Chapter 4: Common Reproductive Issues

A nurse is teaching a female client who is unable to conceive how to monitor her basal body temperature. Which instruction would the nurse prioritize for this client?

Chart body temperature for at least a month

The nurse has provided information to a client about oral contraceptive pills (OCPs). Which statement by the client would indicate a need for further education?

"Some oral contraceptive pills protect against STIs."

A nurse is helping a couple choose a contraception method that is right for them. Which is the least likely factor the nurse should consider?

the popularity of the method among the couple's friends

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

The nurse should carefully screen a client who insists on using only oral contraceptive pills (OCPs) for which contraindication?

deep vein thrombosis

Which definition best explains the term "subfertility/infertility"?

failure to achieve pregnancy after 1 year of unprotected intercourse

A nurse is assessing a 26-year-old married female client for use of oral contraceptive pills (OCPs). Which findings in her health history would suggest that natural family planning may be a better option? Select all that apply.

smokes 1 pack per day blood pressure 138/88 mm Hg migraine headaches

A young woman says she needs a temporary contraceptive but has a latex allergy. She mentions that she has had a papillomavirus infection. Also, she says she is terrible about remembering to take pills. Which method should the nurse recommend?

transdermal contraception

A client desires protection from unwanted pregnancies. However, the client does not enjoy sex when her partner wears a male condom. Also, the client experiences breast tenderness, headache, and nausea after taking oral contraceptive pills (OCPs). Which method would be the most likely choice for the couple to help them enhance their sexual experience as well as prevent any side effects?

transdermal contraceptive

A 30-year-old client would like to try using basal body temperature (BBT) as a fertility awareness method. Which instruction should the nurse provide the client?

Take temperature before rising, and record it on a chart.

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)

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 nurse is preparing a client for intrauterine device (IUD) insertion. Which education will the nurse provide to the client?

"Checking the strings is recommended following insertion."

The nurse is assessing a male client who is concerned about his ability to produce enough sperm to have a child. He tells the nurse, "I have had some issues in my younger years." What questions would be important for the nurse to ask this client? Select all that apply.

"Do you use drugs or use alcohol excessively? "Are you exposed to X-rays or other radioactive substances?" "Have you ever had any type of trauma or surgery on or near your testicles?"

A nurse is completing an informed consent on a client preparing for a tubal ligation. Which statement by the client would require the nurse to notify the health care provider?

"I will be able to have my third child in about a year from now."

A client who is scheduled for hysteroscopy says to a nurse, "I thought I would be able to have children, but now I know that will never be possible." Which response would be most appropriate for the nurse to make?

"I will call the health care provider to come visit with you."

A female client has been trying to conceive for 3 months. She tells the nurse, "I just know something is wrong with me." Which response by the nurse is best?

"It can take up to 1 year of regular, unprotected intercourse to conceive."

The nurse educates a 15-year-old female client on ways to prevent pregnancy. Which statement will the nurse include in the teaching?

"The use of a condom is a method often recommended to prevent pregnancy for people your age."

A client is seen in the clinic requesting an emergency postcoital contraception pill levonorgestrel (Plan B). The client states that she had unprotected sex 3 ½ days ago. What is the most appropriate response by the nurse?

"Unfortunately you are past the time frame to take that prescription."

A client states she has purchased home-use ovulation strips to help her know when she is ovulating. Which response by the nurse is most appropriate?

"You can also test your vaginal discharge to determine if you are ovulating."

The nurse is caring for a client requesting oral contraceptive pills (OCPs). She has multiple sexual partners. The nurse recommends condoms to the client, but the client states, "I cannot use condoms because I am allergic to latex." Which response by the nurse is appropriate?

"You can still use condoms because they make latex-free condoms."

A woman has opted to use medroxyprogesterone injections for birth control. The client receives the first injection today. The nurse instructs the woman to return to the clinic in how many months for the next injection?

3

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 nurse is visiting with a couple who has recently completed subfertility assessments and are awaiting the results. Throughout the conversation the wife intermittently begins to cry. What would be the most appropriate nursing diagnosis for this couple?

Fear related to possible outcome of subfertility studies

The school nurse is counseling a sexually active 16-year-old adolescent about the various forms of contraception. She is afraid of getting pregnant or contracting a sexually transmitted infection because her boyfriend refuses to use a condom. In answering the client's questions as to which option will be best suit her needs, which form should the nurse recommend?

Female condom

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

General health Medication history Sexual history Surgical history

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

The nurse is instructing a client with dysmenorrhea on how to manage her symptoms. Which suggestions should the nurse include in the teaching plan? Select all that apply.

Increase water consumption. Use heating pads or take warm baths. Increase exercise and physical activity.

Which statement best explains the action of the lactational amenorrhea method (LAM) of fertility control?

LAM causes suppression of the ovulation process.

A nurse supervisor observes a nurse massage a client's injection site after giving a dose of depot medroxyprogesterone acetate (Depo-Provera). What is the priority response by the nurse supervisor?

Remind the nurse that this injection should absorb slowly.

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.

Why is fertility testing initiated with sperm analysis of the male partner?

Sperm analysis is one of the easiest tests to complete.

When caring for a client with reproductive issues, the nurse is required to clear up misconceptions. This enables new learning to take hold and a better client response to whichever methods are explored and ultimately selected. Which misconceptions will the nurse needs to clear up? Select all that apply.

Taking birth control pills protects against sexually transmitted infections (STIs). Douching after sex will prevent pregnancy. Irregular menstruation prevents pregnancy.

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.

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

The nurse is preparing a teaching session for a client considering tubal ligation. Which factor should the nurse prioritize in this session?

This is a permanent and irreversible procedure for birth control.

A nurse is providing follow-up teaching to a client regarding the medically induced termination of her pregnancy. Which assessment finding should the nurse tell the client to report to the health care provider? Select all that apply.

Vaginal bleeding of more than two pads per hour Severe depression or sadness Severe abdominal pain

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 (contraceptive) ring

A female client is having a procedure this morning that involves radiologic examination of the fallopian tubes using a radiopaque medium. What procedure should the nurse document as being performed?

a hysterosalpingography

The school nurse is preparing a health education session on the topic of birth control for a college group. Which method should the nurse emphasize for this group?

barrier

A client is being prepared for intrauterine (artificial) insemination. Which finding is the most suggestive to determine if the client is ovulating?

change in the cervical mucus

During an education session, the nurse describes the body system changes that occur during perimenopause. What common change(s) does the nurse include? Select all that apply.

hot flashes increased abdominal fat vaginal dryness decreased bone density

The nurse is providing care to a client with abnormal uterine bleeding. Treatment with medications has been unsuccessful, and surgical intervention is being considered. The nurse identifies which technique as being the last resort?

hysterectomy

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.

The nurse is providing contraception counseling to a perimenopausal woman who has had negative reactions to oral contraceptives (OCs) in the past and would like a long-term, nonhormone-based method that has a high rate of success. Neither she nor her husband wants to undergo surgery, however. Which method should the nurse recommend?

intrauterine device

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 healthy 28-year-old female client who has a sedentary lifestyle and is a chain smoker is seeking information about contraception. The nurse informs this client of the various options available and the benefits and the risks of each. Which should the nurse recognize as contraindicated in the case of this client?

oral contraceptive pills (OCPs)

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 pills (OCPs)

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

orally transdermally vaginally implantation 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 couple in their mid-30s are at their primary care provider's office because they have been unable to conceive for 3 years. They already have one child who is 4 years of age. The care provider explains to them that they are dealing with what kind of infertility?

secondary infertility

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.

semen analysis ovulation monitoring tubal patency