chapter 29 prepU
A 40-year-old woman who smokes desires a reliable contraceptive method. Which should the nurse recommend to this patient?
A condom and spermicide
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.
An Rh-negative woman at 6 weeks' gestation is scheduled for a medically induced termination. Which outcomes should the nurse identify as appropriate for this patient? Select all that apply.
Attended contraceptive counseling Received Rho (D) immune globulin Scheduled postprocedure sonogram
A patient who has unprotected intercourse has obtained the morning after pill but has not yet taken the prescribed dosage. What nursing diagnosis should the nurse identify as appropriate for the patient at this time?
Decisional conflict
A nurse supervisor observes a nurse massage a client's injection site after giving a dose of depot medroxyprogesterone acetate. What is the priority response by the nurse supervisor?
Remind the nurse that this injection should absorb slowly.
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
The nurse is planning an educational session on contraceptives for a group of adolescent high school students. What does the nurse need to do when planning this session?
Teaching about contraceptive options while avoiding indirect encouragement of sexual activity.
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 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 artificial insemination. Which finding is the most suggestive to determine if the client is ovulating?
change in the cervical mucus
When discussing contraceptive options, the nurse would recommend which option as being the most reliable?
intrauterine system
A woman is using depot medroxyprogesterone acetate (Depo-Provera) as a method of birth control. Which side effect would the nurse most likely include as common?
irregular menstruation
When using the contraceptive patch, a client should understand that it:
should be applied to the abdomen, buttocks, or back
The estrogen content in the contraceptive pill performs which action?
suppresses follicle-stimulating hormone (FSH)
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 Explanation:
A woman opts to use a diaphragm for contraception. Which instruction would be mostimportant for the nurse to provide?
"Have your diaphragm refitted if you lose 10 pounds (4.5 kilograms) or more."
A 25 year old having a yearly check-up informs the nurse that she has stopped taking birth control pills because she and her husband want to start a family. She states, "I know I will get pregnant right away, because my mother was very fertile." What is the nurse's best response?
"Women who used oral birth control pills may have difficulty becoming pregnant for several months after discontinuing them."
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
For which patient assessment finding would an intrauterine device (IUD) be contraindicated?
Misshapen uterus
The nurse is preparing to meet with a couple who have requested counseling concerning family planning. The nurse will prioritize which topics for discussion?
Possible genetic abnormalities
The nurse discusses various contraceptive methods with a client and her partner. Which method would the nurse explain as being available only by prescription?
diaphragm
A woman in the 15th week of gestation is planning on terminating the pregnancy. The procedure done for second trimester terminations is which of the following?
dilatation and extraction
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 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
The nurse instructs a patient on the use of a vaginal estrogen/progestin rings (NuvaRing) for contraception. Which patient statement indicates that additional instruction is needed?
"I am to take the ring out overnight."
A couple comes to the clinic for a fertility evaluation. The male partner is to undergo a semen analysis. After teaching the partner about this test, which client statement indicates that the client has understood the instructions?
"I have to abstain from sexual activity for about 1 to 2 days before the sample."
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."
A teenage male client asks the nurse if there is any 100% effective method of birth control and protection against sexually transmitted disease. Which should the nurse mention to him?
Continual abstinence
A client presents at the clinic and is interested in obtaining emergency contraception (EC). The nurse explains that EC must be used within 72 hours of unprotected sex to be effective. This is because:
ECs simply prevent embryo creation and uterine implantation from occurring in the first place.
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
A woman trying to conceive has been diagnosed with a luteal phase defect. Which medication would the nurse most likely anticipate as being prescribed for this woman?
Progesterone vaginal suppositories
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
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 client decides to use the cervical mucus method as her contraceptive method. When describiing this method, the nurse explains that the client can determine ovulation based on which characteristic of the mucus?
thin and slippery
A 26-year old mother of three children tells the nurse at her annual check-up that she does not want to have any more children; however, her religion forbids the use of contraceptive devices. Which of the following methods would be the best option for this client?
Rhythm method
The nurse should carefully screen a client who insists on using only combined oral contraceptives for which contraindication?
deep vein thrombosis
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 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?
a diaphragm and spermicide
Which definition best explains the term "subfertility/infertility"?
failure to achieve pregnancy after 1 year of unprotected intercourse
The nurse informs the client that a diaphragm is an example of which type of contraception?
mechanical barrier
Which description best explains the hysterosalpingogram procedure?
radiograph of the uterus and fallopian tubes following introduction of a radiopaque medium through the cervix
The nurse has provided information to a client about oral contraceptives. Which statement by the client would indicate a need for further education?
"Some oral contraceptives protect against STIs."
A nursing instructor is teaching about subfertility to nursing students and perceives their understanding when they define subfertility existing when a pregnancy has not occurred after how much time of engaging in unprotected coitus?
12 months
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
A patient comes into the family planning clinic and requests a prescription for birth control pills. Which assessment finding indicates that an ovulation suppressant would not be the best contraceptive method for the patient?
History of thromboembolism
The nurse is explaining the various evaluations used to determine infertility to a young couple who have been trying to get pregnant for 5 years. Which instruction should the nurse prioritizewhen teaching about the postcoital test?
Is performed close to time of ovulation
A client is beginning to take a combined oral contraceptive. Which of the following side effects will the nurse caution the client might be expected? Select all that apply.
Nausea Headache Breast tenderness
The nurse is caring for a woman who had a dilation and curettage (surgical abortion) 1 hour prior. What assessment finding would alert the nurse to immediately intervene?
Pulse rate of 122 beats/min
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.
A couple comes in and tells the nurse that they have been trying diligently to conceive for the last 3 months and are subfertile. What should the nurse explain to the couple about the definition of subfertility?
Subfertility is said to exist when a pregnancy has not occurred after at least 1 year of engaging in unprotected coitus.
Subfertility/infertility is said to exist when a couple has failed to achieve pregnancy after how many months of unprotected sexual intercourse?
12
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?
Relatively easy procedure with few complications
The nurse discusses various contraceptive methods with a client and her partner. After the discussion, the nurse determines that the couple understood the information when they identify which method as being available only with a prescription?
cervical cap
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
After reviewing the various types of contraception available and discussing the pros and cons about each with the nurse, a young woman decides to use a spermicidal cream. When teaching the woman about this type of contraception, the nurse would instruct the woman to insert the cream at which time frame before intercourse?
1 hour
The health care provider prescribes 50 mg daily by mouth of clomiphene for a client having fertility problems. The client cannot swallow pills. Available is 200 mg/5 mL elixir. How many milliliters of the medication would the nurse administer? Record your answer using two decimal points.
1.25
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
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 school health nurse is providing education to a group of adolescents regarding the proper procedure for male condom use. The nurse knows the teaching has been effective when which statement is made by a student?
"Withdraw the penis erect, holding the condom firmly against the penis."
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 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.
A young woman comes to the free clinic asking for birth control pills. Which factor best indicates that another type of contraception would be better for this client?
history of noncompliance with medications
A female patient has forgotten to take an ovulation suppressant for two mornings in a row. What should the nurse advise the patient to do
Take two pills now and use a second method of contraception for the remainder of the month.
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 nurse is providing education to a client with infertility concerns. Which statement by the client indicates appropriate understanding of the Spinnbarkeit Test?
"Halfway in my cycle I will need to check my cervical mucus to see if I can stretch it in to long strands, indicating I am close to ovulating."
After teaching a group of college-aged students about condom use, the nurse determines that additional teaching is needed when the students make which statement?
"It's okay to use petroleum jelly with a latex condom."
A female patient being treated for infertility is completing the third course of clomiphene citrate. What information should the nurse prepare for the patient in the event this course does not result in conception?
Additional options to achieve conception
The female partner of a young couple is concerned about what the results of fertility tests might reveal. Which nursing diagnosis should the nurse use to plan care for this patient?
Fear related to possible outcome of subfertility studies
A postpartum patient asks the nurse when the subdermal hormone implant for contraception can be inserted. What should the nurse respond to this patient?
In 6 weeks
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
Which statement best indicates that a client has taken self-care measures to reduce her risk for cervical cancer?
My partner always uses a condom when we have sexual intercourse."
A patient received a scheduled dose of depot medroxyprogesterone acetate (DMPA) 6 weeks ago. Today, the patient reports that a regular menstrual cycle is 2 weeks late. What is the first thing that should be done for this patient?
Perform a pregnancy test.
nurse is preparing a presentation for a health fair on the topic of vasectomy. Which information should the nurse point out in the information?
Relatively easy procedure with few complications
The nurse is planning instruction for a patient desiring to have a tubal ligation. Which information should the nurse emphasize when teaching the patient?
She must think of the procedure as irreversible.
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
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 client in her second trimester of pregnancy asks the nurse for information regarding certain oral medications to induce a miscarriage. What information should this client be given about such medications?
They can be taken only in the first trimester.
What important information should the nurse give a client about the use of a diaphragm during menstruation
Toxic shock syndrome is possible
What important information should the nurse give a client about the use of a diaphragm during menstruation?
Toxic shock syndrome is possible
A woman comes to the clinic because she has been unable to conceive. When reviewing the woman's history, the nurse would least likely identify which factor as a possible risk?
age of 25 years
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?
combination oral contraceptives
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?
combination oral contraceptives
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 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
A male patient comes to the clinic and informs the primary care provider that he and his wife are trying unsuccessfully to conceive. He adds that he cannot get an erection and believes this problem started when he began taking blood pressure medicine. What type of erectile dysfunction would be suspected?
secondary erectile dysfunction
A client decides to use the cervical mucus method as her contraceptive method. When describing this method, the nurse explains that the client can determine ovulation based on which characteristic of the mucus?
thin and slippery
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.
