Chapter 8/9

Endometriosis

Tubal/peritoneal

A couple is trying to cope with an infertility problem. They want to know what they can do to preserve their emotional equilibrium. The nurse's most appropriate response is:

"Get involved with a support group. I'll give you some names."

In vitro fertilization-embryo transfer (IVF-ET) is a common approach for women with blocked fallopian tubes or unexplained infertility and for men with very low sperm counts. A husband and wife have arrived for their preprocedural interview. The husband asks the nurse to explain what the procedure entails. The nurse's most appropriate response is:

"IVF-ET is a type of assisted reproductive therapy that involves collecting eggs from your wife's ovaries, fertilizing them in the laboratory with your sperm, and transferring the embryo to her uterus."

You (the nurse) are reviewing the educational packet provided to a client about tubal ligation. What is an important fact you should point out (Select all that apply)?

"It is highly unlikely that you will become pregnant after the procedure." "Sterilization offers no protection against STIs."

A male client asks the nurse why it is better to purchase condoms that are not lubricated with nonoxynol-9 (a common spermicide). The nurse's most appropriate response is:

"Nonoxynol-9 does not provide protection against sexually transmitted infections, as originally thought; it has also been linked to an increase in the transmission of human immunodeficiency virus and can cause genital lesions."

A man smokes two packs of cigarettes a day. He wants to know if smoking is contributing to the difficulty he and his wife are having getting pregnant. The nurse's most appropriate response is:

"Smoking can reduce the quality of your sperm."

A woman currently uses a diaphragm and spermicide for contraception. She asks the nurse what the major differences are between the cervical cap and diaphragm. The nurse's most appropriate response is:

"The cervical cap can safely be used for repeated acts of intercourse without adding more spermicide later."

An unmarried young woman describes her sex life as "active" and involving "many" partners. She wants a contraceptive method that is reliable and does not interfere with sex. She requests an intrauterine device (IUD). The nurse's most appropriate response is:

"The risk of pelvic inflammatory disease (PID) will be higher for you."

A married couple is discussing alternatives for pregnancy prevention and has asked about fertility awareness methods (FAMs). The nurse's most appropriate reply is:

"They can be effective for many couples, but they require motivation."

A physician prescribes clomiphene citrate (Clomid, Serophene) for a woman experiencing infertility. She is very concerned about the risk of multiple births. The nurse's most appropriate response is:

"This is a legitimate concern. Would you like to discuss this further before your treatment begins?"

A woman inquires about herbal alternative methods for improving fertility. Which statement by the nurse is the most appropriate when instructing the client in which herbal preparations to avoid while trying to conceive?

"You may want to avoid licorice root, lavender, fennel, sage, and thyme while you are trying to conceive."

A woman is using the basal body temperature (BBT) method of contraception. She calls the clinic and tells the nurse, "My period is due in a few days, and my temperature has not gone up." The nurse's most appropriate response is:

"You probably didn't ovulate during this cycle."

A woman who has a seizure disorder and takes barbiturates and phenytoin sodium daily asks the nurse about the pill as a contraceptive choice. The nurse's most appropriate response would be:

"Your current medications will reduce the effectiveness of the pill."

A woman had unprotected intercourse 36 hours ago and is concerned that she may become pregnant because it is her "fertile" time. She asks the nurse about emergency contraception. The nurse tells her that:

An over-the-counter antiemetic can be taken 1 hour before each contraceptive dose to prevent nausea and vomiting.

Which contraceptive method best protects against sexually transmitted infections (STIs) and human immunodeficiency virus (HIV)?

Barrier methods

A woman was treated recently for toxic shock syndrome (TSS). She has intercourse occasionally and uses over-the-counter protection. On the basis of her history, what contraceptive method should she and her partner avoid?

Cervical cap

Which test used to diagnose the basis of infertility is done during the luteal or secretory phase of the menstrual cycle?

Endometrial biopsy

Practice of the calendar rhythm method is based on the number of days in each menstrual cycle. The fertile period is determined after monitoring each cycle for 6 months. The beginning of the fertile period is estimated by subtracting 18 days from the longest cycle and 11 days from the shortest. If the woman's cycles vary in length from 24 to 30 days, what would her fertile period be? ________ to _________

Day 6 to day 19 To avoid pregnancy, the couple must abstain from intercourse on days 6 through 19. Ovulation occurs on day 12 (plus or minus 2 days either way).

Nurses, certified nurse-midwives, and other advanced practice nurses have the knowledge and expertise to assist women in making informed choices regarding contraception. A multidisciplinary approach should ensure that the woman's social, cultural, and interpersonal needs are met. Which action should the nurse take first when meeting with a new client to discuss contraception?

Determine the woman's level of knowledge about contraception and commitment to any particular method.

A woman is 16 weeks pregnant and has elected to terminate her pregnancy. The nurse knows that the most common technique used for medical termination of a pregnancy in the second trimester is:

Dilation and evacuation (D&E).

In their role of implementing a plan of care for infertile couples, nurses should: A. Be comfortable with their sexuality and nonjudgmental about others to counsel their clients effectively. B. Know about such nonmedical remedies as diet, exercise, and stress management. C. Be able to direct clients to sources of information about what herbs to take that might help and which ones to avoid. D. Do all of the above plus be knowledgeable about potential drug and surgical remedies.

Do all of the above plus be knowledgeable about potential drug and surgical remedies.

Although remarkable developments have occurred in reproductive medicine, assisted reproductive therapies are associated with numerous legal and ethical issues. Nurses can provide accurate information about the risks and benefits of treatment alternatives so couples can make informed decisions about their choice of treatment. Which issue would not need to be addressed by an infertile couple before treatment?

Financial ability to cover the cost of treatment

A couple comes in for an infertility workup, having attempted to get pregnant for 2 years. The woman, 37, has always had irregular menstrual cycles but is otherwise healthy. The man has fathered two children from a previous marriage and had a vasectomy reversal 2 years ago. The man has had two normal semen analyses, but the sperm seem to be clumped together. What additional test is needed?

Follicle-stimulating hormone (FSH) level

Injectable progestins (DMPA, Depo-Provera) are a good contraceptive choice for women who:

Have difficulty remembering to take oral contraceptives daily.

Informed consent concerning contraceptive use is important because some of the methods:

Have potentially dangerous side effects

With regard to the use of intrauterine devices (IUDs), nurses should be aware that:

IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse.

Nurses should be aware that infertility:

Is perceived differently by women and men.

While instructing a couple regarding birth control, the nurse should be aware that the method called natural family planning:

Is the only contraceptive practice acceptable to the Roman Catholic church.

Which statement is true about the term contraceptive failure rate?

It varies from couple to couple, depending on the method and the users.

A woman has chosen the calendar method of conception control. During the assessment process, it is most important that the nurse:

Obtain a history of menstrual cycle lengths for the past 6 to 12 months.

Thyroid dysfunction or obesity

Other factors

Anorexia

Ovarian

Postcoital contraception with Ovral:

Requires that the first dose be taken within 72 hours of unprotected intercourse.

Which contraceptive method has a failure rate of less than 25%?

Standard days

A woman will be taking oral contraceptives using a 28-day pack. The nurse should advise this woman to protect against pregnancy by:

Taking one pill at the same time every day.

With regard to the noncontraceptive medical effects of combined oral contraceptive pills (COCs), nurses should be aware that:

The effectiveness of COCs can be altered by some over-the-counter medications and herbal supplements.

With regard to the assessment of female, male, and couple infertility, nurses should be aware that:

The investigation takes 3 to 4 months and a significant financial investment.

Which of the following statements is the most complete and accurate description of medical abortions?

They can be either elective or therapeutic.

Endometrial or myometrial tumors

Uterine

Isoimmunization

Vaginal/cervical