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":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"},"G":{"answers":"B"}}
Explanation
Placement of an internal fetal spiral electrode is contraindicated because it requires ruptured membranes and no active vaginal bleeding. In cases of antepartum bleeding, especially without rupture of membranes, it increases infection risk and fetal injury.
Laboratory testing (CBC, blood type, Rh factor, coagulation studies) is anticipated to evaluate maternal blood loss, anemia, blood type compatibility, and coagulation status. These are essential for managing bleeding risk and potential transfusions.
IV fluids are anticipated to maintain maternal hemodynamic stability and manage possible blood loss, preventing hypovolemia and hypotension.
Abdominal ultrasound is anticipated for placental localization, fetal wellbeing assessment, and to differentiate causes of bleeding (placenta previa vs. abruption).
Betamethasone administration is anticipated at 30 weeks to accelerate fetal lung maturity in case of preterm delivery.
Continuous fetal heart rate (FHR) monitoring is essential to assess fetal status and detect hypoxia or distress promptly.
Digital cervical exam is contraindicated due to risk of exacerbating bleeding and infection in the presence of unknown placental position or bleeding source.
Correct Answer is ["B","D"]
Explanation
Choice A rationale
A single dose of the rubella vaccine is typically sufficient to confer immunity. A second dose is not routinely recommended after postpartum administration. The primary goal is to prevent congenital rubella syndrome in future pregnancies by ensuring the mother develops adequate antibody titers to the virus.
Choice B rationale
The rubella vaccine contains live attenuated virus, which carries a theoretical risk of congenital rubella syndrome if the vaccine virus crosses the placenta during pregnancy. Therefore, clients are advised to avoid conception for at least 1 to 3 months, commonly stated as 4 months, after vaccination to minimize any potential fetal exposure.
Choice C rationale
The rubella immunization typically provides long-lasting immunity. It is not necessary to receive an additional rubella immunization during the first trimester of a subsequent pregnancy. Antibody titers are usually maintained, protecting against future rubella infection and subsequent fetal harm.
Choice D rationale
The rubella vaccine is considered safe for breastfeeding mothers and their infants. The live attenuated virus is not shed in breast milk in significant amounts that would pose a risk of infection to the infant. Therefore, breastfeeding can continue without interruption after rubella immunization.
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