended because it can interfere with the harness system and compromise the safety of the car seat. Only products that come with the car seat or are specifically designed for it should be used.

(c) "I can turn the car seat so it faces forward when my baby weighs 15 pounds."
The car seat should remain rear-facing until the child reaches the maximum weight or height limit allowed by the car seat manufacturer, which is typically around 2 years of age or longer. Turning the car seat to face forward at just 15 pounds is too early and not safe.

(d) "I will place the retainer clip at the level of my baby's armpits."
This is correct. The retainer clip should be positioned at the level of the baby's armpits. This placement ensures that the harness straps are properly positioned over the baby's shoulders and chest, providing optimal protection in the event of a crash.

A. "You should recognize that your baby sucking on his hands is a hunger cue." B. "You should feed your baby for 10 minutes on each breast.” C. "You should feed your baby six times a day." D. "You should wake your baby at least every 6 hours at night for feedings."

Correct Answer is A

Explanation

(A) "You should recognize that your baby sucking on his hands is a hunger cue."
Recognizing hunger cues is crucial for successful breastfeeding. Early hunger cues like sucking on hands, rooting, and lip-smacking indicate that the baby is ready to feed. Responding to these cues can help establish a good breastfeeding routine and ensure the baby gets adequate nutrition before becoming too distressed to feed effectively.

(B) "You should feed your baby for 10 minutes on each breast."
Feeding duration can vary significantly among babies. Some may need longer than 10 minutes on each breast, while others might feed more efficiently in a shorter time. Instead of a strict time limit, it's important to encourage the mother to allow the baby to feed until they show signs of being full, such as pulling away from the breast or falling asleep.

(C) "You should feed your baby six times a day."
Newborns typically need to feed more frequently than six times a day. Most newborns breastfeed 8-12 times in 24 hours. Limiting feeds to six times a day may not provide sufficient nutrition and can affect the baby’s growth and milk supply.

(D) "You should wake your baby at least every 6 hours at night for feedings."
Newborns, especially in the first few weeks, often need to be fed more frequently than every 6 hours, including at night. Typically, it’s recommended to wake a baby to feed if they sleep for more than 4 hours at a time in the early weeks to ensure adequate intake and to help establish the mother’s milk supply.

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A nurse in an obstetric clinic is caring for four clients. The nurse should identify that an intrauterine device is contraindicated for which of the following clients?

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