A nurse is providing teaching to a client who has a new prescription for oral contraceptives (OCs).

Which of the following statements by the client indicates an understanding of how to initiate OCs?

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 A.A history of toxic shock syndrome (TSS) is a contraindication for the use of a diaphragm.

TSS is a rare but serious condition caused by a bacterial infection that can occur when using a diaphragm for too long or not cleaning it properly.

Choice B is wrong because a history of uterine fibroids is not a contraindication for the use of a diaphragm.

Uterine fibroids are benign tumors that grow in the uterus and usually do not affect the cervix or the fit of the diaphragm.

Choice C is wrong because a history of irregular menstrual periods is not a contraindication for the use of a diaphragm.

Irregular periods may be caused by various factors such as stress, hormonal imbalance, or medical conditions, but they do not affect the effectiveness or safety of the diaphragm.

Choice D is wrong because a history of breast cancer is not a contraindication for the use of a diaphragm.

Breast cancer is not related to the use of barrier methods of contraception such as the diaphragm.

However, some hormonal methods of contraception may increase the risk of breast cancer or be contraindicated for women who have or had breast cancer.