Ricci Ch 4 PrepU

A woman opts to use a diaphragm for contraception. Which instruction would be most important for the nurse to provide? "Replace the diaphragm every 6 months." "Have your diaphragm refitted if you lose 10 pounds (4.5 kilograms) or more." "Keep the diaphragm in place for no more than 4 hours after intercourse." "Wet the diaphragm with water first before inserting it."

"Have your diaphragm refitted if you lose 10 pounds (4.5 kilograms) or more." Diaphragms should be refitted after pregnancy, abdominal or pelvic surgery, or weight loss or gain of 10 pounds (4.5 kilograms) or more. A diaphragm usually is replaced every 1 to 2 years. A diaphragm should remain in place for at least 6 hours after intercourse. A contraceptive sponge, not a diaphragm, should be wetted with water before insertion.

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."

"I have a degree as a chemical engineer and work at the local plant." The client works around chemicals that could cause infertility issues. The nurse should further question the client as to what types of chemicals he is exposed to and what type of precautions are taken to protect him. Eating fast food and occasionally consuming alcohol are not risk factors for infertility. The client does not state a direct family member having issues with conception. An uncle is not concerning; however, a brother would be of concern. The client's asthma status should be monitored; however, this is not an issue regarding fertility.

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? "Adoption is always an acceptable option for anyone." "I will call the health care provider to come visit with you." "The use of surrogates is more acceptable today." "Being childless is not as bad as you think it is."

"I will call the health care provider to come visit with you." The nurse needs to notify the health care provider because the client does not have a clear understanding of the outcomes of the procedure in which she is about to undergo.

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

"It can be done with frozen donor sperm." Fresh or frozen sperm may be used. The success of in vitro fertilization is not related to the incidence of ovarian cancer in the family. Quite often, more than one attempt is needed before successful implantation.

The nurse working in a free health clinic assesses a 17-year-old client interested in contraceptives. Which statement by the client would indicate that female or male condoms would be the appropriate recommendation? "I have no problems swallowing medications." "Last year I was diagnosed with HPV." "I am leaving for college in just a few months." "I do not want to follow in my sister's footsteps."

"Last year I was diagnosed with HPV." The client has already contracted HPV; to prevent further spread of it—or contracting other STIs—the nurse should recommend the client use male or female condoms.

A woman is diagnosed with primary dysmenorrhea and is prescribed ibuprofen as part of her treatment plan. When teaching the woman about using this medication, which instruction would be important for the nurse to emphasize? "Take the medication on an empty stomach." "Start taking the medication when you first get your period." "Add an aspirin to the regimen if you do not get relief right away." "It is normal for your bowel movements to be black."

"Start taking the medication when you first get your period." When taking a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, for dysmenorrhea, it is important for the woman to start therapy prophylactically and use sufficient doses to maximally suppress prostaglandin production. NSAIDs should be taken with food to prevent gastrointestinal upset. They should not be taken with aspirin because doing so can increase the risk of bleeding, which would be noted with black stools.

A 52-year-old client reports recent onset of hot flashes, fatigue, and vaginal dryness. While assessing the client, which response should the nurse prioritize? "Is this causing any issues between you and your partner?" "I will schedule you an appointment with your gynecologist." "Tell me what you are currently doing to manage these symptoms?" "I will request you have your calcium level checked today."

"Tell me what you are currently doing to manage these symptoms?" The client is exhibiting signs of perimenopause, which is managed by treating the symptoms. The nurse first needs to know what, if anything, the client is doing to manage the symptoms. The nurse would then make recommendations for the client to manage symptoms. Once the client provides information on current treatment options, the nurse may determine if there are concerns with the client's sexual relationship. There is no need for the client to be referred to a specialist to treat perimenopausal symptoms because the client is having expected symptoms. Osteoporosis can occur in clients during menopause. A bone mineral density (BMD) test, however, is the primary test used to identify osteoporosis, not calcium levels.

A client is scheduled to have in vitro fertilization (IVF) in 1 week. Which statement made by the client indicates that further teaching is needed? "The primary care provider will transfer my fertilized eggs into the uterus." "The primary care provider will transfer the egg and sperm into the fallopian tube where the egg will become fertilized." "I will receive fertility drugs to stimulate ovulation." "The primary care provider will harvest eggs from my ovary."

"The primary care provider will transfer the egg and sperm into the fallopian tube where the egg will become fertilized." In vitro fertilization (IVF) is a procedure used when the client has absent or blocked fallopian tubes, when the client has a low sperm count, or when the etiology of infertility is unknown. Oocytes are fertilized in the lab and transferred to the uterus.

The 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."

"The use of a condom is a method often recommended to prevent pregnancy for people your age." The nurse would state condoms as the best option for preventing pregnancy for this age group. Oral contraceptives are also effective but must be taken daily at approximately the same time. The withdrawal method is not effective, regardless of the number of sexual partners because sperm can be released before ejaculation occurs. An intrauterine device could be removed if the client desired pregnancy in the upcoming years.

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."

"You can also test your vaginal discharge to determine if you are ovulating." The appropriate statement for the nurse to make is regarding testing vaginal or cervical discharge (spinnbarkeit test). This testing and basal body temperature monitoring are free methods clients can use at home to test for ovulation. The home-use ovulation kit monitors luteinizing hormone (LH) levels in a urine sample. The home-use kit monitors for a surge in LH that would indicate ovulation is getting ready to occur. They are typically effective; however, they can be expensive to use repeatedly. Although being tested in the clinic would be most accurate, this is not feasible for most clients financially nor easy to fit into daily schedules. The nurse would not provide false assurance that usage will lead to a quick pregnancy as other factors could be present.

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? "I will let the health care provider know you desire oral contraceptive pills." "You can still use condoms because they make latex-free condoms." "We can have you allergy tested to see if certain condoms may work for you." "Do you understand the potential ramifications of having multiple sexual partners?"

"You can still use condoms because they make latex-free condoms." Because this client has multiple partners, there is concern over the risk for sexually transmitted infections (STIs) as well as pregnancy. Condoms are the only method of contraception that protects against STIs, which is an important concern if the client is not in a monogamous relationship. The nurse would inform the client of latex-free condoms and where to purchase them first. Regardless of whether the client chooses to use latex-free condoms, the client can discuss other options for contraception with the health care provider at that time. There is no need to have the client tested for latex sensitivity. The nurse should educate the client on risks associated with multiple sexual partners; however, using therapeutic language will be most effective.

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

12 Infertility is the failure to achieve conception after 1 year of unprotected intercourse.

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

37-year-old client who has migraines with aura several times a week and smokes The nurse would question giving an oral contraceptive to the 37-year-old client who has migraines with aura and smokes. This client has three risk factors (age, migraines with aura, and smokes) for complications such as deep vein thrombus formation, myocardial infarction, and cerebrovascular accident. The 25-year-old client should be counseled on becoming active. The 30-year-old client does not have any risk factors. The 40-year-old client should be monitored due to her age; however, her other factors are not contraindications. A total cholesterol level of 200 mg/dl (5.18 mmol/L) or less is considered normal.

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

Bicornuate uterus The client has an abnormally shaped uterus, which could be a contraindication for the use of an IUD due to increased risk for uterine wall perforation. All other findings would not contraindicate the device.

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? Record body temperature every night Record menses and time of intercourse Chart body temperature for at least a month Record body weight along with the temperature

Chart body temperature for at least a month The nurse should instruct the client to record her temperature each morning immediately upon awakening (at rest) using the same thermometer. The nurse should also instruct the client to record her menses, any events that would alter her temperature (e.g., infections, insomnia), and when she has intercourse. To maintain a basal body temperature chart, the client has to monitor her basal body temperature for several months. It is not necessary to record body weight along with the temperature.

A couple is being assessed for infertility. The male partner is required to collect a semen sample for analysis. What instruction should the nurse give him? Abstain from sexual activity for 10 hours before collecting the sample. Avoid strenuous activity for 24 hours before collecting the sample. Collect a specimen by ejaculating into a condom or plastic bag. Deliver sample for analysis within 1 to 2 hours after ejaculation.

Deliver sample for analysis within 1 to 2 hours after ejaculation. The nurse should instruct the client to deliver the semen sample to the laboratory for analysis within 1 to 2 hours after ejaculation. The client should also be instructed to collect the sample in a specimen container, not a condom or plastic bag. The client needs to abstain from sexual activity for at least 24 hours before giving the sample, but he need not avoid strenuous activity.

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? Hopelessness related to perception of no viable alternative to usual conception Anticipatory grieving related to failure to conceive or sustain a pregnancy Situational low self-esteem related to the apparent inability to conceive Fear related to possible outcome of subfertility studies

Fear related to possible outcome of subfertility studies The nurse should recognize that the client may be expressing fear related to the possible outcomes of the testing. The nurse should address those fears with the client and answer any questions to help reduce fears.

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 Tubal ligation Oral contraceptive Coitus interruptus

Female condom The female condom would be the best choice for this client, as it provides protection against both STIs and conception. A tubal ligation would not be recommended for a 16-year-old girl, as it is a permanent measure and she may decide to have children in the future. Neither an oral contraceptive nor coitus interruptus would provide protection against STIs.

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. Excitement at the possibility of conceiving Sexual stimulation and excitement Guilt related to the lack of conception Anger toward others who have conceived Fear of the possible outcome of the testing

Guilt related to the lack of conception Anger toward others who have conceived Fear of the possible outcome of the testing Couples who have experienced infertility may experience guilt related to the lack of conception, anger toward others, and fear of the outcome. The nurse should be prepared to visit with the couple regarding these feelings, and should view these feelings as a normal process.

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

In vitro fertilization This client has damage to her fallopian tubes, so any procedure would need to bypass this structure. In vitro fertilization fertilizes an ovum and then inserts it into a women's uterus.

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 intake of salty foods. Increase water consumption. Avoid keeping legs elevated while lying down. Use heating pads or take warm baths. Increase exercise and physical activity.

Increase water consumption. Use heating pads or take warm baths. Increase exercise and physical activity. When instructing a client with dysmenorrhea on how to manage her symptoms, the nurse should ask her to increase water consumption, use heating pads or take warm baths, and increase exercise and physical activity. Water consumption serves as a natural diuretic, heating pads or warm baths help increase comfort, and exercise increases endorphins and suppresses prostaglandin release. The nurse should also tell the client to limit salty foods to prevent fluid retention during menstruation and to keep legs elevated while lying down because this helps increase comfort.

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? It's usually done as an office procedure. The client will no longer ejaculate. Client may notice permanent increased scrotal swelling. The testes will no longer produce sperm.

It's usually done as an office procedure. Vasectomy is an outpatient surgical procedure that is usually performed in the office. It involves ligating and cutting the vas deferens, which stops the flow of sperm from the testes to the outside of the body; however, it does not stop sperm production. There may be short-term swelling immediately after the procedure, but there should not be any permanent swelling. The client should still have normal sexual function.

Which statement best explains the action of the lactational amenorrhea method (LAM) of fertility control? LAM causes suppression of the ovulation process. LAM prevents introduction of sperm into the vagina. LAM prevents fertilization between the egg and sperm. LAM thickens the cervical mucus and blocks sperm.

LAM causes suppression of the ovulation process. LAM prevents pregnancy by suppressing the ovulation process. Withdrawal and barrier methods of contraception prevent the introduction of sperm into the vagina. The copper IUD, combined hormonal methods, and oral contraceptive pills (OCPs) prevent fertilization between the egg and the sperm. Levonorgestrel system thickens the cervical mucus and blocks sperm.

A nurse is preparing a presentation for a health fair on the topic of vasectomy. Which information should the nurse point out in the presentation? Relatively easy procedure with few complications Regular sperm counts are not essential Procedure is effective immediately Birth control measures are not required

Relatively easy procedure with few complications The nurse should inform the individuals that vasectomy is a relatively easy procedure with few complications. Regular sperm counts following a vasectomy are important, as it will take approximately a month for the remaining sperm to exit the body. The client should use birth control measures until his sperm count remains at zero for 6 weeks.

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 is 30 years old. She has irregular menstrual cycles. She has a history of allergy to foreign protein. She has a family history of thromboembolism.

She has a family history of thromboembolism. The estrogen content of birth control pills may lead to increased blood clotting, leading to an increased incidence of thromboembolism. Women who already are prone to this should not increase their risk further.

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 only with both partners present so they will feel more comfortable. Speak separately with each partner so both will feel more free to talk. Speak both separately and together with both partners. Only speak with the woman, who is the client.

Speak both separately and together with both partners. Talking with both partners together may be advantageous, because this may make them feel more comfortable to discuss their problem. On the other hand it is important to spend time alone with each partner, in case there is something one person wants to discuss privately. Both partners are the client in this case.

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.

Sperm analysis is one of the easiest tests to complete. Because sperm analysis is noninvasive, it is one of the easiest tests (and therefore most cost-effective) to complete.

A couple consults with the nurse regarding their infertility issues. The female says "I don't know what I have done so bad that God would punish me like this." What would be the most appropriate nursing diagnosis for this couple? Spiritual distress related to inability to conceive Hopelessness related to inability to conceive Powerlessness related to infertility Anticipatory grieving related to infertility

Spiritual distress related to inability to conceive The client is experiencing spiritual distress in trying to understand that the couple's infertility issue is a punishment from God. The nurse should plan interventions specifically related to education of the health problems they are experiencing so that the clients have a better understanding. In addition, the nurse should identify community resources for the client.

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? Avoid unprotected intercourse until BBT has been elevated for 6 days. Avoid using other fertility awareness methods along with BBT. Use the axillary method of taking the temperature. Take temperature before rising, and record it on a chart.

Take temperature before rising, and record it on a chart. The client should be instructed to take her temperature before rising and record it on a chart. If using this method by itself, the client should avoid unprotected intercourse until the BBT has been elevated for 3 days. The client should be informed that other fertility awareness methods should be used along with BBT for better results. The oral method is better suited than the axillary method for taking the temperature in this case.

The nurse is preparing to teach a client how to conduct the basal body temperature method to determine her fertile window. Which instruction should the nurse prioritize? It depends on the average temperature taken each morning. Temperature should be taken prior to any activity every morning. Avoid intercourse only on the days the temperature drops. It is the best method for predicting ovulation.

Temperature should be taken prior to any activity every morning. BBT is the basal body temperature method and requires the woman to take her temperature and record it every morning. This should be the first activity of the day before exiting the bed or doing other activities. To prevent conception, avoid unprotected intercourse from the day the BBT drops through the fourth day of temperature elevation. The BBT alone is not a reliable method for predicting ovulation. Use BBT along with calendar or cervical mucus methods to increase effectiveness.

A nurse is teaching a female client about fertility awareness as a method of contraception. The nurse should mention to the client that this method relies on which assumption? Sperm can live up to 24 hours after intercourse. The "unsafe period" is approximately 6 days. The exact time of ovulation can be determined. The "safe period" is 3 days after ovulation.

The "unsafe period" is approximately 6 days. The nurse should explain to the client that the fertility awareness method relies on the assumption that the "unsafe period" is approximately 6 days—3 days before and 3 days after ovulation. The method also assumes that sperm can live up to 5 days, not just 24 hours after intercourse. An ovum lives up to 24 hours after being released from the ovary. The exact time of ovulation cannot be determined, so 2 to 3 days are added to the beginning and end to avoid pregnancy.

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 nurse's best response? Families are always best when pregnancies are not planned. The couple can control the time between births when they plan their family. An unwanted pregnancy can always be aborted. The couple can decide on a method of birth control.

The couple can control the time between births when they plan their family. Women and couples can avoid unwanted pregnancies, bring about wanted births, and control the intervals between births with family planning.

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 man will no longer produce testosterone. The man will continue to ejaculate sperm. The man will no longer ejaculate seminal fluid.

The man will still have full erection capacity. Some men resist the concept of vasectomy because they are not sufficiently aware of their anatomy to know exactly what the procedure will involve. They can be assured vasectomy does not interfere with the production of sperm; the testes continue to produce sperm as always, but the sperm simply do not pass beyond the plugged vas deferens and are absorbed at that point. The man will still have full erection capacity and continue to produce testosterone. Because he also continues to form seminal fluid, he will ejaculate seminal fluid; it will just not contain sperm.

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

a diaphragm and spermicide Women over 40 who smoke should not take ovulation suppressants; irregular menstrual cycles make natural methods difficult; women over 40 may have vaginal dryness, so a spermicidal suppository would not be activated.

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

a hysterosalpingography A hysterosalpingography, a radiologic examination of the fallopian tubes using a radiopaque medium, is a frequently used technique.

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

a weight gain of 10 lb (4.5 kg) A substantial weight gain or weight loss of 10 pounds (4.5 kilograms) or more may shift the relationship of pelvic organs enough that the diaphragm no longer fits correctly.

A client prescribed oral contraceptive pills (OCPs) has presented for a routine visit. Which finding, if reported by the client upon assessment, should the nurse prioritize? abdominal pain small amount of breakthrough bleeding light menstrual flow cramping during menses

abdominal pain The warning signs to report for a client on OCPs are severe abdominal or chest pain, dyspnea, headache, weakness, numbness, blurred or double vision, speech disturbances, or severe leg pain and edema. Light bleeding, light flow, and cramping are all normal.

A healthy 28-year-old female client is planning a pregnancy with the support of a female partner. What does the nurse anticipate will be the first method of assisting this client to achieve a pregnancy? artificial insemination intracytoplasmic sperm injection (ICSI) gestational carrier in vitro fertilization (IVF)

artificial insemination For a healthy female client with no known challenges with fertility, artificial insemination with donor sperm is the most affordable and least invasive approach to achieving a pregnancy. The other methods listed will be considered if artificial insemination is not effective.

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 hormonal rhythm transdermal

barrier The nurse should emphasize a barrier method of birth control such as a condom. The condom will help not only with birth control but with the spread of STIs, which is common in this age group. The other methods, such as hormonal, rhythm, and transdermal, will only prevent pregnancy and are more commonly utilized in long-term monogamous relationships.

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? as part of foreplay at least 1 hour prior to sex before penile-vulvar contact immediately after ejaculation

before penile-vulvar contact Some sperm may be released with pre-ejaculation semen, so a condom needs to be used with any penile-vulvar contact. It is best applied when the penis is erect. It is not necessary to apply an hour in advance. Waiting until after ejaculation would not be effective. It can be part of the foreplay; however, the primary goal is to prevent sperm from entering the vagina, so it should be in place before any penile-vulvar contact occurs.

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. hyperthermia bradycardia hypotension reduced subcutaneous fat evidence of secondary sex characteristics

bradycardia hypotension reduced subcutaneous fat Hypothermia, bradycardia, hypotension, and reduced subcutaneous fat may be observed in women with amenorrhea with anorexia nervosa as the contributing factor. Evidence of secondary sex characteristics would be a normal finding for a girl of this age.

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: dilating the cervix. acting as a toxin to the trophoblastic tissue. blocking the action of progesterone on the endometrium. causing uterine contractions to expel the uterine contents.

causing uterine contractions to expel the uterine contents. Misoprostol works by causing uterine contractions, which help to expel the uterine contents. It has no effect on cervical dilation. Methotrexate is toxic to the trophoblastic tissue. Mifepristone blocks the action of progesterone, which is responsible for preparing the endometrium for implantation and then maintenance of the pregnancy.

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

coitus interruptus method Fertility awareness refers to any natural contraceptive method that does not require hormones, pharmaceutical compounds, physical barriers, or surgery to prevent pregnancy. Techniques used to determine fertility include the cervical mucus ovulation method, the basal body temperature (BBT) method, the symptothermal method, standard days method, and 2-day method. Coitus interruptus or withdrawal is not considered a fertility awareness based method.

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

condoms Because the client has multiple sex partners, condoms will help offer protection against sexually transmitted infections (STIs) and are best suited for her needs. The client cannot use an IUD because of her history of various pelvic infections. Although OCPs will help the client as a means of contraception, this method is not the best choice for her because it does not offer protection against STIs. Tubal ligation is a sterilization procedure and does not suit the client's purpose.

An intrauterine device (IUD) has been inserted into a client as a requested birth control method. What is an advantage of IUDs? decreased incidence of tubal pregnancies decreased incidence of pelvic inflammatory disease (PID) continuous protection without client's active participation protection against sexually transmitted infections (STIs)

continuous protection without client's active participation IUDs provide continuous protection without the need for the client's active participation. IUDs give no protection against sexually transmitted infections and may cause an increased incidence of pelvic inflammatory disease and tubal pregnancies.

A nurse is working with a couple who is dealing with infertility. Which aspect would be most important for the nurse to consider? culture insurance restrictions family budget emotional limits

culture Infertility is not only a physiologic problem but is also one that can initiate a life crisis that is experienced with psychologic, familial, social, and cultural consequences. Although insurance constraints, budget, and emotional aspects are important considerations, the manner in which the various cultures, ethnic groups, and religious groups perceive and manage infertility are very different and must be considered when working with couples who have been unable to conceive. Nurses need to include awareness of these differences in their counseling of the couples as they try to help them achieve their goal of getting pregnant.

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 various religious viewpoints sexually transmitted infection statistics nurse's personal opinion on abortion (elective termination of pregnancy)

encouragement of abstinence proper condom application sexually transmitted infection statistics The nurse should talk about all safer sex options, including abstinence and its 100% effectiveness. Within that teaching it is important to educate adolescents on the proper techniques for application of a condom as well as to discuss statistics related to sexually transmitted infections.

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 multigravida status hormonal imbalance perimenopause

endometriosis Secondary dysmenorrhea is painful menstruation due to pelvic or uterine pathology. Endometriosis is the most common cause of secondary dysmenorrhea. Other recognized causes include adenomyosis, fibroids, pelvic infection, an intrauterine device, cervical stenosis, or congenital uterine or vaginal abnormalities.

Which definition best explains the term "subfertility/infertility"? failure to achieve pregnancy after 6 months of unprotected intercourse failure to achieve pregnancy after 1 year of unprotected intercourse inability to achieve pregnancy because of a known factor that prevents conception inability to achieve pregnancy following a previous viable pregnancy

failure to achieve pregnancy after 1 year of unprotected intercourse Infertility is the failure to achieve conception after 1 year of unprotected intercourse. Because most couples have the potential to conceive but are just less able to conceive without additional help, the term subfertility is more often used today.

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

increase a degree. The effect of progesterone, released with ovulation, is to increase body temperature.

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? the medroxyprogesterone injection oral contraceptive pills (OCPs) a copper intrauterine device implantable contraceptives

oral contraceptive pills (OCPs) Considering the client's smoking habit, oral contraceptive pills may be contraindicated. Oral contraceptives are highly effective when taken properly, but can aggravate many medical conditions, especially in women who smoke. The medroxyprogesterone injection or copper intrauterine devices are not contraindicated in this client and can be used with certain precautions. Implantable contraceptives are subdermal time-release implants that deliver synthetic progestin; these are highly effective and are not contraindicated in this client.

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? oral contraceptive pills (OCPs) condoms coitus interruptus spermicides

oral contraceptive pills (OCPs) Oral contraceptive pills (OCPs) are contraindicated for women who smoke; these women would be at a higher risk for blood clots. Condoms, coitus interruptus, and spermicides can be used at no risk.

A clinic nurse is interviewing a young client during a subfertility work up. When the client asks the nurse what causes infertility, the nurse informs the client that the problem can rest with the man, the woman, or both. What does the nurse tell the client are common problem areas related to the woman? Select all that apply. ovulation tubal transport diabetes impaired implantation lack of exercise

ovulation tubal transport impaired implantation Female factors that cause subfertility are problems with ovulation, tubal transport, and implantation.

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. antipsychotic medications reduction of caffeine intake vitamin and mineral supplements decrease in water intake NSAIDs

reduction of caffeine intake vitamin and mineral supplements NSAIDs Treatment options for PMS include lifestyle changes such as reduction in caffeine intake, a well-balanced diet with increased water intake, and limited alcohol intake. Vitamin and mineral supplements, NSAIDs, and diuretic therapy may be used. Antidepressants and antianxiety agents, not antipsychotic agents, may also be options.

A woman is diagnosed with premenstrual dysphoric disorder. To address the woman's behavioral symptoms, which class of agents would the nurse anticipate needing to be addressed in the woman's teaching plan? diuretics nonsteroidal anti-inflammatory drugs (NSAIDs) selective serotonin reuptake inhibitors (SSRIs) vitamin supplements

selective serotonin reuptake inhibitors (SSRIs) Although diuretics, NSAIDs, and vitamin supplements may be used as part of the treatment plan for premenstrual dysphoric disorder, SSRIs are commonly prescribed to address the behavioral and mood symptoms of this condition.

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. in vitro fertilization counseling fertility drugs semen analysis ovulation monitoring tubal patency

semen analysis ovulation monitoring tubal patency Today, a subfertility investigation usually is limited to three assessments: semen analysis, ovulation monitoring, and tubal patency.

A couple who is in for fertility testing ask the nurse what tests are commonly performed to assess fertility. The nurse replies that there are only three primary tests that are used. What are these tests? semen analysis, ovulation monitoring, and tubal patency assessment semen analysis, urinalysis, and ovulation monitoring serologic test for syphilis, semen analysis, and tubal patency assessment pelvic sonogram, ovulation monitoring, and semen analysis

semen analysis, ovulation monitoring, and tubal patency assessment Only three tests are commonly used to test fertility: semen analysis in the male and ovulation monitoring and tubal patency assessment in the female. Additional testing may be performed both on the man and the woman, which may include urinalysis, serologic test for syphilis, and pelvic sonogram, but these are not the primary tests used.

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.

should be applied to the abdomen, buttocks, or back. The patch should be applied only to the buttocks, back, abdomen, or torso (never the breasts). The patch is safe for wearing during swimming and bathing. The patch requires application for 1 week before becoming effective.

A woman who is using an intrauterine system for contraception comes to the clinic. When assessing the woman, which finding(s) would alert the nurse to a possible complication? Select all that apply. absence of pain with intercourse string length shorter than on initial visit reports of abdominal pain menstrual flow lighter and shorter oral temperature of 101°F (38.3°C)

string length shorter than on initial visit reports of abdominal pain oral temperature of 101°F (38.3°C) Warnings for potential complications for intrauterine system users include: late period, pregnancy, or abnormal spotting or bleeding; abdominal pain or pain with intercourse; exposure to infection or abnormal vaginal discharge; not feeling well, fever or chills; and a string length that is shorter, longer or missing. Intrauterine systems make monthly periods lighter, shorter, and less painful.

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 ability to use a method correctly financial factors whether the method will affect sexual enjoyment

the popularity of the method among the couple's friends Important things to consider when helping a couple to choose a method that will be right for them include the following: personal values, ability to use a method correctly, whether the method will affect sexual enjoyment, financial factors, whether a couple's relationship is short-term or long-term, prior experiences with contraception, and future plans. The popularity of the method is the least likely factor the nurse should consider.

A male client asks the nurse to explain which structure is cut during a vasectomy. What response should the nurse give the client? the vas deferens the epididymis the ejaculatory ducts the scrotum

the vas deferens The two vas deferens or ductus deferentia are ligated and cut in the male sterilization procedure, called a vasectomy. The epididymis serves as a site for sperm to mature and be stored until ejaculation occurs. The ejaculatory ducts empty into the urethra and receive secretions from the prostate gland to make up semen. The scrotum is a sac-like structure that sits behind the penis and houses the testicles.

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 sterilization cervical cap diaphragm

transdermal contraception The fact that this woman has a latex allergy rules out the cervical cap and diaphragm. Moreover, the diaphragm is contraindicated in her case due to her papillomavirus infection. The best choice for her is transdermal contraception, which involves wearing a patch for a week at a time and does not require taking pills daily.

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? natural membrane condom polyurethane condom transdermal contraceptive ethinyl estradiol

transdermal contraceptive Application of transdermal contraceptive patches to the skin would most likely be the option for this couple. These patches will not hamper the sexual experience nor cause side effects such as those caused by oral contraceptive pills (OCPs). Natural membrane and polyurethane condoms are forms of male condoms, which the client does not like. Ethinyl estradiol is an oral contraceptive pill, which would most likely cause the client to experience breast tenderness, headache, and nausea.

The client with subfertility has semen analysis completed (above). What element of the semen analysis does the nurse identify as abnormal? volume count motility morphology

volume The expected volume for semen analysis is a minimum of 1.4 ml in a sample; this client's volume is low. The normal sperm count is 33 to 46 million/ml. The normal motility (movement) is 50% and higher; the normal morphology (shape) is 50% and higher.