A nurse is providing teaching to a female client regarding an intrauterine device (IUD) in the outpatient clinic.
Which of the following statements should the nurse include in the teaching?
“You might have to have cultures for sexually transmitted infections prior to placement of the device.”
“The device will have to be replaced every 2 years.”
“You might experience irregular spotting the first few months after placement of the device.”
“You will need to avoid using tampons during menstrual cycles.”
“You will need to sign informed consent prior to the procedure.”
Correct Answer : A,C,E
Choice A rationale: Screening for sexually transmitted infections (STIs) prior to IUD placement is essential to reduce the risk of pelvic inflammatory disease (PID). The insertion process can introduce bacteria from the cervix or vagina into the uterine cavity, increasing infection risk if an STI is present. Guidelines recommend screening high-risk patients or those with recent STI history. Identifying infections before insertion allows treatment, preventing serious reproductive complications, including infertility.
Choice B rationale: Most intrauterine devices (IUDs) have a lifespan longer than 2 years; copper IUDs last up to 10 years, and hormonal IUDs typically last between 3 and 7 years depending on the type. Replacing the device every 2 years is unnecessary and not evidence-based. Premature removal or replacement increases risk of procedure-related complications without added contraceptive benefit.
Choice C rationale: Irregular spotting or breakthrough bleeding during the first few months after IUD insertion is common due to endometrial adjustment to the foreign body and hormonal changes (for hormonal IUDs). This occurs as the endometrial lining remodels, and bleeding usually decreases with time. Patient education about this transient effect improves adherence and reduces anxiety related to unexpected bleeding.
Choice D rationale: There is no contraindication to tampon use while an IUD is in place. Tampons do not interfere with IUD function or position. Although some clinicians advise caution initially post-insertion to prevent infection, scientific evidence does not support a permanent restriction on tampon use during menstruation after proper healing.
Choice E rationale: Signing informed consent before IUD insertion is legally and ethically required. It ensures the client understands benefits, risks, potential complications (such as expulsion or perforation), and alternative contraceptive methods. This process protects patient autonomy and supports shared decision-making, critical components of safe clinical practice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
For clients prescribed methadone during pregnancy, breastfeeding is generally encouraged due to the benefits of breast milk for the infant. Methadone excretion into breast milk is minimal and not considered harmful, and it can help to reduce the severity of neonatal abstinence syndrome.
Choice B rationale
Methamphetamine use during pregnancy is associated with several adverse fetal outcomes, but fetal macrosomia (abnormally large baby) is not typically one of them. Instead, it is more commonly linked to intrauterine growth restriction, preterm birth, and small for gestational age infants due to vasoconstrictive effects.
Choice C rationale
For newborns experiencing neonatal abstinence syndrome due to prenatal substance exposure, environmental stimuli should be decreased, not increased. Reducing stimuli like bright lights, loud noises, and excessive handling helps to minimize agitation, irritability, and seizures in these vulnerable infants.
Choice D rationale
Increased head circumference is not an expected finding in a newborn with fetal alcohol syndrome (FAS). In fact, microcephaly (abnormally small head circumference) is a characteristic diagnostic criterion for FAS, reflecting the detrimental effects of alcohol on fetal brain development.
Correct Answer is A
Explanation
Choice A rationale
Fetal heart rate (FHR) accelerations occurring with fetal movement signify a healthy autonomic nervous system and adequate fetal oxygenation. These accelerations, typically 15 beats per minute (bpm) above baseline for 15 seconds in a fetus beyond 32 weeks, indicate a reactive nonstress test, reflecting good fetal well-being.
Choice B rationale
Late decelerations are a concerning finding, indicating uteroplacental insufficiency and potential fetal hypoxia. They are characterized by a gradual decrease in FHR that begins after the peak of the contraction and returns to baseline after the contraction ends, signifying a non-reassuring fetal status.
Choice C rationale
Variable decelerations are abrupt decreases in FHR, often indicative of umbilical cord compression. While not always pathological, frequent or severe variable decelerations can compromise fetal oxygenation and require further assessment, thus not indicating a reactive nonstress test.
Choice D rationale
Minimal variability in FHR, defined as an amplitude range of 5 bpm or less, suggests a compromised fetal central nervous system or a sleeping state. Persistent minimal variability can be a sign of fetal hypoxia or acidosis, and it does not meet the criteria for a reactive nonstress test. Normal variability is 6-25 bpm.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.