Chapter 4: Common Reproductive Issues 1-4

lifestyle modification

A middle-aged woman with a history of hypertension and high cholesterol levels asks the nurse about ways to reduce her risk for heart disease as she approaches menopause. Which area would the nurse emphasize as most important? medications screening stress management lifestyle modification

orally transdermally vaginally implantation injection

What are methods for delivering hormonal contraception? Select all that apply. orally transdermally vaginally rectally implantation injection

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

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? "These strips are often not reliable and end up being a waste of money." "It is a lot more accurate if you come to the clinic routinely to get tested." "You can also test your vaginal discharge to determine if you are ovulating." "I am sure these strips will help you become pregnant faster."

12

Subfertility/infertility is said to exist when a couple has failed to achieve pregnancy after how many months of unprotected sexual intercourse? 3 6 12 18

84 active; 7 placebo

The client has heard of extended-cycle 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 70 active; 6 placebo 56 active; 5 placebo 42 active; 4 placebo

coitus interruptus method

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 cervical mucus ovulation method basal body temperature method symptothermal method

toxic shock syndrome.

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: pelvic inflammatory disorder. sexually transmitted infections. toxic shock syndrome. cervical inflammation.

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

When using the contraceptive patch, a client should understand that it: should be applied to the breasts, hips, or back. should be covered when swimming in a pool because of chlorine's effect on the adhesive. is immediately effective after application. should be applied to the abdomen, buttocks, or back.

Stimulate the release of ova

client is to take clomiphene citrate for infertility. Which outcome should the nurse explain is the expected action of this medication? Reduce inflamed endometrium Break down scar tissue Stimulate the release of ova Decrease testosterone levels

a hysterosalpingography

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 uterine endometrial biopsy a sonohysterography a hysterosalpingography a hysteroscopy

"It can be done with frozen donor sperm."

A woman is going to have in vitro fertilization. When preparing her for this, the nurse would make which statement? "You will need to select a surrogate mother." "Most procedures are effective the first time tried." "It can be done with frozen donor sperm." "This is dangerous if there is ovarian cancer in your family."

a weight gain of 10 lb (4.5 kg)

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? cervical infection a weight gain of 10 lb (4.5 kg) a vaginal infection six months of nonuse

"Some oral contraceptive pills protect against STIs."

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? "Hormonal oral contraceptive pills reduce the risk of ovarian cancer." "Some oral contraceptive pills protect against STIs." "Oral contraceptive pills need to be taken on a daily basis." "Some hormonal contraceptives do not contain estrogen and rely instead on progestin only."

oral contraceptive pills (OCPs)

The nurse is meeting with a 36-year-old client who wishes to begin using contraceptives. The client reports being in a long-term, monogamous relationship, runs 2 miles per day, and smokes a pack of cigarettes each day. Which method will the nurse be least likely to suggest to the client? condoms coitus interruptus oral contraceptive pills (OCPs) spermicides

Altered sexual pattern related to fear of pregnancy

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 Spiritual distress related to partner's preference for contraception Decisional conflict related to unintended pregnancy Powerlessness related to failure of chosen contraceptive

Vaginal estrogen/progestin (contraceptive) ring

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? Oral contraceptive pills (OCPs) Subdermal hormone implant Intramuscular injections Vaginal estrogen/progestin (contraceptive) ring

increase a degree.

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: decrease a degree. increase a degree. fluctuate a degree daily. no longer reflect basal body temperature.

medroxyprogesterone acetate

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 etonogestrel norelgestromin/ethinyl estradiol levonorgestrel/ethinyl estradiol

37-year-old client who has migraines with aura several times a week and smokes

The nurse is caring for four female clients, all prescribed oral contraceptive pills (OCPs). The nurse will question giving an oral contraceptive pill to which client? 25-year-old client who has had three miscarriages and leads a sedentary lifestyle 30-year-old client who drinks a glass of wine daily and whose aunt had breast cancer 40-year-old client who has a history of asthma and a total cholesterol level of 170 mg/dl (4.40 mmol/L) 37-year-old client who has migraines with aura several times a week and smokes

intrauterine device

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? transdermal patch tubal ligation subdermal progestin implant intrauterine devicetubal ligation

deep vein thrombosis

The nurse should carefully screen a client who insists on using only oral contraceptive pills (OCPs) for which contraindication? gastrointestinal disease impaired absorption deep vein thrombosis use of alcohol

Sperm analysis is one of the easiest tests to complete.

Why is fertility testing initiated with sperm analysis of the male partner? Asking the male partner to undergo diagnostic procedures is the best way to assess his interest in treatment of subfertility. The man is found to be fertile in over 75% of couples with subfertility problems. Male fertility testing is time-consuming and, therefore, should be initiated early. Sperm analysis is one of the easiest tests to complete.

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

he nurse educates a 15-year-old female client on ways to prevent pregnancy. Which statement will the nurse include in the teaching? "Oral contraceptive pills are effective at preventing pregnancy as long as you take one each week." "The withdrawal method is effective as long as you have a monogamous partner." "The use of a condom is a method often recommended to prevent pregnancy for people your age." "If you do not want to become pregnant within the next 10 years, an intrauterine device would be best."

when it is thin, watery, and copious

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 when it is thick Cervical mucus is not a reliable indicator. when it does not stretch

In vitro fertilization

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? Gamete intrafallopian transfer In vitro fertilization Surrogate mother Ovulation stimulation

Bicornuate uterus

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? Sexually active since 16 Dysmenorrhea G1P0 Bicornuate uterus

condoms

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? intrauterine device (IUD) condoms oral contraceptive pills (OCPs) tubal ligation

"Checking the strings is recommended following insertion."

A nurse is preparing a client for intrauterine device (IUD) insertion. Which education will the nurse provide to the client? "An IUD will prevent sexually transmitted infections (STIs)." "The insertion procedure for an IUD is painless." "Checking the strings is recommended following insertion." "Expect to have continuous uterine cramps after insertion."

Weight gain Breakthrough bleeding Depression

A nurse is providing medication education to a teen client who is being prescribed oral contraceptive pills (OCPs). Which of the side effects are more important for the nurse to discuss with the client? Select all that apply. Nausea Weight gain Breast tenderness Breakthrough bleeding Depression

endometriosis

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? multigravida status endometriosis hormonal imbalance perimenopause

Reduce caffeine, walk several times a week, use relaxation techniques, and maintain a regular sleep schedule.

A nurse should instruct a client who has premenstrual syndrome (PMS) to make which lifestyle modification? Walk several times a week, maintain a regular sleep schedule, decrease complex carbohydrates, and avoid complex sugars. Reduce caffeine, walk several times a week, use relaxation techniques, and maintain a regular sleep schedule. Walk every day, increase caffeine and salt intake, and sleep 8 to 10 hours a night. Reduce caffeine, perform cardio exercise 3 times a week, and sleep 12 hours every other night.

secondary infertility

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? primary infertility secondary infertility tertiary infertility There is no name for different kinds of infertility.

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

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 is time to talk to your health care provider about hormone testing." "Do you or your partner have a family history of subfertility?" "The problem can be with the man, woman, or both. We will explore all possibilities." "It can take up to 1 year of regular, unprotected intercourse to conceive."

extreme rapid weight gain pregnancy hypothyroidism emotional distress

A mother presents to the clinic with her 15-year-old daughter who is reporting amenorrhea. The girl's menarche was at age 12. When conducting the health history and physical exam, which findings might the nurse identify as suggesting the underlying cause? Select all that apply. extreme rapid weight gain pregnancy hypothyroidism lack of exercise emotional distress

a diaphragm and spermicide

A woman is 40 years old and a heavy smoker. She has a single sexual partner but has very irregular menstrual cycles. She wants a highly reliable contraceptive. Which method would be the best recommendation? an ovulation suppressant a spermicidal suppository the rhythm (calendar) method a diaphragm and spermicide

"I have a degree as a chemical engineer and work at the local plant."

The nurse is conducting a health history on a couple planning to become pregnant over the next few months. Which statement by the male client most concerns the nurse? "I consume fast food a few times each week and enjoy a few beers on the weekends." "My uncle and his wife have not been able to conceive a child." "I have severe asthma and use my inhaler several times each month." "I have a degree as a chemical engineer and work at the local plant."

It's usually done as an office procedure.

The nurse is teaching a client about a vasectomy. The nurse determines the session is successful when the client correctly chooses which fact concerning the vasectomy? The client will no longer ejaculate. It's usually done as an office procedure. Client may notice permanent increased scrotal swelling. The testes will no longer produce sperm.