Ch4 Common Reproductive Issues

A client is scheduled to have in vitro fertilization (IVF) in 1 week. Which statement made by the client indicates that she needs further teaching?

"The primary care provider will transfer the egg and sperm into the fallopian tube where the egg will become fertilized."

Subfertility/infertility is said to exist when a couple has failed to achieve pregnancy after how many months of unprotected sexual intercourse?

12

The client has heard of extended oral contraceptive regimens and desires more information. The nurse explains that these regimens consist of active combination pills, followed by placebo pills. How many days of active combination pills and placebo pills are contained in these regimens?

84 active; 7 placebo

A client who delivered her baby 3 months ago is seen in the clinic and tells the nurse that she and her husband have yet to resume a sexual relationship. The nurse notes that no contraception is currently being used. What is the most appropriate nursing diagnosis for this client?

Altered sexual pattern related to fear of pregnancy

A couple who has not conceived after 6 years of not using birth control are being seen in the infertility clinic. In assessing the client's psychosocial response to infertility, which might the nurse expect to find? Select all that apply.

Guilt related to the lack of conception Anger toward others who have conceived Fear of the possible outcome of the testing

A client is requesting information on the various available contraceptives. When explaining a vaginal spermicide, which information should the nurse prioritize?

Insert the product by applicator in the vagina several hours prior to intercourse.

A client has been following the conventional 28-day regimen for contraception. She is now considering switching to an extended oral contraceptive (OC) regimen. She is seeking information about specific safety precautions. Which is true for the extended OC regimen?

It carries the same safety profile as the 28-day regimen.

The nurse is conducting a well-visit physical assessment on a 29-year-old female. The nurse determines the client is probably ovulating based on which condition of the cervical mucus?

Thin, slippery, and stretchy

A client with liver disease is seen in the clinic wanting to begin contraception. The nurse recognizes that which type of contraception is best for this client?

Vaginal estrogen/progestin ring

A nurse is teaching a couple about how to use a condom. The nurse determines the couple can properly apply the condom when they state that it should be applied at which time to be most effective?

before penile-vulvar contact

A woman is to receive methotrexate and misoprostol to terminate a first-trimester pregnancy. When preparing the teaching plan for this client, the nurse understands that misoprostol works by:

causing uterine contractions to expel the uterine contents.

The public health nurse is teaching a community class of couples on fertility awareness-based methods. The nurse determines that additional teaching is needed when one of the couples states that they will be using which method?

coitus interruptus method

A young, sexually active woman asks the nurse what type of birth control would help prevent sexually transmitted infections as well as pregnancy. Which method would the nurse recommend?

condom

A client reports that she has multiple sex partners and has a lengthy history of various pelvic infections. She would like to know if there is any temporary contraceptive method that would suit her condition. Which method should the nurse suggest for this client?

condoms

A nurse is reviewing the history and physical examination of a client diagnosed with secondary dysmenorrhea for possible associated causes. Which etiology would the nurse need to keep in mind as being the most common?

endometriosis

The estrogen content in the contraceptive pill performs which action?

suppresses follicle-stimulating hormone (FSH)

During examination of clients, the nurse will question women concerning their LMP. This indicates:

the first day of their last menstrual period.

A couple comes to the clinic and states to the nurse, "I don't think we are ever going to be able to have children. We have been trying but have had no luck." What assessments does the nurse anticipate will be performed for this couple? Select all that apply.

tubal patency ovulation monitoring semen analysis

A nurse is instructing a client on birth control methods. The client asks about the cervical mucus method. When should the nurse tell the client she is fertile in relation to her mucus?

when it is thin, watery, and copious

A nurse is receiving a client from the post anesthesia unit to the recovery unit at the ambulatory surgery center. The client just had a laparoscopic tubal ligation. Which is the nurse's priority assessment?

Bleeding

When using the contraceptive patch, a client should understand that it:

should be applied to the abdomen, buttocks, or back.

When teaching the client how to use a contraceptive sponge, the nurse must tell the client that leaving the sponge in place longer than 30 hours may lead to:

toxic shock syndrome.

The nurse working in a free health clinic assess a 17-year-old client interested in contraceptives. Which statement, if said by the client, would indicate that female or male condoms would be the appropriate recommendation for this client?

"Last year I was diagnosed with HPV."

A client expresses interest in having an intrauterine device (IUD) placed for contraception. Which finding noted in the health history would indicate to the nurse that this would not be an appropriate contraceptive option?

Bicornate uterus

A client is scheduled to start taking tadalafil for erectile dysfunction. A nurse should teach the client to observe for side effects and notify a health care provider immediately if what occurs?

Priapism

A nurse is counseling women on birth control choices. Which woman is the best candidate for an IUD?

a woman who has one partner and three children

A 45-year-old client and her spouse are present in the clinic. Results of fertility testing indicate that the client has damage to her fallopian tubes. Which would be the most appropriate infertility option for this client?

In vitro fertilization

A young woman is newly married and is seeking advice on contraception. She is in a monogamous relationship and would like a temporary contraceptive, as she plans to have children in the future. Her husband dislikes the feel of condoms. Also, she mentions that she typically experiences dysmenorrhea and has a history of recurrent urinary tract infections. Which method should the nurse recommend?

oral contraceptive

The nurse is preparing to teach a client how to conduct the BBT method to determine her fertile window. Which instruction should the nurse prioritize?

Temperature should be taken prior to any activity every morning.

A couple is considering vasectomy as a contraception option. However, the husband is nervous about how such a procedure would affect his sexual functioning. Which information should the nurse mention to the man?

The man will still have full erection capacity.

A couple has chosen fertility awareness as their method of contraception. The nurse explains that the unsafe period for them during the menstrual cycle would be at which time?

three days before and three days after ovulation

The nurse is conducting a routine well-visit on a 43-year-old client who is concernd about developing breast cancer, although no family members have experienced it. What is the best advice for this client at this time?

Conduct regular breast self-examination.

A 16-year-old girl is brought to the clinic by her mother because she has not had a menstrual period for the past 8 months. Which findings might alert the nurse to the possibility that anorexia nervosa may be contributing to the client's amenorrhea? Select all that apply.

reduced subcutaneous fat hypotension bradycardia

The nurse is developing a presentation for a group of young adult women about premenstrual syndrome. Which treatment options should the nurse point out as most appropriate? Select all that apply.

reduction of caffeine intake vitamin and mineral supplements NSAIDs

Semen analysis has been ordered for the partner of a client who has been unable to become pregnant. What instructions should the nurse provide to the partner?

"Bring the sample to the lab immediately after you collect it."

A client 6 weeks postpartum is preparing to receive a depot medroxyprogesterone acetate injection. Which statement by the client indicates that further teaching is necessary?

"I need to be patient as it will take a while before I can get pregnant."

A client has been given instructions about a scheduled sonohysterosalpingogram. Which statement, if made by the client, should indicate to a nurse that the client has an adequate understanding of the instructions?

"They will place a catheter in my uterus and use an ultrasound to see what the problem is."

Relatively easy procedure with few complications

A nurse is preparing a presentation for a health fair on the topic of vasectomy. Which information should the nurse point out in the information?

A nurse is preparing a client for intrauterine device (IUD) insertion. What should the nurse inform the client when educating her on IUDs?

A regular check of threads must be done.

The nurse is caring for a client at the ambulatory care clinic who questions the nurse for information about contraception. The client reports that she is not comfortable about using any barrier methods and would like the option of regaining fertility after a couple of years. Which method should the nurse suggest to this client?

CycleBeads or medroxyprogesterone injection

A nurse is conducting education classes at the local high school on reproductive life planning. Which would be appropriate for the nurse to implement during the teaching? Select all that apply.

Encouragement of abstinence Proper condom application Sexual transmitted infection statistics

When conducting a health history with a couple who are experiencing subfertility, the nurse will include which of the following? Select all that apply.

Sexual history General health Surgical history Medication history

A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her?

She has a family history of thromboembolism.

The nurse has been working with a subfertile couple through the process of determining their best plan of action to conceive a child. Which action should the nurse prioritize to provide emotional support to this couple?

Speak both separately and together with both partners.

A young couple is having difficulty getting pregnant. The nurse is preparing the couple for the initial tests to determiine their fertility. When asked by the couple why they need to start with a sperm analysis, what will be the nurse's best response?

Sperm analysis is one of the easiest tests to complete.

A client is to take clomiphene citrate for infertility. Which outcome should the nurse explain is the expected action of this medication?

Stimulate the release of ova

The nurse in a primary care clinic and a client have come to see the primary care provider because the client is getting married and wants to have a prenuptial gynecologic examination. After the exam, the nurse asks about the woman's plan to have a family. The woman responds, "Why do I have to plan for a family?" What would be the nurses's best response?

The couple can control the time between births when they plan their family.

A woman uses a diaphragm for contraception. The nurse would instruct her to return to the clinic to have her diaphragm fit checked after which occurrence?

a weight gain of 10 lb (4.5 kg)

A client prescribed COC has presented for a routine visit. Which finding upon assessment should the nurse prioritize?

abdominal pain

A young couple is exploring their contraceptive options and are curious about using an intrauterine contraceptive device. The nurse explains that there are two types, one that uses hormones and one that uses:

copper

A nurse is asked to teach a woman to take her basal body temperature daily to assess the time of ovulation. She can detect her day of ovulation, following ovulation, because her temperature will:

increase a degree.

A nurse is preparing a presentation for a local community women's group about menopause. When describing the body system changes that occur, the nurse would include which changes? Select all that apply.

increased abdominal fat vaginal dryness decreased bone density hot flashes

The nurse is preparing to assess a client who is noted to have a history of dysmenorrhea. The nurse predicts the client will report which potential symptom during the examination?

intermittent, sharp suprapubic pain

A 52-year-old client is seeking treatment for menopause. She is not very active and has a history of cardiac problems. Which therapy option should the nurse recognize as contraindicated for this client?

long-term hormone replacement therapy

The client is interested in using an injectable contraceptive that works by suppressing pituitary secretions. The nurse provides the client with literature and discusses which contraceptive with her?

medroxyprogesterone acetate

A male client visits a fertility clinic after one year of attempting unsuccessfully to impregnate his wife. What is a risk factor associated with male infertility?

no or few sperm cells produced

What are methods for delivering hormonal contraception? Select all that apply.

orally transdermally implantation vaginally injection

A woman has just been prescribed clomiphene citrate to stimulate ovulation. Which possible effect should the nurse warn the woman about?

overstimulation of the ovary resulting in potential multiple births

A client is diagnosed with endometriosis. As part of the teaching plan, the nurse is explaining the condition, including the ways that the diagnosis would be confirmed. The nurse determines that the teaching was successful when the client states that which test would confirm the diagnosis?

pelvic laparoscopy